Asia Pac Allergy.  2011 Apr;1(1):43-49. 10.5415/apallergy.2011.1.1.43.

Hypersensitivity manifestations to the fruit mango

• Sareen R
• Shah A

• KMID: 2397145
• DOI: http://doi.org/10.5415/apallergy.2011.1.1.43

Abstract

The objectives of this study are 1) To review the published data and document the current knowledge on allergic manifestations to the fruit mango 2) To highlight the two distinct clinical presentations of hypersensitivity reactions caused by mango 3) To discuss the role of cross-reactivity 4) To increase awareness of potentially life threatening complications that can be caused by allergy to mango. An extensive search of the literature was performed in Medline/PubMed with the key terms "mango", "anaphylaxis", "contact dermatitis", "cross-reactivity", "food hypersensitivity", "oral allergy syndrome" and "urticaria". The bibliographies of all papers thus located were searched for further relevant articles. A total of 17 reports describing 22 patients were documented, including ten patients with immediate hypersensitivity reaction and twelve patients with delayed hypersensitivity reaction to mango. Ten of these patients (four with immediate reaction; six with delayed reaction) were from geographical areas cultivating mango, whereas twelve patients (six with immediate reaction; six with delayed reaction) were from the countries where large scale mango cultivation does not occur. The clinical features, pathogenesis and diagnostic modalities of both these presentations are highlighted. The fruit mango can cause immediate and delayed hypersensitivity reactions, as also "oral allergy syndrome". Although rare, it can even result in a life threatening event. Reactions may even occur in individuals without prior exposure to mango, owing to cross reactivity. It is imperative to recognize such a phenomenon early so as to avoid potentially severe clinical reactions in susceptible patients.

Keyword

Allergy; Anaphylaxis; Contact dermatitis; Cross-reactivity; Mango; Oral allergy syndrome; Urticaria

MeSH Terms

Anaphylaxis
Dermatitis, Contact
Fruit*
Humans
Hypersensitivity*
Hypersensitivity, Delayed
Hypersensitivity, Immediate
Mangifera*
Urticaria

Reference

1. Zakon SJ. Contact dermatitis due to mango. J Am Med Assoc. 1939. 113:1808.

2. Kahn IS. Fruit sensitivity. South Med J. 1942. 35:858–859.

3. Rubin JM, Shapiro J, Muehlbauer P, Grolnick M. Shock reaction following ingestion of mango. JAMA. 1965. 193:397–398.

4. Dang RW, Bell DB 2nd. Anaphylactic reaction to the ingestion of mango. Case report. Hawaii Med J. 1967. 27:149–150.

5. Miell J, Papouchado M, Marshall AJ. Anaphylactic reaction after eating a mango. BMJ. 1988. 297:1639–1640.

6. Duque S, Fernández-Pellón L, Rodríguez F. Mango allergy in a latex-sensitized patient. Allergy. 1999. 54:1004–1005.

7. Hegde VL, Venkatesh YP. Anaphylaxis following ingestion of mango fruit. J Investig Allergol Clin Immunol. 2007. 17:341–344.

8. Renner R, Hipler C, Treudler R, Harth W, Süß A, Simon JC. Identification of a 27 kDa protein in patients with anaphylactic reactions to mango. J Investig Allergol Clin Immunol. 2008. 18:476–481.

9. Silva R, Lopes C, Castro E, Ferraz de Oliveira J, Bartolomé B, Castel-Branco MG. Anaphylaxis to mango fruit and cross-reactivity with Artemisia vulgaris pollen. J Investig Allergol Clin Immunol. 2009. 19:420–422.

10. Sareen R, Gupta A, Shah A. Immediate hypersensitivity to mango manifesting as asthma exacerbation. J Bras Pneumol. 2011. 37:135–138.

11. Calvert ML, Robertson I, Samaratunga H. Mango dermatitis: allergic contact dermatitis to Mangifera indica. Australas J Dermatol. 1996. 37:59–60.

12. Tucker MO, Swan CR. The mango-poison ivy connection. N Engl J Med. 1998. 339:235.

13. Weinstein S, Bassiri-Tehrani S, Cohen DE. Allergic contact dermatitis to mango flesh. Int J Dermatol. 2004. 43:195–196.

14. Oka K, Saito F, Yasuhara T, Sugimoto A. A study of cross-reactions between mango contact allergens and urushiol. Contact Dermatitis. 2004. 51:292–296.

15. Wiwanitkit V. Mango dermatitis. Indian J Dermatol. 2008. 53:158.

16. Thoo CH, Freeman S. Hypersensitivity reaction to the ingestion of mango flesh. Australas J Dermatol. 2008. 49:116–119.

17. Lee D, Seo JK, Lee HJ, Kang JH, Sung HS, Hwang SW. A case of allergic contact dermatitis caused by a duoderm extrathin® dressing. Korean J Dermatol. 2009. 47:612–614.

18. Dube M, Zunker K, Neidhart S, Carle R, Steinhart H, Paschke A. Effect of technological processing on the allergenicity of mangoes (Mangifera indica L.). J Agric Food Chem. 2004. 52:3938–3945.

19. Katelaris CH. Food allergy and oral allergy or pollen-food syndrome. Curr Opin Allergy Clin Immunol. 2010. 10:246–251.

20. Ausucua M, Dublin I, Echebarria MA, Aguirre JM. Oral Allergy Syndrome (OAS). General and stomatological aspects. Med Oral Patol Oral Cir Bucal. 2009. 14:e568–e572.

21. Saraswat A, Kumar B. Anaphylactic reaction to apple, banana and lychee: what is common between botanically disparate plant families? Int J Dermatol. 2005. 44:996–998.

22. Paschke A, Kinder H, Zunker K, Wigotzki M, Steinhart H, Weβbecher R, Vieluf I. Characterization of cross-reacting allergens in mango fruit. Allergy. 2001. 56:237–242.

23. Brehler R, Theissen U, Mohr C, Luger T. "Latex-fruit syndrome": frequency of cross-reacting IgE antibodies. Allergy. 1997. 52:404–410.

24. Hershko K, Weinberg I, Ingber A. Exploring the mango-poison ivy connection: the riddle of discriminative plant dermatitis. Contact Dermatitis. 2005. 52:3–5.

25. Trehan I, Meuli GJ. Mango contact allergy. J Travel Med. 2010. 17:284.