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Alan Khadavi, MD, APC
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January 10, 2022 by Alan Khadavi

Mango Allergy can come in many flavors

Mango 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.

The fruit mango (Mangifera indica) belongs to the family Anacardiacae and is often, regarded as the ‘king of fruits’.

Mangoes are delicious simply peeled and eaten plain. They are also good in fruit salads and have long been made into chutney, pickles and squash. The ground seed is a source of flour. Green or unripe mango has many uses in the cuisines of India, Malaysia and Thailand. Mango is used in various vegetable and lentil dishes, and also as a meat tenderiser. It is a good source of beta carotene and vitamin C.

Mango antigen has been shown to cross react with artemesia pollen, birch pollen, poison ivy, poison oak, mugwort, celery, carrot, pistachio nut, tomato, papaya and banana

Types of reactions to Mango:

  1. Mucosal irritation-Mango has been implicated in an array of adverse reactions, including uncomfortable mucosal irritation due to acidic pH. The mango can also cause itching of the skin when touched which is a form of allergic contact dermatitis.

    In mango, urushiol is found in high concentrations in the peel and the fruit just beneath the peel. In most people, contact with urushiol will induce an allergic skin response. With mango, the allergy may not be as common as, say, poison oak or poison ivy but, in some cases, it can be just as profound.

  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.  Treatment is heating the fruit or just avoiding it. Mango contains a number of different allergens which are found in many other foods besides pistachio and cashew. For example, there is a fruit profilin in mango which is also found in pear, peach, and apple. There is a panallergen found in celery, carrot, apple, peanut, paprika, anise, fennel, coriander, and cumin that demonstrates cross-reactivity with mango. Mango has also demonstrated cross-reactivity to foods in the “latex-fruit cross-reactivity syndrome.” A chitinase-like protein cross-reacting with latex has been found in mango as well as avocado, chestnut, banana, kiwi, tomato, passion fruit, and papaya. Clinical cross-reactivity varies. Some patients who react to mango have demonstrable cross-reactivity to pistachio or cashew, and others do not.
  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 mango all can be used to test for mango allergy. Mango can induce anaphylaxis, and two major mango allergens have been identified – Man i 1 and Man i 2.

The exact incidence of mango allergy is unknown, but clearly reactions to this fruit occur far less frequently than more common culprits. Even though it is rare, mango can cause immediate and delayed hypersensitivity reactions which can lead to anaphylaxis.

Mango, cashew nut and pistachio nut belong to the same botanical family (sumac species). Several allergens have been identified in mango pulp. It appears that mango seed, which is not intended for consumption, shares common proteins with cashews and pistachios. Industrially processed mango puree may unpredictably contain seed proteins that can cause severe allergic reactions, particularly in patients with cashew nut allergy. However, seed allergens are not included in the mandatory labeling directives for food ingredients. Parents of children with cashew nut (sumac) allergy should be aware of the likely presence of seed proteins in baby foods and other machine-processed drupe fruit products.

Filed Under: Blog, Food allergy, Uncategorized

alan-khadavi
Dr. Alan Khadavi
Allergy & Asthma Specialist

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