Pineapple Allergy Comes in Many Flavors

Pineapple Allergy Symptoms & Treatment

Do you have a pineapple allergy? Learn more about pineapple allergy symptoms, how to tell if you have a pineapple allergy, and how to treat it from the allergy specialists at St. Louis Family Allergy in Missouri. Schedule a visit today!

“Dr. Cajigal was friendly, professional, and informative. She took the time to explain the tests and what was going on with my allergies. She is so knowledgeable and really cared about how I was feeling. I would highly recommend this practice if you suffer from allergies and asthma.”

– Sue D, July 2020

Pineapple Allergy Doctor Sonia Cajigal of St. Louis Family Allergy in St. Louis, Missouri
Pineapple Allergy Doctor Dr. Sonia Cajigal of St. Louis Family Allergy review badges and affiliations

Allergy to Pineapple

Pineapple Allergy Overview
Pineapple Allergy Symptoms
Pineapple Allergy Treatment
Other Foods to Avoid
Pineapple allergy is relatively uncommon compared to other food allergies. In the 2018 Australian Schoolnuts study, 5 out of 372 children with self-reported allergies reported that they were allergic to pineapple, which would indicate that only 1-2% of food allergies involve pineapple. Readers should also keep in mind that studies where allergies are self-reported tend to overstate the true prelance of the allergy in question, as many subjects can believe that they are allergic without undergoing proper diagnosis and testing.

Despite how rare it is, the topic of pineapple allergy is actually rather complex. While some individuals experience localized mouth, tongue, or throat irritation when eating pineapple, it is also possible to react to pineapple when you’re actually allergic to something else. Such is the case in certain types of oral allergy syndrome (OAS) or latex-fruit syndrome. Further complicating the topic of pineapple allergy is the fact that the allergenic proteins in pineapple can are often cross reactive with other foods.

We’ve introduced a lot of unique terminology so far, so we’ll break down the different sources of pineapple allergy in more detail below.

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Pineapple allergy symptoms, testing, treatment

Isolated Pineapple Allergy

Isolated pineapple allergy describes the case where you’re allergic to pineapple itself and do not experience any cross reactivity, oral allergy syndrome, or latex-fruit syndrome.

Bromelain is an allergenic substance that is found in pineapple. Isolated pineapple allergy follows the symptoms of typical food allergies, including hives, itching, swelling, and difficulty breathing.

Pineapple Allergy Cross-Reactivity

When discussing allergic reactions, the term ‘cross-reactivity’ describes when the proteins in one substance are similar to the proteins found in another substance. If you’re allergic to pineapple, for example, you may also experience allergic reactions to other foods because of proteins that are similar enough to the substance that you’re allergic to. Pineapple allergy cross-reactivity is often attributed to profilin, another allergenic protein found in pineapple.

There are many foods that can be cross-reactive with pineapple, including apricot, avocado, banana, cherry, chestnut, grape, kiwi, papaya, passion fruit, and peaches. Not only do these other reactions make it more difficult to avoid trigger foods, they also make it harder to pin down a pineapple allergy.

Cross reactive foods should generally be avoided if you have a pineapple allergy. Although cross-reactive allergy reactions are usually not as severe as a ‘normal’ food allergy, and are often limited to mild symptoms like itching or hives, anaphylaxis is still possible.

Pineapple Oral Allergy Syndrome

Oral allergy syndrome (OAS), also known as pollen fruit syndrome (PFS), is another distinct source of pineapple allergy. Oral allergy syndrome occurs when proteins in certain foods, such as pineapple, are similar to the allergenic proteins found in pollens. When you have pineapple oral allergy syndrome, you’re actually allergic to birch tree pollen, but your body recognizes similar proteins in pineapple as pollen.

Many other foods are implicated in pineapple oral allergy syndrome, including fruits like apples, peaches, apricots, cherries, plums and pears; spices like caraway, fennel, coriander, and aniseed; vegetables like carrot, celery, and parsley; and nuts like soybeans, peanuts, almonds, and hazelnuts.

Oral allergy syndrome symptoms are typically isolated to the mouth, and include itching, swelling, and tingling. If your pineapple allergy is caused by oral allergy syndrome, you can actually prevent pineapple allergic reactions by heating your pineapple before you eat.

Pineapple and Latex Allergy

Another subtlety with pineapple allergy is the fact that your allergy may actually be caused by latex, rather than the unique proteins in pineapple. Many foods contain latex, including kiwi, mangos, passion fruit, figs, avocados, bananas, chestnuts, soy, and strawberries, giving rise to term latex-fruit syndrome. Latex allergy by food consumption typically causes itching, swelling, and difficulty breathing, similar to normal food allergies.

