What is Pollen Food Syndrome (PFS)?
Pollen Food Syndrome (PFS), also known as Oral Allergy Syndrome (OAS) is a type of food allergy that occurs when children have a hypersensitivity to certain raw fruits and vegetables, or nuts due to cross-reactions with pollen proteins.
PFS is more common in children with hay fever, particularly those allergic to birch pollen. The body mistakes certain proteins in these foods for pollen, causing an allergic reaction.
Children may suddenly start having reactions to certain foods they’ve previously eaten without issue, which can be concerning for parents.
Common Symptoms of Pollen Food Syndrome
Symptoms of PFS are usually mild and limited to the lips, mouth and throat. These may include:
- Itching or tingling in the mouth, lips, or throat
- Swelling of the lips, tongue, or mouth
- Tightness in the throat
- Facial swelling or redness
- Irritation or itching on the hands from handling raw foods
- In rare cases, more severe reactions like anaphylaxis
PFS reactions are typically triggered by raw plant-based foods like apples, peaches, carrots, potatoes, peanuts, and various nuts. Cooking or processing these foods usually prevents reactions, as the heat breaks down the allergenic proteins.
What is Home Apple Oral Immunotherapy?
For children with Pollen Food Syndrome triggered by apples, Home Apple Oral Immunotherapy is a safe and effective way to desensitise them to the fruit.
By introducing small amounts of apple and gradually increasing the dose, children may eventually be able to eat apples without allergic symptoms.
How Home Apple Oral Immunotherapy Works
Step 1: Initial In-Person Appointment
- The first appointment, where the initial apple dose will be introduced, will take place in person at the clinic. During this appointment, your child will eat small amounts of a Golden Delicious apple under the supervision of a specialist. This helps to determine the eliciting dose—the small amount of apple that triggers mild symptoms. This dose will be the starting point for desensitisation at home.
Step 2: Up-Dosing Process
- After the initial in-person appointment, your child will begin eating their eliciting dose at home daily for 2-3 weeks.
- If well-tolerated, the dose will be gradually increased every 2-3 weeks, following a stepwise schedule.
- Once your child can tolerate a regular portion of apple, they should continue eating apples regularly, at least 3 times per week, to maintain their tolerance.
Step 3: Maintenance
- After reaching the target dose, your child should continue eating Golden Delicious apples 3 times a week. Skipping long periods without eating apples may result in the loss of tolerance.
Is Home Desensitisation Safe?
Yes, home apple desensitisation is generally safe, with the risk of severe allergic reactions being very low. However, some children may experience mild symptoms like mouth or throat itching during the early stages of treatment.
In the rare case that symptoms worsen, you should stop the treatment and seek medical help. Our clinical team will guide you through each step to ensure your child’s safety.
Managing Symptoms During Desensitisation
Mild symptoms (such as itching or swelling in the mouth) are common during desensitisation. If your child experiences discomfort, they may take an antihistamine (e.g., cetirizine or loratadine) to relieve symptoms. If symptoms worsen or persist, stop the treatment and consult your healthcare provider.
How to Prevent Reactions in the Future
To prevent allergic reactions from Pollen Food Syndrome:
- Cook or process raw foods to break down the allergenic proteins.
- Read food labels carefully to avoid accidental exposure to allergens.
- Manage other allergic conditions like asthma or hay fever, as this can reduce the risk of severe reactions.
Why Choose Children’s Allergy Doctors?
At Children’s Allergy Doctors, we use cutting-edge allergy testing methods and a comprehensive approach to distinguish between pollen food allergy and primary food allergies. We provide personalised treatment plans, including home desensitisation protocols like home apple oral immunotherapy, to help children manage their allergies effectively.
For more information on Home Apple Oral Immunotherapy and Pollen Food Syndrome or to book a consultation, please contact us today.