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 the body recognizes as being the same. The one fruit that stands apart in its ability to cause an allergy is the mango Mangifera indica. As the national fruit of India, Pakistan, and the Philippines, the mango is grown on a tree that 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, but it can also sometimes be downright dangerous.
Oral allergy syndrome is typically an uncomplicated allergy that occurs almost immediately after eating a piece of fresh fruit and usually resolves without treatment within minutes. OAS occurs as a result of similarities in the proteins found in mangoes and pollens most often birch pollen or mugwort pollen. Strangely enough, 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 commonly associated allergens.
However, due to the relatively small risk of a more serious reaction, people with a mango allergy are advised to avoid all raw forms of the fruit. Cooked fruit rarely poses a problem. 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 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 as common as, say, poison oak or poison ivy but, in some cases, it 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. 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 required. 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.
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.
The fruit mango Mangifera indica belongs to the family Anacardiacae and is often, regarded as the 'king of fruits'. It is partaken in many forms, both during as well as off season. During season, it is eaten as fresh fruit, shakes and ice creams while off season, it is available as pickles, juices and jams. Native to southern Asia, especially India and Burma, mango has been cultivated in the Indian subcontinent for thousands of years. Nearly half of the world's mangoes are cultivated in India alone and is the country's national fruit.
By the 10th century AD, cultivation of mango had begun in East Africa and later in Brazil, the West Indies and Mexico and is now cultivated in most frost-free tropical and warmer subtropical climates including Spain and Australia.
Despite the large consumption of mangoes, especially in India, hypersensitivity reactions to mango are distinctly rare. Allergy to mango can manifest in two forms viz. Allergic reaction to mango was first described in , by Zakon [ 1 ] in a year-old female who developed acute vesicular dermatitis involving lips and circumoral area, 24 h after eating a mango. Kahn in [ 2 ] was the first to document immediate hypersensitivity to mango in a female patient, who also suffered from hay fever.
To our knowledge, this is the first systematic review on hypersensitivity manifestations to the fruit mango; it aims to document an updated summary of the evidence in the field. As this is a narrative review of published studies, institutional review board clearance was not required.
A total of 17 reports documenting 22 patients were found on searching the databases. A total of only ten patients with immediate hypersensitivity reaction [ 2 - 10 ] and twelve patients with delayed hypersensitivity reaction [ 1 , 11 - 17 ] to mango were documented in these reports.
Ten of these patients four with immediate reaction [ 6 , 7 , 9 , 10 ]; six with delayed reaction [ 11 , 15 , 16 ] were reported from geographical areas cultivating mango. Five of these patients were documented from Australia [ 11 , 16 ], two each from Spain [ 6 , 9 ] and India [ 10 ] and one patient from Thailand [ 15 ] Table 1. Twelve patients six with immediate reaction [ 2 - 5 , 8 ]; six with delayed reaction [ 1 , 12 - 14 , 17 ] were reported from the countries where large scale mango cultivation does not occur.
Six of these patients were documented from USA [ 1 - 4 , 12 , 13 ], two each from Germany [ 8 ] and Japan [ 14 ] and one patient each from UK [ 5 ] and Korea [ 17 ] Table 2. Documented reports of hypersensitivity manifestations to mango from geographical regions cultivating the fruit.
Documented reports of hypersensitivity manifestations to mango from geographical regions not cultivating the fruit. The first patient, documented with immediate hypersensitivity to mango, by Kahn [ 2 ], had "some symptoms" initially on ingestion of mangoes.
She was "persuaded" to undergo a mango ingestion provocation test with which she experienced "rapidly acute symptoms such as hoarseness, dyspnoea and bronchitic rales asthma ". Her symptoms were relieved with injection epinephrine. Since then, this phenomenon has been described in only nine other patients. We have recently documented a year-old lady [ 10 ], who presented to us with exacerbation of asthma within 15 min of ingestion of fresh mango.
Immediate hypersensitivity reaction to mango may manifest either as a systemic anaphylaxis or a local reaction. It presents as wheezing dyspnoea, erythema, urticaria, angioedema and anaphylaxis. Mango allergy may rarely present as anaphylactic shock and was documented in two patients [ 3 , 4 ]. Rubin et al.
The patient required intervention with parentral epinephrine and hydrocortisone for control of symptoms. A similar event was described in a year-old Caucasian lady [ 4 ] within five minutes of ingestion of mango. Both these reports [ 3 , 4 ] highlighted the fact that ingestion of mango can be life threatening in some susceptible individuals.
Type I hypersensitivity reaction occurs within a few minutes of mango ingestion. It was observed that symptoms in most of these patients occurred almost immediately [ 4 - 9 ], while in two patients, symptoms commenced in about 30 min [ 2 , 3 ].
Our patient too developed wheezing dyspnoea, cough and throat irritation within 15 min after ingestion [ 10 ]. The immediate hypersensitivity reaction to mango is mediated through the classical IgE pathophysiological mechanisms and is thought to occur in individuals who were previously sensitized to the antigens present in the mango [ 6 ]. Sensitization usually occurs by prior ingestion, but it may also follow intake of other fruits belonging to family Anacardiaceae viz. Sensitization by ingestion of mango in unrecognisable forms, such as fruit punch and fruit salad has also been reported [ 3 ].
Consumption of canned or packaged mango too can precipitate an allergic reaction as allergenicity of mango nectar persists even after heating, enzymatic degradation and mechanically caused tissue degradation [ 18 ]. This type of hypersensitivity reaction is thought to occur within minutes of combination of the mango antigen with the corresponding IgE antibody [ 6 ], which is in turn bound to the mast cell.
This promptly causes mast cell degranulation, with the release of primary histamine, proteases and acid hydrolases and secondary leukotrienes, prostaglandins and platelet activating factor mediators of inflammation. People with this allergy who eat the fruit with the peel intact could also develop rashes in and outside their mouth, as well as on the chin and neck, as a result. According to Dr. Frieling, people don't typically have an allergic reaction to mangoes unless they're handling the peeling, as urushiol oil is only located in the rind, not the flesh of the fruit.
If you're sensitive to urushiol oil, you can prevent a rash by buying pre-cut mango from the grocery store, having someone else prepare the mango for you or wearing gloves when peeling the fruit in order to prevent direct contact, she says. What works or doesn't work depends on the person. If you wind up with a rash due to a mango allergy, Dr. Frieling says it's important to avoid picking or scratching your rash, no matter how badly you want to.
To calm the area, start by washing it with a bland soap and lukewarm water, taking time to massage the soap into the affected area. Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights. Measure content performance. Develop and improve products. List of Partners vendors. Mangoes can cause an allergic reaction in some people, although it is very uncommon.
Skin rashes may develop in response to touching the mango peel, but more severe reactions are also possible. If you have a mango allergy, you may be able to eat mangoes if you don't come into contact with the peel. However, some people may need to avoid mangoes altogether if their allergy is more severe. This article explains the causes and symptoms of mango allergies. It also explores how mango allergies are diagnosed, as well as the treatment options available.
There are two types of allergic reactions to mangoes:. An allergic reaction to mango may occur immediately after contact with the mango or days later, depending on the individual. Contact dermatitis , an itchy rash with blisters or bumps, is the most common allergic response to mangoes. The rash is usually near the lips and the skin around the mouth, but it can affect any area of the body. This type of skin rash may take up to seven days after contact to show up.
Symptoms of mango-induced contact dermatitis include:. Keep in mind that it is the peel of the mango that typically triggers the rash. The most common type of allergic reaction to mango is a rash called contact dermatitis.
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