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Woman reacting to food allergy symptoms scratching rash on her neck

Pineapple Allergy Symptoms

Pineapple allergy symptoms are often similar to those caused by other food allergies, but may include additional symptoms due to cross-reactivity with pollen or reactions to latex, depending on what you’re allergic to.

Learn how to tell if you’re allergic to pineapple for looking for these common pineapple allergy symptoms:

  • Itching and swelling of the lips, tongue, and oropharynx
  • Burning and soreness affecting the tongue and the oral mucosa
  • General mouth and throat irritation
  • Swelling
  • Hives
  • Difficulty breathing
  • Gastrointestinal symptoms, including stomach pain, vomiting, diarrhea, or constipation
  • Asthma symptoms
  • Anaphylaxis (rare), causing severe hives, vomiting, diarrhea, angioedema, difficulty breathing, wheezing, coughing, and/or low blood pressure

Pineapple Allergy Test

A detailed medical history is the first step to diagnosing pineapple allergy. We encourage our patients to be mindful of what they’ve eaten and what foods may have caused their allergies, especially in the complex case of pineapple allergic reactions. Writing down what you ate leading up to the allergic reaction may be helpful. A pineapple allergy test may consist of an oral food challenge, elimination diet, skin prick test, blood test, or a combination of these methods.

An oral food challenge sees the patient eat a small amount of the food in question (pineapple) under medical supervision to see if a reaction occurs. Because pineapple is a common culprit of cross reactivity and oral allergy syndrome, your doctor may recommend a food challenge with other foods as well to observe reactivity.

An elimination diet is another method that may help you determine if pineapple is the source of your allergy symptoms. As the name suggests, an elimination diet asks the patient to eliminate the food in question from their diet to see if allergy symptoms subside. You may also be asked to keep a diary of the foods you eat throughout the elimination diet to help identify the source of reactions should they continue.

For a faster and more definitive answer on whether or not you’re allergic to pineapple, a skin prick test may be prescribed. A tiny prick is made on your skin with a needle, usually on the arm, and then a drop of pineapple juice is applied to the prick to see if an allergic reaction occurs.

Blood testing is another option that can be used to confirm or rule out pineapple allergy. Pineapple allergy blood tests measure pineapple-specific IgE antibodies in the blood where elevated amounts indicate an allergy.

How to Treat Pineapple Allergy Symptoms

Learn how to treat pineapple allergy symptoms by effectively managing it with the right mix of allergen avoidance strategies and reactive medication use.

  • Avoid pineapple.
  • Avoid fruits with latex if you’re actually allergic to latex.
  • Avoid reactive foods if you have oral allergy syndrome. Symptoms of oral allergy syndrome can be prevented by heating reactive foods before eating them.
  • Antihistamines can be taken to relieve allergy symptoms.
  • Carry epinephrine (an EpiPen) in case of anaphylactic emergencies.
  • Bronchodilators can relieve asthma symptoms.
  • Corticosteroids can reduce inflammation in the airways.

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Girl using EpiPen to treat severe food allergy reaction

Pineapple Allergy Other Foods to Avoid

As we’ve covered above, the source of your pineapple allergy may be caused by allergenic proteins in the pineapple itself, latex-fruit syndrome, or oral allergy syndrome. Given these unique causes, it’s important to get a proper diagnosis from an allergist to best understand how to navigate your pineapple allergy. General guidance on food avoidance states that:

  • If you’re allergic to profilin in pineapple, you should probably avoid apricot, avocado, banana, cherry, chestnut, grape, kiwi, papaya, passion fruit, and peaches.
  • If you have oral allergy syndrome that reacts to pineapple, you should probably also avoid apples, peaches, apricots, cherries, plums pears, caraway, fennel, coriander, aniseed, carrot, celery, parsley, soybeans, peanuts, almonds, and hazelnuts. You should also remember that oral allergy symptoms can usually be avoided by heating these foods before eating them.
  • If you have latex-fruit syndrome, you should probably avoid kiwi, mangos, passion fruit, figs, avocados, bananas, chestnuts, soy, and strawberries.

We caution readers that the guidance above may not apply to everyone. Based on your diagnosis and your medical history, your allergist will be able to provide more specific advice for foods to avoid if you have pineapple allergy.

References

[1] American College of Allergy, Asthma & Immunology: https://acaai.org/
[2] Asthma and Allergy Foundation of America: https://www.aafa.org/
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"Dr. Cajigal was friendly, professional, and informative. She took the time to explain the tests and what was going on with my allergies. She is so knowledgeable and really cared about how I was feeling. I would highly recommend this practice if you suffer from allergies and asthma."

- Sue D, July 2020

“Dr Cajigal is a great listener. She trusts her patients instead of treating them as if they are not the experts of their own bodies. I really appreciate that (many doctors do not have that quality). She also immediately treats the symptoms instead of waiting to see if things clear. I use her for my children and myself. We have never left her office feeling as if it was a waste of time.”

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