Pear allergy
Pear allergy.
About pear allergy
Pear is a member of the rose family, alongside apple, cherry and peach. Allergy to it is most often linked to birch-pollen sensitivity rather than being a primary food allergy, so it is common in adolescents and adults with hay fever in northern Europe. The reaction is IgE-mediated, but in pollen-related cases the antibodies are really directed at pollen proteins that closely resemble a heat-sensitive protein (a Bet v 1 homologue) found in raw pear.
This usually causes oral allergy syndrome: itching or tingling of the lips, mouth and throat within minutes of eating raw pear, sometimes with mild lip swelling. Symptoms are typically mild and short-lived because the responsible protein is broken down by cooking and stomach acid, so cooked or tinned pear is often tolerated. A minority of people, particularly where a stable lipid transfer protein is involved, can react more strongly.
Diagnosis uses the history alongside skin-prick testing (sometimes with fresh fruit) or specific-IgE blood tests, and component testing can distinguish pollen-related from more serious sensitisation. Management means avoiding raw pear if it causes symptoms while often still enjoying it cooked. Anyone who has had throat tightness, breathing difficulty or widespread symptoms should seek medical assessment; a severe reaction needs 999.
Common triggers
- Pear and products containing it
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.