Angioedema after ingestion of persimmon fruit

Methods A 41-year-old woman developed severe facial angioedema and dyspnea within 15 minutes of persimmon fruit intake. She was treated with intravenous corticosteroids and antihistamines, monitored in a hospital for two days and attended our clinic the next week for assessment of possible fruit allergy. She reported a previous episode of angioedema and generalized urticaria some months ago, immediately after had eaten a kaki. The patient had an allergic rhinitis to house dust mites and also she suffered diabetes mellitus. She was in treatment with metformine 1500 mg a day. Skin prick tests were positive for Dermatophagoides pteronyssinus and farinae. (Stallergenes, Cedex, France). Prick by prick were performed by placing a piece of persimmon fruit on the forearm and pricking through them and itwas positive in our patient (++++) but not in 3 healthy controls. We realized also an open food challenge with fresh persimmon fruit. Traces of this fruit were introduced to the patient initially by contacting the lip without getting any allergic symptoms. Finally a substantial amount of the fruit was consumed and 15 minutes later our patient experienced pruritus, facial angioedema and dyspnea. The test was stopped when the adverse reaction occured.