The Facts About Mango Allergy

Reactions range from annoying to life-threatening

Cut mango on bamboo tray
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Food allergies are common and will affect nearly everyone at some point in their life. These include fruits, some of which have a high propensity for oral allergy syndrome (OAS), a cross-reaction between certain pollens and fruits that body recognizes as being the same.

The one fruit that stands apart in its ability to cause allergy is the mango (Mangifera indica). As the national fruit of India, Pakistan, and the Philippines, the mango is derived from a tree which belongs to the cashew family Anacardiaceae.

This is the same family of plants which include poison oak, poison sumac, and poison ivy. This distinction can not only make eating mango problematic for some people, it can sometimes be downright dangerous.

Mangos and Oral Allergy Syndrome

Oral allergy syndrome (OAS) is typicallt an uncomplicated allergy that occurs almost immediately after eating a piece of fresh mango and usually resolves without treatment within minutes.

OAS occurs as a result of similarities between the proteins in mangoes and pollens (most often birch pollen or mugwort pollen). Strangely, having a latex allergy can also cause OAS symptoms when eating mango (a condition referred to as latex-fruit syndrome).

The diagnosis of OAS is typically made with skin testing to confirm whether there is a cross-reaction between mango and the other associated allergens.

OAS is generally not considered a serious condition as the saliva in a person’s mouth is usually able to break down the allergen quickly.

As such, any response is usually limited to the mouth and/or lips. However, due to the small risk of a more serious reaction, people with a mango allergy are typically advised to avoid all raw forms of the fruit. Cooked fruit rarely poses a problem.

Contact Dermatitis to Mango

Another type of reaction that can occur as a result of eating mango is something called contact dermatitis, This is due specifically to a substance found in plants of the Anacardiaceae family called urushiol.

In mango, urushiol is found in relatively high concentrations in the peel and the fruit just beneath the peel. In most people, contact with urushiol will induce an allergic skin response. With mango, the allergy may not be a common as, say, poison oak or poison ivy but, in some cases, can be just as profound.

This reaction, which resembles a poison oak rash, most often occurs on the face within hours of eating the fruit and can last for several days. The rash will appear as small, itchy blisters that can sometimes ooze.

While this type of mango allergy isn’t particularly dangerous or life-threatening, it can be uncomfortable and annoying. Treatment, when needed, will involve a topical or oral corticosteroid, depending on the severity of symptoms.

The diagnosis can be made based on the appearance of the rash. Testing is usually not necessary. If the reaction is especially severe, patch testing may be used to confirm that mango is, in fact, the causal allergen.

Anaphylaxis to Mango

In rare instances, a severe allergic reaction can result after eating a mango. Known as anaphylaxis, the response usually occurs within minutes of eating the fruit and may include:

  • Difficulty breathing
  • Wheezing
  • Hives
  • Facial swelling
  • Tightness of the throat
  • Nausea
  • Vomiting
  • Abdominal pain
  • Chest tightness
  • Diarrhea
  • Dizziness
  • Fainting
  • Rapid heartbeat
  • A feeling of impending doom

In some cases, the person’s condition may rapidly deteriorate and lead to anaphylactic shock, cardiac arrest, and even death. Immediate emergency care should be sought, without exception, if a person experiences a sudden, severe response to mango.

Persons who have experienced severe allergic symptoms after eating cashew or pistachios should also avoid mango due to potential cross-reactivity. Those at risk of anaphylaxis should always carry injectable epinephrine (known as the EpiPen) in the event of accidental exposure to mango or any cross-reactive substance.

Source:

Sareen R. and Shah, A. "Hypersensitivity Manifestations to the Fruit Mango." Asia Pac Allergy. 2011; 1:43-9.

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