JACKFRUIT INDUCED ANAPHYLAXIS ASSOCIATED BIRCHPOLLEN-RELATED FOOD ALLERGIES

Introduction Oral allergy to jackfruit, linked with cross reactive plant protein allergen Bet V1 has been associated with latex and birchpollen-related food allergy but anaphylaxis to jackfruit is rare. Case Description A 57-year old Jamaican black female health care aid with diabetes mellitus, hypertension, mild intermittent allergic rhinitis and oral allergy symptom to pineapple presented to the emergency room (ER) after consuming two avrils of a fresh, ripe jackfruit. She immediately had oral pruritus, generalized rash, and rapidly worsened with swelling of face, lips and tongue, throat constriction and hoarseness. At the ER, she was managed as an anaphylactic reaction but subsequently was intubated due to respiratory arrest. She was managed with standard treatment for eight days and discharged home in stable condition. ImmunoCAP showed elevated IgE to Jackfruit (1.53 kD/L), and related plants including birch (13.80 kU/L), peach (7.34 kU/L), hazelnut (6.22 kD/L), and almond (0.93 kD/L). Skin prick testing was performed with raw jackfruit (RS:11 mm) and peel (RP:4 mm), cooked (skin and pulp microwaved for two minutes) fruit (CF:0 mm), birch (13 mm), soybean (5 mm), and carrot (9 mm). ImmunoCAP and skin prick testing to latex and related foods were negative. Discussion Jackfruit belongs to the Moraceae (mulberry) family that contains homologous allergen to Bet-V1 cross reactive to birch pollen-associated food. The duration of her allergy to birchpollen and related foods preceding the jackfruit sensitization in unclear. While jackfruit anaphylaxis related to latex was reported once, this is the first reported incident of jackfruit anaphylaxis to birchpollen related food allergy.