While eggs, milk, nuts, fish, shellfish, wheat and soy account for 90 percent of food allergies, kiwi allergy is not rare -- especially in people with other allergies. Among older children and adults, an allergic reaction to kiwis usually represents cross reactivity to another allergy-provoking substance, or allergen. Due to cross reactivity, people with an allergy to birch pollen, grass pollen or latex are commonly also allergic to kiwis. A direct reaction in which a person has kiwi-specific antibodies can also occur. Kiwi allergy symptoms vary from mild to potentially life-threatening, and can affect the skin and respiratory, digestive and circulatory systems.
A kiwi allergy often manifests as a condition called oral allergy syndrome (OAS), or pollen-food allergy syndrome. People with OAS have pollen allergies and experience oral symptoms when eating certain raw fruits or vegetables due to cross reactivity. People with kiwi-induced OAS are typically allergic to birch or grass pollen, or latex. Typical symptoms include itching or tingling in the lips, mouth, tongue and upper throat, which may be accompanied by mild swelling. Some people also experience sneezing and itchy eyes or ears. OAS symptoms typically disappear relatively quickly once the food is no longer in the mouth -- although they might progress to a more severe reaction.
As with many other kinds of allergies, a kiwi allergy can cause skin symptoms. Localized hives and itchiness might develop on the hands after handling kiwis. Facial hives and itching can occur in sensitive people after being kissed by someone who has recently eaten a kiwi. Widespread hives, generalized itchiness, and flushed or pale skin frequently occur with a more severe allergic reaction to kiwis, and are usually accompanied by other symptoms.
Respiratory symptoms occur frequently with a moderate to severe allergic reaction to kiwis. Swelling of the tongue, throat and airways can lead to difficulty breathing, shortness of breath and wheezing. Coughing, nasal congestion, throat tightness, difficulty swallowing and hoarseness can also occur. Respiratory symptoms caused by an allergic reaction to kiwis often progress quickly. The development of any respiratory symptoms associated with an allergic reaction to kiwis requires emergency medical care.
Digestive System Symptoms
Digestive system symptoms commonly occur with a systemic allergic reaction to kiwis. A systemic reaction refers to one affecting the body as a whole rather than just the area of direct contact, as in OAS. Possible symptoms include abdominal pain, stomach cramps, nausea, vomiting and diarrhea. Whereas OAS symptoms occur almost immediately, digestive system symptoms might be delayed for up to 2 hours after eating kiwis.
Circulatory System Symptoms
A severe allergic reaction to kiwis typically causes circulatory system symptoms. Lightheadedness, dizziness or fainting frequently develop due a drop in blood pressure. A rapid or pounding heart rate, and abnormal heart rhythms might also occur. These signs and symptoms often herald the most severe type of allergic reaction called anaphylaxis. Unless treated urgently, anaphylaxis can lead to shock, circulatory collapse and potentially death.
Warnings and Precautions
See your doctor right away if you experience any signs or symptoms of a kiwi allergy. Even if your symptoms to date are limited to those consistent with OAS, your next exposure to kiwis might lead to anaphylaxis. Your doctor can order tests to determine whether you are allergic to kiwis and advise you about how to manage the condition, including what other foods to might also cause an allergic reaction.
Seek immediate, emergency medical care if you experience any respiratory or circulatory symptoms that might indicate anaphylaxis. A few minutes delay in treatment can potentially endanger your life.
Reviewed and revised by: Tina M. St. John, M.D.