How an orange connected asthma to dangerous food allergies

Food allergies and asthma, on their own, can be two life-threatening conditions, but when combined, they can be the recipe for disaster. Such was the case for a 2-year-old Pennsylvania girl who was admitted to the hospital after suffering an abnormally severe food reaction–to an orange.

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Orange allergies, grouped into the category of “citrus allergies”, are considered rare and when they occur, they typically only present as an itchiness inside of the mouth. According to Family Allergy & Asthma Care of Montana, individuals with orange allergies often show sensitivity to pollen as well as other citrus fruits such as grapefruit, lemon, or lime. Though several cases of orange allergies have been documented, there has never been a report of one linked to anaphylaxis, where the reaction becomes life-threatening. That is, until now.

The little girl in question was in Wal-Mart with her mother where they purchased an orange while shopping. Within just a few minutes of eating it, the child’s airways started to swell shut and she was transported by helicopter to The Children’s Hospital of Philadelphia. Doctors there quickly identified her condition as food allergy-related anaphylaxis, but they were forced to administer a higher-than normal dose of the drug epinephrine to reduce the inflammation in her airways.

“Her lips and tongue swelled, she broke out in hives and couldn’t breathe well,” Dr. Sigrid DaVeiga, an allergist who was involved with the case, told Live Science. “It’s just a really astounding reaction to an orange.”

The child’s severe reaction is the first of its kind to be reported in connection with an orange, though experts handling the case explain more than just a food allergy was likely at fault. During testing, the 2-year-old did, in fact, test positive for an allergy to oranges as well as to other citrus fruits and peaches, but she also presented with an undiagnosed asthma condition.

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“I don’t think anybody really believed that it was the orange,” DaVeiga said.

The case is important for individuals who have food allergies or asthma to practice caution if they are trying new foods. Asthma is considered by most medical professionals as a manifestation of allergies, so people with food allergies show be aware of a potential asthma complication if they eat something they shouldn’t. Similarly, people with asthma should be wary of food allergies they may have an are unaware of. When anaphylaxis happens, it can cause death within a matter of minutes.

“She was advised to avoid orange and peach, and also told to start asthma therapy, both of which will keep future allergic reactions under control,” said Dr. Sayantani Sindher, the girl’s allergist and study co-author.