In a clinical practice guideline issued by the British Society of Allergy and Clinical Immunology and published in Clinical & Experimental Allergy, recommendations are presented for the diagnosis and management of pollen food syndrome (PFS). Noting that PFS sufferers experience allergic symptoms when consuming raw plant foods, Isabel J. Skypala, PhD, and colleagues developed guidelines for the diagnosis and management of PFS. Correct diagnosis of PFS ensures avoidance of misdiagnosis of a primary peanut or tree nut allergy or confusion with another plant food allergy, the authors noted. PFS can often be diagnosed from history alone due to the characteristic foods involved and rapid onset of oropharyngeal symptoms. Additional diagnostic tests may be required for reactions involving tree nuts, peanuts, and soy milk or severe/atypical reactions to fruits and vegetables. Management involves exclusion of known trigger foods, which can be highly problematic if coupled with a pre-existing food allergy or for those following a vegetarian/ vegan diet. Immunotherapy for pollens is not an effective treatment for PFS, according to Dr. Skypala and colleagues, who added that oral or sublingual immunotherapy to foods seems more promising.
