title: Oral allergy syndrome in a child provoked by royal jelly.
abstract: Royal jelly has been demonstrated to have several physiological activities. However, in the literature, different reactions induced by royal jelly are reported. We describe a case of seven-year-old child that was referred to our observation for two episodes of oral allergy syndrome (OAS) that appeared ten minutes after ingestion of royal jelly. Skin prick test with standard panel of inhalant and food allergens, a prick-to-prick test using the royal jelly's extract responsible for patient's reactions, and royal jelly patch test with extemporaneous preparation were performed. The specific IgE by ImmunoCAP System method versus Hymenoptera venom, inhalant allergens, food allergens, and lipid transfer proteins was dosed. According to the positive reactions to royal jelly both by prick-by-prick test and by a first reading patch test, royal jelly immediate hypersensitivity was diagnosed. According to the positive response for almond in both in vivo and in vitro tests we can think of the royal jelly contamination with almond pollen as possible cause of patient's reaction. Moreover, from the results of specific IgE titers versus Compositae pollens, we have argued the possibility that this case of royal jelly allergy could be explained also by the mechanism of cross-reaction with Compositae pollens.
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy.
authors.forename: Fantini
authors.initials: F
authors.lastname: Paola
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy.
authors.forename: Delle Donne
authors.initials: DD
authors.lastname: Pantalea
authors.affiliation: Fourth Pneumology Department, Pneumologic Hospital A. Galateo, San Cesario di Lecce, Italy.
authors.forename: Calogiuri
authors.initials: C
authors.lastname: Gianfranco
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy.
authors.forename: Ferrannini
authors.initials: F
authors.lastname: Antonio
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy ; Department of Internal Medicine and Clinical Oncology, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy.
authors.forename: Vacca
authors.initials: V
authors.lastname: Angelo
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy.
authors.forename: Nettis
authors.initials: N
authors.lastname: Eustachio
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Policlinico, Piazza Giulio Cesare, 11 70124 Bari, Italy ; Section of Allergy and Clinical Immunology, Unit of Internal Medicine-"F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy.
authors.forename: Di Leo
authors.initials: DL
authors.lastname: Elisabetta