A pineapple allergy can lead to irritation in the mouth, rashes, swelling, and — in severe cases — anaphylaxis, a life-threatening condition that needs urgent medical attention. A person with a pineapple allergy may also be allergic to other fruits, such as kiwi.

Symptoms of pineapple allergies include skin rashes, itching of a person’s mouth or lips, and tongue swelling.

This article will explain the symptoms of pineapple allergies, the cross-reactivity of a pineapple allergy, its diagnosis, and its treatment.

A pineapple fruit, which some people are allergic to.Share on Pinterest
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A pineapple allergy is an allergic reaction. A person may experience it after eating pineapple or drinking pineapple juice. People may also have an allergic reaction after touching the fruit.

Pineapple allergies are much less common than other food allergies. They can be serious and, in certain cases, can cause anaphylaxis, a life threatening condition.

The symptoms of a pineapple allergy can range from mild to severe, depending on the reaction type. A person usually experiences symptoms immediately after contact with pineapple.

A milder form of pineapple allergy includes mucosal irritation. The mucosa is the membrane that lines the inside of the body’s passages, organs, and cavities. Symptoms may include burning and soreness of a person’s oral mucosa and tongue.

Symptoms of oral allergy syndrome (OAS) usually occur immediately or several minutes after consuming pineapple, according to a 2019 research review. They include itching and swelling of the:

  • lips
  • tongue
  • throat
  • face

In severe cases, a person may experience anaphylactic shock, which is life threatening. Symptoms include:

A person who experiences anaphylactic shock needs immediate medical help.

In babies

There aren’t enough specific studies into pineapple allergies in babies to assess how the condition presents in infancy.

However, the 2019 research review mentioned previously found that pineapple was a common cause of pollen-food allergy syndrome (PFAS) in children in Mexico. PFAS is another name for OAS.

According to a 2021 research review, food allergies are usually more common in babies, and babies are usually more sensitive to allergic reactions.

Learn more about allergy reactions in babies.

Anaphylaxis: Symptoms and what to do

Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:

  • hives
  • swelling of the face or mouth
  • wheezing
  • fast, shallow breathing
  • a fast heart rate
  • clammy skin
  • anxiety or confusion
  • dizziness
  • vomiting
  • blue or white lips
  • fainting or loss of consciousness

If someone has these symptoms:

  1. Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
  2. Dial 911 or the number of the nearest emergency department.
  3. Lay the person down from a standing position. If they have vomited, turn them onto their side.
  4. Stay with them until the emergency services arrive.

Some people may need more than one epinephrine injection. If the symptoms do not improve in 5–15 minutes, or they come back, use a second pen if the person has one.

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There are several potential causes of pineapple allergy, according to 2019 research.

Pineapple contains bromelain, which is a proteolytic enzyme, meaning that it breaks down proteins. When coupled with pineapple’s acidic content, this can cause mild irritation in a person’s oral mucosa (tongue, mouth, and throat).

The body may also recognize bromelain as a threat and release histamine to protect itself. The activation of histamine release can cause allergic symptoms such as swelling, itching, and difficulty breathing.

Pineapple also contains profilin, which may cause allergies in some people. Profilin is a key mediator of cross-reactivity between certain fruits, like pineapple, and pollen. This means that people with pineapple allergies may also be allergic to other cross-reactive foods or substances.

Learn more about pollen allergies.

OAS is an allergic reaction that occurs when the proteins of certain foods are similar to those contained in certain pollens.

When these proteins and the mucous membranes inside the mouth come into contact, a local allergic reaction may occur.

A 2022 study explains that OAS occurs when people eat pineapple because the proteins contained in the fruit are similar to those in certain pollens. The symptoms of OAS are similar to those of allergic reactions, including localized itching, tingling, and swelling. Rarely, the reactions may be more severe.

Learn more about OAS.

People with a pineapple allergy may also be allergic to other fruits of the same family.

This cross-reactivity is typically not severe, and a person usually experiences only mild allergic symptoms, such as mouth or tongue itching.

However, in some rare cases, it may cause severe symptoms, such as anaphylaxis. Anaphylaxis is a life threatening reaction that requires immediate medical treatment.

According to the 2022 study mentioned earlier, the fruits that may cross-react with pineapple include:

Anaphylaxis is the most serious complication of pineapple allergy. It is a medical emergency and may be life threatening. Anaphylaxis requires immediate medical help.

Anaphylaxis symptoms include:

  • rapid heartbeat
  • difficulty breathing
  • wheezing
  • swelling of the lips, throat, or tongue
  • loss of consciousness
  • angioedema
  • diarrhea and vomiting

A person with a pineapple allergy should avoid eating both canned and fresh pineapples and drinking pineapple juice.

Other foods and products that may contain pineapple include:

  • cocktails
  • canned fruit salads
  • pineapple jam, rum, soda, soft drink, and salsa
  • banana chips
  • tropical beverages
  • candies

It is a good habit to check the ingredients label on food products to ensure they do not contain pineapple or other allergens that may cause an allergic reaction.

Substitutes

Pineapple substitutes may include:

A common method for diagnosing pineapple allergy is a skin prick test. A doctor will prick a person’s skin with a needle and then apply a drop of pineapple juice to it. If a person is allergic to pineapple, they will develop an itchy bump within minutes.

Another testing method for pineapple allergy is the pineapple allergy IgE blood test. This measures the quantity of allergen-specific IgE antibodies in the blood. This test can confirm or rule out an allergy.

Learn more about allergy testing.

There are treatment options for people with a pineapple allergy. Doctors may prescribe treatments including:

  • Antihistamines: This may help relieve allergy symptoms by blocking the action of histamine.
  • Epinephrine (EpiPen): This may be the choice to treat severe pineapple allergy reactions. Epinephrine can reduce anaphylaxis symptoms. A person must inject it and then go to the hospital for further treatment.
  • Bronchodilators: This may help relieve asthma symptoms that pineapple allergy may cause. Bronchodilators open up the airways.
  • Corticosteroids: This may help reduce the inflammation in the airways and make breathing easier.

In most cases, the mild symptoms of pineapple allergies last for minutes to hours. The most severe cases may result in anaphylaxis.

Once a healthcare professional diagnoses the allergy, a person should avoid contact with the fruit. The doctor may also prescribe taking medications such as antihistamines or carrying an EpiPen as a safety measure.

Pineapple allergy is a rare type of allergy. Its most common symptoms include localized itching and rashes. However, in some serious cases, it can cause an anaphylactic reaction, a life threatening condition that requires immediate medical treatment.

People with pineapple allergies may also experience cross-reactive reactions after eating other fruits, such as kiwi, papaya, apricot, or chestnut.

Doctors can diagnose pineapple allergy with a skin prick test or a blood test. They may also prescribe antihistamines or other types of treatment that can help a person improve their symptoms.