The Latex-Fruit Syndrome: A Review on Clinical Features

During the last decade, latex IgE-mediated allergy has been recognized as a very important medical problem. At the same time, many studies have dealt with allergic cross-reactions between aeroallergens and foods. Recently, a "latex-fruit syndrome" has been postulated, because there is clear evidence of the existence of a significant clinical association between allergies to latex and certain fruits. Several studies have demonstrated that from 20% to 60% of latex-allergic patients show IgE-mediated reactions to a wide variety of foods, mainly fruits. Although implicated foods vary among the studies, banana, avocado, chestnut and kiwi are the most frequently involved. Clinical manifestations of these reactions may vary from oral allergy syndrome to severe anaphylactic reactions, which are not uncommon, thus demonstrating the clinical relevance of this syndrome. The diagnosis of food hypersensitivities associated with latex allergy is based on the clinical history of immediate adverse reactions, suggestive of an IgEmediated sensitivity. Prick by prick test with the fresh foods implicated in the reactions shows an 80% concordance with the clinical diagnosis, and therefore it seems to be the best diagnostic test currently available in order to confirm the suspicion of latex-fruit allergy. Once the diagnosis is achieved, a diet free of the offending fruits is mandatory. Recently, some of the common allergens responsible for the cross-reactions among latex and the fruits most commonly implicated in the syndrome have been identified. Class I chitinases, with an N-terminal hevein like domain, which cross-react with the major latex allergen "hevein", seem to be the panallergens responsible for the latex-fruit syndrome. (Internet Symposium on Food Allergens 2000, 2(3):125-35) latex allergy food allergy cross-reactivity latex-fruit syndrome class I chitinases