Monosensitization to coconut

• Published in: Journal of allergy and clinical immunology 2004-02, Vol.113 (2), p.S315-S315
• Main Authors: Martin, E., Tornero, P., De Barrio, M., Pérez, C.I., Beitia, J.M., Baeza, M.L.
• Format: Article
• Language: English
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2004.01.632

Allergy to coconut (Coccus Nucifera, Arecaceae's family) it is a very uncommon entity. A few published reports sign out immunologic cross-reactivity between coconut and nuts, soybean and legumes. A 64 year-old woman, with hypertension and autoimmune thyroiditis, referred a few minutes after eating a coconut biscuit, a generalized urticaria, facial and uvula edema, dysphagia and dyspnea. A similar second episode was followed by bronchoconstriction, hypotension (100/60) and hypoxemia (PaO2:58) minutes after eating a Spanish sweet containing coconut, almond, sugar, milk, cocoa and yolk. It subsided in a few hours after symptomatic therapy in the emergency room. Next, she tolerated almond, milk, egg, sugar, cocoa, date, other nuts and legumes. Skin prick tests (SPT) were strongly positive to coconut pulp (19×10 mm) and coconut milk (13×10 mm), with a late skin reaction 4-6 hours later (edema and erithema). SPT were negative to palmate, date, palm pollen, peanut, almond, pistachio nut, walnut, hazelnut, sweet chestnut, soybean, cocoa, chickpea, lentil, mustard and latex. Specific Ig E (CAP Pharmacia™) to coconut measured 20,8 KU/L and was negative to nuts, legumes and soybean. Multiple specific Ig E reacting bands to coconut milk and coconut pulp as well as to dry commercial coconut powder were revealed by immunoblotting. The most prominent had an apparent molecular weight of 18, 22 and 28 kD. We report an IgE-mediated anaphylaxis to coconut, demonstrated by SPT, specific Ig E and immunoblotting. No clinical or immunological cross-reactivity was found with other related fruits. The main allergens measured 18, 22, and 28 kD.