It is difficult to do an estimation of prevalence of melon
allergy due to differences in study populations (latex allergy, pollen
allergy, food allergy, fruit allergy, etc.), differences in dietary habits,
geographical areas, or differences in diagnostic procedures. Prevalence
data are based on different diagnostic procedures. While the prevalence
of sensitization can be estimated by SPT, RAST, and immunoblot, a clinical
relevant sensitization (allergy) is evaluated by convincing history or
food challenge tests (ideally by DBPCFC).
1.1 Subjects with Atopic or Other Diseases
Country / Subjects | Allergy / Sensitization | References | ||||||||||||
France, Paris
a) 24 patients with latex and pollen allergy b) 20 patients with latex allergy (no pollen allergy) c) 25 patients with pollen allergy (no latex allergy) |
|
Levy et al. 2000 | ||||||||||||
France, Pierre Benite
580 patients with adverse reactions to food (study period 1984-92) |
melon 11% (RAST) | Andre et al. 1994 | ||||||||||||
Germany
136 latex allergic patients |
melon 19% (RAST)
melon 5.8% (self-reported) |
Brehler et al. 1997 | ||||||||||||
Italy, Genoa
132 pollen and food sensitive patients |
melon 2.2% (self-reported) | Troise et al. 1992 | ||||||||||||
Italy, Milan
262 fruit and/or vegetable allergic patients |
melon 16% (clinical history) | Ortolani et al. 1988 | ||||||||||||
Italy, Milan
100 fruit and/or vegetable allergic patients |
melon 7% (clinical history) | Ortolani et al. 1989 | ||||||||||||
South Africa, Cape Town
112 children with atopic dermatitis (age of 5 months to 13 years) |
melon 3.4% (questionnaire) | Steinman & Potter 1994 | ||||||||||||
Spain, Madrid
29 plant-derived food allergic patients |
melon 38% (SPT) | Diez-Gomez et al. 1999 | ||||||||||||
Spain, Madrid
95 pollen allergic patients |
melon 14% (skin test)
melon 7.4% (oral challenge test) |
Cuesta-Herranz et al. 2000 | ||||||||||||
Spain, Madrid and Toledo
Patients with allergy to Rosaceae fruits a) 11 without pollinosis (mean age 26 years) b) 22 with associated pollinosis (mean age 22 years) |
melon a) 0% and b) 50%
(clinical history and SPT and/or RAST) |
Fernandez-Rivas et al. 1997 | ||||||||||||
Spain, Pamplona
7 patients with latex- fruit syndrome |
melon 50% (SPT)
melon 14% (clinical history) |
Latasa et al. 1995 | ||||||||||||
Spain, Plasencia (Caceres)
262 patients with pollinosis |
melon 9.1% (self-reported) | Garcia-Ortiz et al. 1995 | ||||||||||||
Spain, Salamanca
a) 57 fruit allergic patients (age of 6-56 years, mean 21.5) b) 30 subjects with positive SPT and/or RAST to muskmelon. |
a) muskmelon 58% (clinical history and SPT and/or RAST)
b) muskmelon 10% (reporting symptoms) |
Garcia Ortiz et al. 1998 | ||||||||||||
Sweden, Halmstad / Malmö
a) 380 birch pollen allergic patients b) 103 patients without birch pollen allergy |
a) melon 3%
b) melon 2% (questionnaire) |
Eriksson et al. 1982 | ||||||||||||
Switzerland, Vaudois
111 patients with pollen- associated food allergy |
melon 40% (RAST) | Bircher et al. 1994 | ||||||||||||
Switzerland, Zurich
383 food allergic patients (study period 1990-94) |
melon 2.9% (clinical history, diagnostic tests) | Etesamifar & Wüthrich 1998 | ||||||||||||
USA, Rochester, NY
a) 2067 allergic patients including b) 1447 with pollinosis |
Percentage in group a)
melon and/or banana 4.2% cantaloupe 3.6% honeydew melon 1.7% (cause of oral pruritus, interview survey) all cases occurred in subgroup b) |
Anderson et al. 1970 |
1.2 Prevalence of Associated Allergies
Country / Subjects | Sensitization / Allergy | References | ||||||||||||||||||||||||||||||||
Spain, Madrid
10 children sensitized to melons |
pollen approximately 90% (SPT) | Crespo et al. 1995 | ||||||||||||||||||||||||||||||||
Spain, Plasencia (Caceres)
