Original Article Kiwi pulp hypersensitivity

first documented case of IgE-mediated hypersensitivity to this fruit was reported in 1981. Most series published since that time include only a very small number of patients. Methods: We have studied eight patients who developed symp-toms suggestive of IgE-mediated reaction after the ingestion of kiwi; one of these patients also developed symptoms while handling the fruit. All eight patients tolerated other foodstuffs, with the exception of one, who reported having fainted while drinking pineapple juice. Skin tests were performed including the prick-by-prick and a modification of the occluded prick test of Dreborg and Foucard with the pulp of various fruits (kiwi, pineapple, papaya and avocado), and prick tests with a kiwi peel extract. The presence of specific IgE was also investigated in all cases by in vitro pro-cedures with these same allergens. Results: The skin tests with kiwi pulp were positive in all patients, regardless of the actual technique used. Two patients developed clinical symptoms during the prick-by-prick tests with the pulp of this fruit. The one patient who had reported symptoms while manipulating the fruit also evidenced IgE-mediated hyper-sensitivity to the fruit's rind. Some patients also evidenced positive tests to other fruits, in most cases without clinical relevance. Conclusions: In the present study, skin testing was a more sensitive method than the in vitro tests in the detection of kiwi pulp hypersensitivity. Because of its greater safety, the modified Dreborg and Foucard technique may represent a diagnostic alternative for the assessment of fruit hypersensitivity in patients reporting severe symptoms. The kiwi pulp appears to contain at least three different allergens, some of which might be shared by the other fruits tested