False Optimism and Food Allergies

Lise Broer
Mar 3, 2018 · 3 min read
Peaches can be deadly to a person who has anaphylactic Oral Allergy Syndrome. Image credit US Department of Agriculture, Public Domain.

What to do about an awareness raising news report that slips in a bizarre claim? Most published information about Oral Allergy Syndrome fails to mention that it can escalate to life threatening severity. OAS can become as serious as a peanut allergy except it causes a reaction to common spices, vegetables, and fruits. Getting accommodation is problematic because OAS is not protected under food allergy labeling laws. So any published information that raises public awareness is usually a good thing. This week a report profiled a woman with a life threatening case of OAS caused by peaches. Yet this new report also makes a strange claim that that a deadly adult onset case can be outgrown later in life?

Is that so? Outgrowing this life threatening disorder would be wonderful if true.

The profile cites an immunologist at a London hospital as an expert. The tabloid where it appears is not the most reliable publication so followup was appropriate. Wrote to Dr. Zoe Adhya through her employer King’s College Hospital asking for followup. Afterward I also contacted the American College of Allergy, Asthma, and Immunology — a leading US professional association of board certified allergists.

The usual age of onset for Oral Allergy Syndrome is late adolescence to early adulthood. Most case of OAS are mild. About 1 case in 60 escalates to anaphylaxis — individuals with severe OAS carry epinephrine injectors the same as people who have any other life threatening allergy. Affected people become allergic pollen or mold, then their immune system antibodies also interact to certain foods because of a similar molecular structure.

This makes OAS a secondary food allergy: the cause is an allergy to another substance. Childhood food allergies are usually primary food allergies. The well-known process of outgrowing a food allergy is normally associated with primary allergies, not adult onset OAS.

In 30 years of living with this condition I had never found an instance of adult onset anaphylactic OAS getting outgrown during middle ages from my database searches on PubMed — the online archive of medical research operated by the US National Institute of Health. Maybe a professional in the field has seen presentations at conferences which aren’t in that database. There might be research coming down the pipeline that someone like myself would not have access to.

On the other hand, maybe the reporter misunderstood the interview notes. It could be possible Dr. Adhya was referring to pollen allergies in general, not to anaphylactic OAS in particular.

Unfortunately there is no way to confirm what Dr. Adhya actually intended: neither she nor King’s College Hospital responded to a request for comment. The ACAAI did write back and none of their experts are familiar with any research that supports a claim that patients with anaphylactic OAS outgrow the condition in their forties or fifties.

It turned out I was chasing a unicorn. We all want good news but a deadly medical condition is no situation for make believe.

Lise Broer

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science-based writing about food allergies