We consider them positive when a wheal at least 3 mm greater in diameter than the negative control is observed. We performed a complete allergological work-up including skin prick tests (SPTs) (Lofarma, Milan, Italy Alk-abellò, Lainate, Milan) with commercial extracts of latex, apple profilin, peach lipid transfer protein (LTP), other food and airborne allergens. She was treated in emergency room with inhalator salbutamol and intravenous antihistamines and corticosteroids showing a progressive improvement of symptoms. We present a case of a 10-years-old-girl with a history of no-seasonal mild intermittent rhinitis, who experienced an immediate reaction characterized by an oral allergy syndrome (OAS), drooling, urticaria, lips and face angioedema and dyspnea after ingestion of a fresh fig. The symptoms presented by our patient could be related to a cross reactivity between these two proteins which present a structural homology. The ficin, the major fig allergen, belongs to cysteine protease family like Der p 1. In contrast specific IgE levels for latex, LTP, profilin, PR-10 and pollen allergens were negative. Fig specific serum IgE levels were 1.08 U/ml and specific IgE for rDer p1 was 16.20 U/ml (total serum IgE = 377 U/ml). We also carried out a positive SPT with a commercial fig allergen (Lofarma, Milan, Italy) and prick-by-prick (PBP) both with skin and pulp of green raw and cooked fig. SPT revealed a sensitization only for dermatophagoides farina and dermatophagoides pteronyssinus which was then confirmed with by specific IgE assay (UniCAP, Phadia, Uppsala, Sweden). Skin prick tests (SPT) with commercial extracts of food, airborne allergens, latex and panallergens (profilin, PR-10 and lipid transfer protein) were performed. We present a case of a 10-years-old-girl, with a history of no-seasonal mild intermittent rhinitis, who experienced an immediate reaction after ingestion of a fresh fig. We describe the first case of fig allergy that occurred as a cross-reactivity between fig and Derp 1. Ficus carica is an edible fruit, belonging to the Moraceae family, rarely described as cause of food allergy.
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