24 melon allergic patients (age of 8-50 years, mean of 23 years) |
|
Garcia-Ortiz et al. 1995 | ||||||||||||||||||||||||||||||||
Spain, Madrid
19 patients with confirmed allergy to melon |
avocado 37%
banana 37% kiwi 32% watermelon 32% peach 26% (DBPCFC or convincing episode of anaphylaxis) asthma / allergic rhinitis 95% (clinical history and SPT) |
Rodríguez et al. 2000 | ||||||||||||||||||||||||||||||||
Spain, Salamanca
33 melon allergic patients |
latex 91% (SPT and/or RAST)
latex 10% (clinical history) |
Garcia Ortiz et al. 1998 | ||||||||||||||||||||||||||||||||
USA, Detroit, MI
192 patients allergic to cantaloupe, honeydew melon, watermelon, cucumber, zucchini, banana, and/or ragweed pollen |
II: honeydew melon |
Enberg et al. 1987 | ||||||||||||||||||||||||||||||||
USA, Detroit, MI
a) 48 patients allergic to cantaloupe b) 34 patients allergic to honeydew melon |
a) ragweed pollen 96% (RAST)
b) ragweed pollen 100% (RAST) |
Enberg et al. 1987 | ||||||||||||||||||||||||||||||||
USA, Rochester, NY
90 patients who report symptoms of oral pruritus to melon and/or banana |
watermelon 56%
banana 52% citrus fruits 16% peach, unpeeled 12% tomato 8.9% celery and walnut 6.7%, each cucumber and pear 5.6%, each green pepper, apple, grape, and pineapple 4.4%, each other < 4% (oral pruritus, interview survey) ragweed pollen 100% (SPT, clinical history) prevalence of asthma 78% (control group 47%) |
Anderson et al. 1970 |
Symptoms & Case Reports | References | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Systemic reactions
anaphylaxis (5, 8), hypotension (8), systemic reactions (not specified) (1) Symptoms of skin and mucous membranes
Gastrointestinal symptoms
Respiratory symptoms
|
(1) Ortolani et al. 1988
(2) Ortolani et al. 1989 (3) Garcia-Ortiz et al. 1995 (4) Latasa et al. 1995 (5) Garcia Ortiz et al. 1998 (6) Asero 2000 (7) Asero et al. 2000 (8) Rodríguez et al. 2000 |
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Percentage of Reactions
(2) melon allergic patients (extra-oral symtoms in 12%) * also having oral allergy syndrome (3) melon allergic patients (age of 8-50 years, mean of 23 years) (4) patients with confirmed allergy to melon |
(1) Anderson et al. 1970
(2) Ortolani et al. 1988 (3) Garcia-Ortiz et al. 1995 (4) Rodríguez et al. 2000 |
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Onset of Symptoms
Onset of symptoms within 5 min after ingestion (1 melon allergic patient, open food challenge) (1) Onset of symptoms within 30 min after ingestion (17 melon allergic patients, DBPCFC positive) (2) Onset of symptoms in less than 1 h after ingestion in 2 patients with history of convincing anaphylaxis induced by melon (2) |
(1) Ortolani et al. 1989
(2) Rodríguez et al. 2000 |
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Age at Onset of Melon Allergy
Age at onset of ranged from 6 to 45 years (median 27 years) in 19 melon allergic patients (1) |
(1) Rodríguez et al. 2000 |
3 Diagnostic Features of Melon Allergy
Parameters / Subjects | Outcome | References | ||||||||||||
Primary Sensitization
17 melon allergic patients |
Seasonal rhinitis, asthma, or both preceeded the first reaction to melon in 88% of patients | Rodríguez et al. 2000 | ||||||||||||
Primary Sensitization
(latex)
57 fruit allergic patients |
In all patients, clinical symptoms of fruit allergy preceeded latex allergy, fruits mostly associated to latex sensitization: melon, peach, and banana | Garcia Ortiz et al. 1998 | ||||||||||||
IgE and Clinical Relevance
8 latex allergic patients with self-reported melon intolerance |
Melon specific IgE (RAST):
Sensitivity 38% Specificity 82% |
Brehler et al. 1997 | ||||||||||||
SPT, IgE and Clinical Relevance
melon allergic patients (positive clinical history) |
Positivity in SPT:
Fresh food 76% (n=21) Positivity in RAST: 0% (n=7) |
