A Case Report of Allergy to Peach’s Lipid Transfer Protein

Abstract

Peach belongs to the Rosaceae family. One of the particularities of this allergy is the difference in clinical reactivity according to geography. We report a 4-year 8-month-old boy with well-controlled asthma and no symptoms of allergic rhinitis, that at the age of 1 year, 15 minutes after the ingestion of a fruit compote, presented urticaria with respiratory discomfort. At the age of 3 years, following ingestion of fruit salad, the child presented a few minutes later, a similar episode but of greater intensity. At the age of 4, following contact with a fruit basket, the child immediately presented a generalized reaction more severe and intense than the previous ones. Investigation of allergies to aerial allergens was negative. Skin tests for cooked and raw peach were positive for the peel and pulp. Specific-IgE was positive for Pru p 3 (5.7 KIU/l) and negative for Pru p 1. LTPs are particularly stable and resistant to proteolysis and heat. Management consisted of avoidance of peach, education of the child and family, and prescription of an emergency kit including self-injectable adrenaline. Our observation highlights the strong association between Pru p 3: peach’s Lipid Transfer Protein (LTP) positivity and the severity of allergy symptoms. We consider this case as a primary sensitization to peach’s LTP.