Apples create allergic reactions in a relatively small percentage of people. Although it is considered a low allergy-incidence food, this fruit can produce oral allergy symptoms in people who are allergic to birch pollen. These individuals may experience sensitivities only to uncooked apples or only to apple skins.
This cross-reactivity with birch pollen and fruits related to apples can confuse the diagnosis of true apple allergies. Patients should track their symptoms closely and discuss them with allergy specialists.
Allergy symptoms of the lips, mouth and throat may precede other signs of apple allergies or may indicate a cross-reaction, especially during the spring birch pollination season. Tingling and itching lips or throat may occur just after eating apples, along with itching and raised bumps inside the mouth.
Patients may also have sensitivities to fruit related to apples, such as quinces and pears. If patients can eat cooked apples without problems, allergic reactions to birch pollen may have triggered the apple cross-reactions.
Like other food allergies, apple allergies usually prompt additional itching of the skin, often in tandem with a topical rash within an hour or so of eating apples. Redness, patchy or flaky skin may persist or lead to hives, a rash of welts or bumps. The area may feel tender or painful, and swelling may occur locally or on the face and eyelids, as the University of Maryland Medical Center reports. Extreme swelling can effectively close the eyes.
Allergy symptoms of the respiratory tract can stem from tissue inflammation or may warn of the onset of anaphylaxis, a medical emergency condition that develops from some allergic reactions. Patients who show moderate to severe swelling may have difficulty swallowing or breathing as a result. The UMMC notes that inflammation of the mucous membranes can obstruct the airways, causing runny nose, nasal congestion and shortness of breath.
According to the National Institutes of Health, digestive allergy symptoms will occur some time after eating apples, when the fruit makes its way through the digestive tract. Pain, vomiting and diarrhea can arise suddenly, even though hours may have passed since ingesting apples.
In very rare cases, all of the physical changes brought on by apple allergies induce anaphylaxis, a full-body allergic reaction that can be fatal. Call 911 if patients report a weak or racing pulse or light-headedness, or if they have trouble speaking or suddenly lose consciousness.