Pollen Food Syndrome guidelines stress accurate diagnosis, dietary management. Rising prevalence impacts vegetarian/vegan diets. Further research needed.
In a clinical practice guideline issued by the British Society of Allergy and Clinical Immunology and published online in Clinical & Experimental Allergy, recommendations are presented for the diagnosis and management of pollen food syndrome (PFS).
Noting that PFS sufferers experience allergic symptoms when consuming raw plant foods, Isabel J. Skypala, Ph.D., from the Royal Brompton & Harefield Hospitals in London, and colleagues developed guidelines for the diagnosis and management of PFS in the United Kingdom. The recommendations were formulated using the SIGN methodology due to a lack of high-quality evidence.
The authors noted that correct diagnosis of PFS ensures avoidance of misdiagnosis of a primary peanut or tree nut allergy or confusion with another plant food allergy. PFS can often be diagnosed from history alone due to the characteristic foods involved and rapid-onset oropharyngeal symptoms. Additional diagnostic tests may be required for reactions involving tree nuts, peanuts, and soya milk or severe/atypical reactions to fruits and vegetables. Management involves exclusion of known trigger foods, which can be highly problematic if coupled with a preexisting food allergy or for those following a vegetarian/vegan diet. Immunotherapy to pollens is not an effective treatment for PFS; oral or sublingual immunotherapy to foods seems more promising. Severe reactions can occur in PFS, and anxiety about symptom onset to new foods can impact quality of life.
“The rising prevalence of PFS comes at a time when there is a world-wide change in dietary habits, with more people adopting a vegetarian or vegan lifestyle, thus nutritional aspects of PFS need further consideration and research,” the authors write.
Several authors disclosed financial ties to the biotechnology and other industries.
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