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Ask the Allergist - What is “Kissing Allergy”?

A. Most allergic responses require contact with the allergic portion of the immune system: interactions between specific IgE and the mast cell, such as when the allergens are inhaled (allergic rhinitis, asthma), eaten (food allergies, oral allergy syndromes, anaphylaxis), touched (dermatitis), or infused (intravenous drugs).

Allergic reactions associated with kissing are real phenomena. Although allergens are more commonly associated with ocular, nasal and respiratory symptoms upon direct contact – food allergens can be transmitted from one person to another by kissing. Sadly, there was a reported case of a Canadian teenager who died from an allergic (anaphylactic) reaction “following a kiss from her boyfriend”. In that case it was learned that the teen was actually severely allergic to peanuts, and even though the kiss happened hours after the boyfriend ate peanut butter, it only takes a minute amount of allergenic protein to set off the reaction. In the literature and reported at our national meetings have been cases of allergic responses developing after a kiss. Oral allergy reactions secondary to kissing can develop in individuals who are severely allergic to peanuts, tree nuts, medicine, and other substances1. Many of the allergenic proteins are heat stable and can last for hours in the environment of the mouth, even with all of its enzymes to break down foodstuffs. Interestingly as high as 5.3% reported allergic responses from kissing even after their partner brushed their teeth.2

1. Moehring R. Kissing and food reactions. The New England Journal of Medicine 2002; 347:1210; author reply 1210.

2. Hallett R, Haapanen LA, and Teuber SS. Food allergies and kissing. The New England Journal of Medicine 2002; 346:1833-1834.

 
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