Latex-fruit syndrome

What it is

Latex-fruit syndrome ties an allergy to rubber with reactions at the table.² Some foods have proteins that are like the proteins in rubber tree sap, and people with a latex allergy may have reactions to some foods.² AAFA calls this latex-fruit syndrome or latex-food allergy syndrome.²

Latex is a milky fluid that comes from the tropical rubber tree.⁷ Latex allergy occurs when the body’s immune system overreacts to proteins found in natural rubber latex.⁵ In most cases, it develops after many earlier exposures to latex.¹ ACAAI says that if you have latex allergy, you also can have food allergies.¹

The link comes from shared proteins: an AAAAI expert answer says latex, banana and avocado share antigens, and that being sensitized to more than one of them, and reacting to more than one, happens quite often.⁴ About 30 to 50% of people with a latex allergy have latex-fruit syndrome.² In a 1994 study cited by AAAAI, banana skin prick tests were positive in 35% of patients with latex allergy, and 52% of 31 patients reported symptoms in the mouth after eating banana.⁴

Symptoms

Reactions to the foods vary in how far they reach: in the AAAAI expert answer, cross-reactions among latex, banana and avocado can be systemic, affecting the whole body, or limited to mucosal surfaces, the body’s moist linings.⁴ AAAAI says certain fruits and vegetables can cause allergic symptoms in some people who are sensitive to latex.⁵

Contact with latex itself brings its own symptoms: ACAAI lists hives, itching, and a stuffy or runny nose, and skin that touched a latex item may itch, redden and swell right away.¹ Latex allergy can also cause asthma symptoms of wheezing, chest tightness and difficulty breathing, and symptoms begin within minutes after exposure.¹ AAFA gives itchy or swollen lips after blowing up a balloon as one early symptom.² Exposure to latex often results in contact dermatitis symptoms.⁵

A rash from a latex product may have another cause: in the AAAAI expert answer, the expert notes that a child’s rash from latex adhesive bandages may have come from the adhesive rather than the latex.⁴

What triggers it

The foods named by different sources overlap. AAFA lists banana, chestnut and kiwi as the most common foods you may react to if you have a latex allergy.² Its less common list is apricot, avocado, celery, bell pepper, coconut, fig, mango, papaya, passion fruit, peach, pineapple, spinach, strawberry and tomato.²

ACAAI lists apple, avocado, banana, carrot, celery, chestnut, kiwi, melons, papaya, raw potato and tomato as the foods most likely to cause problems for people with latex allergy.¹ A 1997 NIOSH update said latex allergy is also associated with allergies to certain foods such as avocados, potatoes, bananas, tomatoes, chestnuts, kiwi fruit and papaya.⁶ AAAAI says certain fruits and vegetables, such as bananas, chestnuts, kiwi, avocado and tomato, can cause allergic symptoms in some people who are sensitive to latex.⁵

Latex is the other half of the picture. Hundreds of everyday products contain latex.⁷ Natural rubber latex is used to make some gloves, condoms, balloons, rubber bands, erasers and toys, and it can also be in bottle nipples and pacifiers.⁵ Synthetic products, including latex house paints, have not been shown to pose any hazard to people sensitive to latex.⁵

Who is at risk

Latex-fruit syndrome affects people with a latex allergy, so the groups at risk of latex allergy matter.² ACAAI names health care workers and others who often wear latex gloves, and people who have had many surgeries (for example, 10 or more), such as children with spina bifida.¹ It also names people often exposed to natural rubber latex, including rubber industry workers, and people with other allergies, such as hay fever or certain food allergies.¹

NIOSH named the same kinds of groups in 1997: workers with ongoing latex exposure, people with a tendency to have multiple allergic conditions, and people with spina bifida.⁶ AAAAI says approximately 50% of people with latex allergy have a history of another type of allergy.³

The order may run the other way, too: in the AAAAI expert answer, a child allergic to banana and avocado was described as being at increased risk of developing latex allergy with exposure, but no long-term studies show what share of such children go on to develop it.⁴

When to see an allergist

If you suspect you’re allergic to latex, ACAAI says the best thing to do is see an allergist.¹ AAFA advises seeing a board-certified allergist to confirm the allergy.² The doctor will ask about your medical history, do a physical exam and may order an allergy skin test or blood test, then compare the results with your history and exam.² For questions about managing latex allergy or the foods linked to it, talk to an allergist.

Some reactions are emergencies. The most severe latex allergy can result in anaphylaxis, a serious allergic reaction involving severe breathing difficulty, a fall in blood pressure (shock), or both.¹ AAAAI calls it life-threatening.⁵ In the most serious allergic reaction, symptoms occur within minutes and involve multiple systems in the body.³ In the AAAAI expert answer, reactions in the latex, banana and avocado group can also be systemic, affecting the whole body.⁴