Background: Many foods can cause food allergies. Grapple® is just one of many new fruits recently introduced into grocery stores. Objective: To describe 2 unique patients with food allergies after consuming a unique food, a Grapple. Methods: Commercial skin prick testing, fresh fruit prick-prick and radioallergosorbent testing were used to characterize the food allergy reaction. Results: Clinical history and appropriate testing confirmed the Grapple food allergy. Conclusions: To our knowledge, these are the first 2 case reports of food allergy to a new fruit called Grapple. These cases illustrate the importance of consumer labeling laws and careful identification of component ingredients by food-allergic individuals.

Sampson HA: Food allergy. Part 1: immunopathogenesis and clinical disorders. J Allergy Clin Immunol 1999;103:717–728.
Joshi P, Mofidi S, Sicherer SH: Interpretation of commercial food ingredient labels by parents of food-allergic children. J Allergy Clin Immunol 2002;109:1019–1021.
Young E, Stoneham MD: A population study of food intolerance. Lancet 1994;343:1127–1130.
Sicherer SH, Munoz-Furlong A, Sampson HA: Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003;112:1203–1207.
Meredith C: Allergic potential of novel foods. Proc Nutr Soc 2005;64:487–490.
Threshold Working Group: Approaches to establish thresholds for major food allergens and for gluten in food, March 2006. US Food and Drug Administration page (serial online). Available at:∼dms/alrgn2.html (accessed April 2, 2006).
Grapple – The Grape Flavored Apples: The Grapple® homepage. Available at:
Bolhaar STHP, Ree R, Bruijnzeel-Koomen CA, et al: Allergy to jackfruit: a novel example of Bet v 1-related food allergy. Allergy 2004;59:1187–1192.
Bolhaar STHP, van Ree R, Ma Y, et al: Severe allergy to Sharon fruit caused by birch allergy. Int Arch Allergy Immunol 2005;136:45–52.
FAO Nutrition Meetings Report Series 1967, No. 44; Wld Hlth Org Techn Rep Ser, 1968, 383: Toxicologic evaluation of some flavouring substances and non-nutritive sweetening agents. The IPCS INCHEM page. Available at: (accessed July 8, 2006).
Wang J, Luca VD: The biosynthesis and regulation of biosynthesis of Concord grape fruit esters, including ‘foxy’ methylanthranilate. Plant J 2005;44:606–619.
General Standard for Food Additives, Codex standard 192-1995 (Rev 6-2005):1–174. The FAO/WHO Food Standards Codex Alimentarius page (serial online). Available at: (accessed April 2, 2006).
Bush RK, Taylor SL, Hefle SL: Adverse reactions to food and drug additives; in Adkinson NF Jr, Yunginger JW, Busse WW, et al (eds): Middleton’s Allergy Principles and Practice, ed 6. Philadelphia, Mosby, 2003, p 1645.
Gern JE, Yang E, Evrad HM, et al: Allergic reactions to milk-containing ‘non-dairy’ products. N Engl J Med 1991;324:976–979.
Fiocchi A, Bouygue GR, Sarratudi T, et al: Clinical tolerance of processed foods. Ann Allergy Immunol 2004;93:S38–S46.
Sancho AJ, Rigby NM, Zuidmeer L, et al: The effect of thermal processing on the IgE reactivity of the non-specific lipid transfer protein from apple, Mal d 3. Allergy 2005;60:1262–1268.
Bolhaar S, van de Weg WE, van Ree R, et al: In vivo assessment with prick-to-prick testing and double-blind, placebo-controlled food challenge of allergenicity of apple cultivars. J Allergy Clin Immunol 2005;116:1080–1086.
Ortolani C, Ispano M, Pastorello EA, et al: Comparison of results of skin tests (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome. J Allergy Clin Immunol 1989;83:683–690.
Sporik R, Hill DJ, Hosking CS: Specificity of allergen skin testing in predicting open food challenges to milk, egg and peanut in children. Clin Exp Allergy 2000;30:1541–1546.
Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004. Title II of public law 108-282. The US Food and Drug Administration page (serial online). Available at:∼dms/alrgact.html (accessed April 2, 2006).
Kolata G: Cloning may lead to healthy pork. New York Times, March 27, 2006.
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.