Ortolani et al. 1988 | ||||||||||||
SPT, IgE and Clinical Relevance
7 patients with clinical history of melon allergy |
Positivity in SPT:
Fresh food (prick-to-prick) 43% Positivity in RAST: 0% |
Ortolani et al. 1989 | ||||||||||||
Reported Reactions, Food Challenges
53 patients reporting adverse reactions to melon |
|
Rodríguez et al. 2000 | ||||||||||||
SPT, IgE and Clinical Relevance
a) 53 patients reporting adverse reactions to melon including b) 19 patients with clinical reactivity to melon |
b) 79% had positive SPT and/or RAST to melon |
Rodríguez et al. 2000 | ||||||||||||
IgE, SPT, Fresh Food and Commercial Extracts
24 melon allergic patients (age of 8-50 years, mean of 23 years) |
Positivity in SPT:
Fresh food 100% Commercial extract 13% Positivity in RAST: 88% |
Garcia-Ortiz et al. 1995 |
Treatment * | Outcome | References |
Pollen Immunotherapy
A 34-year-old woman with long-standing pollinosis and oral allergy syndrome after ingestion of melon, fennel, and cucumber was treated with two commercial depot aluminium hydroxide-adsorbed extracts of grass pollen, mugwort pollen, and ragweed pollen |
After 36 months of specific immunotherapy, the patient tolerated both fresh fennel and cucumber on open oral challenge tests; after 43 months of immunotherapy, the patient tolerated fresh melon as well on open oral challenge; vegetables were reintroduced in her normal diet | Asero 2000 |
Proteins / Glycoproteins | Allergen Nomenclature | References |
Allergens: 14, 31, and 40 to 92 kDa | Garcia Ortiz et al. 1996 |
Extract / Purified Allergens | Methods | References |
Protein extract | Fresh fruits (cantaloupe, honeydew melon) were diced, liquified in a blender, and centrifuged | Enberg et al. 1987 |
Protein extract | Melon was extracted with ammonium bicarbonate buffer (pH 8.5) (ratio 10%, w/v), stirred for 60 min at room temperature, centrifuged, dialyzed, membrane filtered, and lyophilized | Garcia Ortiz et al. 1996 |
Cross-Reacting Allergens | Subjects / Methods | References |
Melon: (fruits, vegetables)
significant associations to: watermelon and tomato* |
262 fruit and/or vegetable allergic patients
(clinical history, SPT, RAST) |
Ortolani et al. 1988 |
Melon: (fruits)
apple |
1 patient with apple and pollen allergy: Approximately 95% inhibition of IgE binding to melon extract by apple peel extract (RAST inhibition) | Asero et al. 2000 |
Melon: (pollen)
Dactylis, Plantago, and olive pollen |
Maximum inhibition of IgE-binding to melon extract by Dactylis, Plantago, and olive pollen were 84%, 84%, and 45%, respectively (pooled serum from melon sensitive patients, RAST inhibition) | Garcia-Ortiz et al. 1995 |
Melon: (pollen)
Dactylis and Plantago pollen |
IgE-binding to melon allergens almost completely
inhibited by grass and Plantago pollen extracts; melon extract inhibited IgE-binding to various allergens of Dactylis at high Mr and partially to 14 kDa and 40 kDa protein; almost complete inhibition of IgE-binding to Plantago extract by melon extract (immunoblot inhibition, 3 sera from patients allergic to melon, and Dactylis glomerata and Plantago lanceolata pollens) |
Garcia-Ortiz et al. 1996 |
Melon: (latex)
latex |
5 latex allergic patients with melon sensitivity: 81-100%
(mean 96%) inhibition of IgE binding to melon allergens by latex extract;
26-100% (mean 55%) inhibition of IgE binding to latex extract by melon extract (RAST inhibition) |
Brehler et al. 1997 |
Reported Adverse Reactions | References |
Food / Food additives
After ingestion of fresh fruits (1) |
(1) see 2 Symptoms of Melon Allergy |
Overripe Melon
Anaphylactic reaction to endogenous ethanol in overripe-melon in a 24 year old woman with history of intolerance to beverages containing ethanol |
Mallon & Katelaris 1997 |