Clinical Experience
IgE-mediated reactions
Although hypersensitivity to the pollen and fruit of the Mulberry tree (Morus alba) has been reported, allergy to Blackberry has rarely been reported (2). This may be related to the general low allergenicity of this berry, the small amounts consumed or the restricted time frame of consumption. Low exposure to certain allergens might be the reason for the limited complaints recorded so far, but with the ongoing promotion for the consumption of small fruits, this situation might change (3).
Although anecdotal reports of allergy to Blackberry have been received, only 1 report has been published in the medical literature. Nonetheless, Blackberry may induce symptoms of food allergy in sensitised individuals (1,4), and suspicion of adverse symptoms to Blackberry should be entertained, in particular because of its frequent consumption and its allergenic potential. This fruit should be taken into consideration in the case of patients with a history of allergy to other fruits of the Rosaceae family, and in the case of pollen-sensitised patients with oral allergy syndrome (1).
A 45-year-old man is reported to have developed systemic anaphylaxis after the ingestion of Blackberries. He had experienced dyspnoea and pharyngeal and labial pruritus over the previous 25 years and clearly related these symptoms to the ingestion of Blackberries, Raspberries, Peanuts, certain brands of margarine, and fruity wines. However, symptoms of oral allergy syndrome were the most intense with Blackberry. In an episode 2 months prior to consultation, he had developed oral allergy syndrome accompanied by generalised urticaria, oedema of the glottis, dyspnoea, vomiting, diarrhoea and loss of consciousness after the ingestion of 2 Blackberries. SPT confirmed sensitisation to Blackberry. Skin reactivity was also found for Goosefoot/Lamb’s quarter (Chenopodium), Peanut, Wheat, Barley and Rye. An oral challenge test was not performed (1).
The same patient was included in a study of 4 patients with thrombosis associated with antiphospholipid syndrome, each of whom had experienced anaphylaxis attributable to ingestion of vegetables or fruit. The presence of IgE antibodies for a 45 kDa protein band in an Almond extract was detected in all 4 of these patients. No IgE antibodies specific for food panallergen lipid transfer proteins were detected (4).