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LETTER TO THE EDITOR
Year : 2014  |  Volume : 7  |  Issue : 4  |  Page : 534-536  

Angioedema of the face following ingestion of mango fruit


1 Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur, India
2 Department of Orthodontics, Government Dental College and Research Institute, Bellary, Karnataka, India

Date of Web Publication25-Jun-2014

Correspondence Address:
Yadavalli Guruprasad
Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur - 584 103, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.135293

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How to cite this article:
Guruprasad Y, Kura U, Chauhan DS. Angioedema of the face following ingestion of mango fruit. Med J DY Patil Univ 2014;7:534-6

How to cite this URL:
Guruprasad Y, Kura U, Chauhan DS. Angioedema of the face following ingestion of mango fruit. Med J DY Patil Univ [serial online] 2014 [cited 2021 Sep 29];7:534-6. Available from: https://www.mjdrdypu.org/text.asp?2014/7/4/534/135293

Sir,

Allergic reactions to fresh fruits have become increasingly common and are very rarely reported in the literature. Mango (Mangifera indica) is a very popular fruit consumed throughout the world and popularly known as "king of fruits." [1] Mango is a very popular fruit in India, and incidences of hypersensitivity reactions reported after ingestion of mango are very few in this region. We report a case angioedema of the face following ingestion of mango fruit in a 21-year-old male patient.

A 21-year-old male patient came with a chief complaint of swelling of the face within 2 h after consuming mango fruit. There was no history of allergy, asthama or any other intake of drugs. Other symptoms were oropharyngeal itching, tiredness, and dizziness. On examination, the swelling was diffuse and very significant over periorbital region bilaterally and lips [Figure 1] and [Figure 2]. Skin over the swelling was normal with no obvious rashes on the face and over the extremities. The patient was referred to emergency care where he was given subcutaneous injection of adrenaline (1:1000) followed by intravenous hydrocortisone and antihistamines. Clinical diagnosis of angioedema of the face secondary to ingestion of mango fruit was made based on the symptoms and history. The patient was sent to Department of Dermatology for confirming the diagnosis where they evaluated serum allergen specific immunoglobulin (IgE) to mango, which was detected by enzyme-linked immunosorbent assay (ELISA). Serum from the mango-allergic patient showed higher ELISA units when compared with that of normal serum, indicating the presence of mango specific IgE in the allergic subject. The patient was kept under observation for 3 days and discharged after the symptoms subsided.
Figure 1: Clinical photograph showing diffuse swelling over the face

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Figure 2: Clinical photograph showing significant swelling over the lips and periorbital region

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Mango is the second most frequently cultivated tropical fruit in India and even worldwide. Mango, together with pistachio and cashew, belongs to the Anacardiae family. [1],[2] All three foods may cause severe anaphylactic reactions, which may be life-threatening if not treated on an emergency basis. Immediate type oral symptoms are most commonly seen after ingestion of mango fruits. Besides allergic reactions to the fruits, sensitizations to mango pollen and seeds have been described in the literature. Immediate hypersensitivity reaction is mediated through the classical IgE pathophysiological mechanisms and is thought to occur in previously sensitized individuals. Canned or packaged mango can also cause an allergic reaction, because the allergenicity of mango nectar persists even after heating, enzymatic degradation, and mechanical tissue damage. [2],[3] Delayed hypersensitivity reaction to mango is usually cell-mediated, which results from direct contact with fruit or even with the tree itself. The sensitizing substances include urushiol, cardol, limonene and B-pinene, which are present in the skin, bark, and pericarp, as well as in the mango pulp, up to 5 mL below the skin. [3],[4] Our case signifies the fact that, mango fruit can cause an immediate hypersensitivity reaction, which can result in a life-threatening event. Therefore, it is imperative to recognize such manifestations early in order to avoid morbidity and mortality in susceptible patients on an emergency basis.



 
  References Top

1.Dang RW, Bell DB 2 nd . Anaphylactic reaction to the ingestion of mango. Case report. Hawaii Med J 1967;27:149-50.  Back to cited text no. 1
    
2.Rubin JM, Shapiro J, Muehlbauer P, Grolnick M. Shock reaction following ingestion of mango. JAMA 1965;193:397-8.  Back to cited text no. 2
[PUBMED]    
3.Miell J, Papouchado M, Marshall AJ. Anaphylactic reaction after eating a mango. BMJ 1988;297:1639-40.  Back to cited text no. 3
    
4.Hegde VL, Venkatesh YP. Anaphylaxis following ingestion of mango fruit. J Investig Allergol Clin Immunol 2007;17:341-4.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]


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[Pubmed] | [DOI]



 

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