D2.44 - Kiwi Allergy in Singaporean Children

This study highlights the unique characteristics of kiwi allergy in Singaporean children and its growing recognition as a significant cause of food-induced anaphylaxis.The study examines the clinical features of kiwi allergy in Singaporean children.

A seven-year retrospective review of patient records from KK Women’s and Children’s Hospital. The research focuses on children aged 0 to 18 years who underwent prick-to-prick (PPT) testing for kiwi allergy from 2017 to 2024.

Out of 94 patients, 56 (59.6%) tested positive for kiwi allergy through PPT. Among them, 51 (54.3%) were diagnosed with IgE-mediated kiwi allergy, and 5 (5.3%) were sensitized but had no known exposure to kiwi.The majority of allergic reactions were cutaneous (82.4%), while isolated oral symptoms occurred in 11.8%, and anaphylaxis was observed in 7.8% of cases.Most patients had mono-allergy to kiwi (82.4%), with only a small number having concomitant allergies to other foods like avocado or banana.Unlike studies from regions with birch pollen (e.g., Europe), there were no cases of pollen-associated oral allergy syndrome or latex allergies in this cohort, likely due to Singapore’s tropical climate.Many of the kiwi-allergic children also had allergies to peanuts or tree nuts (52.9%).The study found that the severity of reactions varied, with younger children and those without pollen allergies more likely to experience severe reactions.Over time, some patients showed clinical tolerance, with 7.8% of those retested eventually testing negative for kiwi allergy.

In conclusion, this study represents the largest cohort of kiwi-allergic children in Asia demonstrating several unique aspects: predominance of mono-allergy to kiwi without concomitant pollen or fruit allergies, co-existing allergies to peanut and/ or tree nuts, and the predominance of cutaneous rather than oral pharyngeal symptoms. While PPT with raw kiwi has been shown to be useful in diagnosing kiwi allergy, future studies including component resolved diagnostics would be valuable in better defining the predominant allergens in our population.