Background: The few cases of food allergy to fig reported to date, whose main manifestations were anaphylactic reactions, have been related to a cross-sensitisation to weeping fig (Ficus benjamina) or to the ‘latex-fruit syndrome’. Here we report on two cases of the oral allergy syndrome (OAS) to fig in patients whose main allergic manifestations were related to sensitisation to grass and birch pollens. Methods: The patients were characterised by clinical history, skin prick tests (SPT) with commercial and in-house extracts, prick-by-prick test, specific IgE measurements and challenge tests. PBS-soluble and insoluble extracts of both fig skin and pulp were examined for the presence of potential allergens by IgE immunoblotting. Results: Both patients showed OAS followed by respiratory symptoms when challenged with fig. They were negative in both specific IgE detection and SPT with commercial extracts of fig and many other plant materials, including F. benjamina and Hevea brasiliensis, while grass and birch pollens gave positive results. Prick-by-prick tests and SPT with in-house extracts indicated that the fig skin had a much higher allergenicity than the pulp. Despite negative IgE detection by the CAP assay, immunoblotting experiments showed that potential fig allergens were PBS-soluble and present only in the skin of the fruit. Conclusions: OAS to fig followed by respiratory symptoms can be present in patients not sensitised to weeping fig or having the latex-fruit syndrome. Different parts of the fig can have different allergenicities, the most important allergens being proteins related to the skin of the fruit. Improved commercial fig extracts to be used for the diagnosis of this type of allergy have to be developed.

Dechamp C, Bessot JC, Pauli G, Deviller P: First report of anaphylactic reaction after fig (Figus carica) ingestion. Allergy 1995;50:514–516.
Diez-Gomez ML, Quirce S, Aragoneses E, Cuevas M: Asthma caused by Ficus benjamina latex: Evidence of cross-reactivity with fig fruit and papain. Ann Allergy Asthma Immunol 1998;80:24–30.
Oei HD, Tjiook SB: A case report of an anaphylactic reaction after fig (Ficus carica) ingestion. Allergy 1998;53:85.
Gandolfo M, Baeza M, De Barrio M: Anaphylaxis after eating fig. Allergy 2001;56:462–463.
Blanco C, Carrillo T, Castillo R, Quiralte J, Cuevas M: Latex allergy: Clinical features and cross-reactivity with fruits. Ann Allergy 1994;73:309–314.
Brehler R, Theissen U, Mohr C, Luger T: Latex-fruit syndrome: Frequency of cross-reacting IgE antibodies. Allergy 1997;52:404–410.
Johansson SGO, Hourihane JO, Bousquet J, et al: A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy 2001;56:813–824.
Pasini G, Simonato B, Giannattasio M, Gemignani C, Curioni A: IgE binding to almond proteins in two CAP-FEIA-negative patients with allergic symptoms to almond as compared to three CAP-FEIA-false-positive subjects. Allergy 2000;55:955–958.
Memorandum sulla diagnostica delle allergopatie. SIAIC position statement. G Ital Allergol Immunol Clin 1992;2:351–370.
Amlot PL, Kemeny DM, Zachary C, et al: Oral allergy syndrome (OAS): Symptoms of IgE-mediated hypersensitivity to foods. Clin Allergy 1987;17:33–42.
Ortolani C, Ispano M, Pastorello E, et al: The oral allergy syndrome. Ann Allergy 1988;61:47–52.
Fernandez-Rivas M, Cuevas M: Peels of Rosaceae fruits have a higher allergenicity than pulps. Clin Exp Allergy 1999;29:1239–1247.
Ebner C, Hoffmann-Sommergruber K, Breiteneder H: Plant food allergens homologous to pathogenesis-related proteins. Allergy 2001;56(suppl 67):43–44.
Simonato B, De Lazzari F, Pasini G, Polato F, Giannattasio M, Gemignani C, Peruffo AD, Santucci B, Plebani M, Curioni A: IgE binding to soluble and insoluble wheat flour proteins in atopic and non-atopic patients suffering from gastrointestinal symptoms after wheat ingestion. Clin Exp Allergy 2001;31:1771–1778.
Pastorello E: Oral allergy syndrome: Clinical aspects and pathogenetic mechanisms. Semin Clin Immunol 1992;4:35–40.
Ortolani C, Ispano M, Pastorello EA, Ansaloni R, Magri GC: Comparison of results of skin prick tests (with fresh foods and commercial extracts) and RAST in 100 patients with oral allergy syndrome. J Allergy Clin Immunol 1989;83:683–690.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.