A rare case of “Inhalation fruit hypersensitivity”

Allergies to vegetables and fruits develop as a primary sensitization to pollen allergens followed by cross-reactive secondary sensitization to foods or as a direct sensitization to foods via the gastrointestinal tract. Although much focus has been placed on food hypersensitivity reactions following oral ingestion, reactions resulting from skin contact and inhalation are slowly gaining attention. A 34-year-old female patient, who had no known history of chronic disease and was a teacher by profession, applied to our outpatient clinic with airway symptoms (dyspnea and cough) triggered by apple odor for 5 years. In our test room, where there are equipment that can intervene in a possible anaphylaxis, the patient was provoked with the smell of an apple. The patient was made to smell the apple cut in half for 10 seconds. The patient developed a dry cough that started as mild and then gradually became more severe, and mild urticarial lesions on the anterior chest wall. The patient was diagnosed with inhalation fruit hypersensitivity. An epinephrine auto-injectorwas prescribed and an IKS-LABA dry powder inhaler was prescribed for use when necessary. She was told to stay away from apples.