Honey allergy T78.1

Rare food allergy (Kiistala R et al. 1995), which is directed against the different components of honey (Aguiar R et al. 2017). The spectrum of clinical manifestations can range from oropharyngeal reactions and asthma attacks to anaphylactic shock (Helbling P et al. 1992; Vezir E et al. 2014).

Honey is composed of various components, such as nectar and honeydew, to which pollen and pollen components are added in varying degrees and composition. The pollen components are mainly pollen from insect-pollinated flowers (clover, dandelion, chrysanthemum, rapeseed, mugwort, birch), less from windflowers (grasses, herbs, trees). Their content and composition depend largely on the place and season of the honey harvest (Helbling P et al. 1992).

There are 3 essential honey components that have to be considered as potential allergens in case of honey intolerance (Bauer L et al. 1996):

• pollen (1g honey contains 2,000-10,000 pollen of different provenance and allergenicity)
• Bee components (glandular secretions of honey bees; bee venom) (Vezir E et al. 2014).
• Fructose (possible fructose intolerance)
• Other ingredients such as: fungal spores, algae

The different pollen compositions in honey, explains that sensitization may be limited to certain types of honey. Almost half of the honey allergic persons reacted with a pollen-associated band (Bauer L et al. 1996).

The clinical symptoms are the symptoms of a classic food allergy (Aguiar R et al. 2017):

• Gastrointestinal symptoms such as: nausea, vomiting, diarrhoea
• Rhinitis
• Oral allergy syndrome
• Angioedema
• Anaphylactic reactions

Since honey is often not the trigger of an allergic reaction, the type of sensitization must be determined. The first measure is to abstain from honey or honey-containing food. Otherwise, the allergic symptoms must be treated symptomatically.

1. Aguiar R et al (2017) Anaphylaxis caused by honey: a case report. Asia Pac Allergy 7:48-50.
2. Bauer L et al (1996) Food-allerg to honey: Pollen or bee products? J Allergy Clin Immunol 97: 65-73
3. Helbling P et al (1992) Allergy to honey: relation to pollen and honey bee Allergy. Allergy 47: 41-49
4. Kiistala R et al (1995) Honey allergy is rare in patients sensitive to pollens. Allergy 50:844-847.
5. Vezir E et al (2014) Anaphylaxis/angioedema caused by honey ingestion. Allergy Asthma Proc 35:71-74.