According to Karen H. Calhoun, MD, of the Department of Otolaryngology- Head and Neck Surgery at Ohio State University in Columbus, one form of food allergy that otolaryngologists need to be aware of is an allergic reaction that involves an adverse reaction to ingesting an antigen that has cross-reactivity to a similar allergy marker (or epitope) on an inhaled antigen, such as pollen.
A common example of this, said Cecelia Damask, DO, of Lake Mary Ear, Nose, Throat and Allergy in Lake Mary, FL, is the situation in which a patient comes in with burning around the mouth. This could possibly be oral allergy syndrome, which is a common form of IgE-mediated food allergy, she said. Birch pollen is known to cross-react with the rose family fruits, especially apples. Local IgE-mediated mast cell activation results in immediate tingling of the lips and tongue.
This type or reaction occurs mainly with raw foods, said Dr. Calhoun, so most patients with oral allergy syndrome can tolerate, for example, applesauce or apple pie without symptoms.