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Alan Khadavi, MD, APC
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January 7, 2022 by Alan Khadavi

Strawberry Allergy can come in many flavors

Strawberry allergy is not commonly reported, but it can cause adverse reactions.  Hypersensitivity reactions to other fruits are commonly reported, particularly apples, stone fruits and bananas. Strawberry fruit contain the allergenic Fra a proteins, members of the pathogenesis-related 10 protein family that causes oral allergic syndrome symptoms. Strawberry (Fragaria × ananassa) is a popular fruit consumed worldwide. Strawberry fruit are rich in secondary metabolites, which contribute to enhanced nutritional value for humans, such as antioxidant activities

Types of reactions to Strawberry:

  1. Mucosal irritation-Strawberry has been implicated in an array of adverse reactions, including uncomfortable mucosal irritation due to acidic pH. The strawberry can also cause itching of the skin when touched which is a form of allergic contact dermatitis.
  2. Oral allergy syndrome-The fruit also contains an allergen that triggers symptoms in individuals that suffer from oral allergy syndrome (OAS). Symptoms of OAS include itching, tingling, and swelling in the mouth or throat. The Fra a proteins are a major allergen group identified in strawberry  This is not a true strawberry allergy, but a cross reactivity of the proteins to the birch tree pollen.  Treatment is heating the fruit or just avoiding it. This means you may need to avoid apples, pears, cherries and peaches, among other fruits in the Rosaceae family. This is called the birch-fruit syndrome with symptoms generally appearing within 5-15 min after consuming raw fruit and comprising local reactions in the mouth and throat with itching and inflammation
  3. Anaphylaxis-symptoms that occur are hives, swelling, wheezing, coughing, vomiting, diarrhea and low blood pressure. This is from IgE mast cell degranulation. Allergy skin testing, specific IgE lab testing and fresh food skin testing with strawberry all can be used to test for strawberry allergy.

Reactions to strawberry can thus come in different forms.  An allergy doctor can help decipher what type of reaction one is having to strawberry and to do the appropriate tests for establishing or ruling out a diagnosis of clinical allergy.

Filed Under: Blog, Food allergy

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Dr. Alan Khadavi
Allergy & Asthma Specialist

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