It is difficult to do an estimation of prevalence of watermelon
allergy due to differences in study populations (latex allergy, pollen
allergy, food allergy, fruit allergy, etc.), differences in dietary habits,
geographical areas, or differences in diagnostic procedures. Prevalence
data are based on different diagnostic procedures. While the prevalence
of sensitization can be estimated by SPT, RAST, and immunoblot, a clinical
relevant sensitization (allergy) is evaluated by convincing history or
food challenge tests (ideally by DBPCFC).
1.1 Subjects with Atopic or Other Diseases
| Country / Subjects | Allergy / Sensitization | References |
| Italy, Florence
54 episodes of food-dependent anaphylaxis in 44 children (age of 1 month to 16 years) (from 1994-1996) |
watermelon 1.9% | Novembre et al. 1998 |
| Italy, Genoa
132 pollen and food sensitive patients |
watermelon 0.7% (self-reported) | Troise et al. 1992 |
| Italy, Milan
262 fruit and/or vegetable allergic patients |
watermelon >5% and <10% (clinical history) | Ortolani et al. 1988 |
| Italy, Milan
100 fruit and/or vegetable allergic patients |
watermelon 4% (clinical history) | Ortolani et al. 1989 |
| Spain, Madrid
19 patients with confirmed allergy to melon |
watermelon 32%
(DBPCFC or convincing episode of anaphylaxis) |
Rodríguez et al. 2000 |
| Spain, Madrid and Toledo
Patients with allergy to Rosaceae fruits a) 11 without pollinosis (mean age 26 years) b) 22 with associated pollinosis (mean age 22 years) |
watermelon a) 0% and b) 18%
(Clinical history and SPT and/or RAST) |
Fernandez-Rivas et al. 1997 |
| Spain, Plasencia (Caceres)
a) 262 patients with pollinosis b) 24 melon allergic patients |
a) watermelon 3.8% (self-reported)
b) watermelon 33% (SPT) |
Garcia-Ortiz et al. 1995 |
| Spain, Salamanca
57 fruit allergic patients (age of 6-56 years, mean 21.5) |
watermelon 19% (clinical history) | Garcia Ortiz et al. 1998 |
| USA, Rochester, NY
a) 2067 allergic patients including b) 1447 with pollinosis c) 90 patients who report symptoms of oral pruritus to melon and/or banana |
a) watermelon 2.4%
(cause of oral pruritus, interview survey; all cases occurred in subgroup b) c) watermelon 56% (oral pruritus, interview survey) |
Anderson et al. 1970 |
| USA, Long Beach, CA
137 patients with latex allergy |
watermelon 4.1% (convincing history of possible IgE mediated symptoms occurring within 60 minutes of ingestion) | Kim & Hussain 1999 |
1.3 Prevalence of Associated Allergies
| Country / Subjects | Sensitization / Allergy | References | ||||||||||||||||||||||||
| USA, Detroit, MI
192 patients allergic to watermelon, cantaloupe, honeydew melon, cucumber, zucchini, banana, and/or ragweed pollen |
|
Enberg et al. 1987 | ||||||||||||||||||||||||
| USA, Detroit, MI
63 patients sensitive to watermelon |
ragweed pollen 95% (RAST) | Enberg et al. 1987 |
2 Symptoms of Watermelon Allergy
| Symptoms & Case Reports | References |
| Systemic reactions
anaphylaxis (5) Symptoms of skin and mucous membranes
Gastrointestinal symptoms
Respiratory symptoms
|
(1) Enberg et al. 1987
(2) Jordan-Wagner et al. 1993 (3) Temesvari & Becker 1993 (4) Garcia Ortiz et al. 1998 (5) Novembre et al. 1998 (6) Reindl et al. 2000 |
| Onset of Symptoms
Onset of symptoms within 5 min after ingestion lasting from 15 to 120 minutes (26 watermelon allergic patients) (1) |
(1) Enberg et al. 1987 |
3 Diagnostic Features of Watermelon Allergy
| Parameters / Subjects | Outcome | References |
| Gender of Patients
a) 26 watermelon allergic patients (10 to 71 years of age, mean 34 years) b) 29 watermelon sensitive patients (10 to 67 years of age) |
a) 77% of patients were male
b) 58% of patients were male; all 6 symptomatic patients were male |
Enberg et al. 1987
Enberg et al. 1988 |
| Specific IgE
26 watermelon allergic patients (10 to 71 years of age, mean 34 years) |
Watermelon specific IgE:
6.9 +/- 4.2 (units unknown) (control group: 1.02 +/- 0.25) |
Enberg et al. 1987 |
| IgE and Clinical Relevance
29 watermelon sensitive patients (with specific serum IgE) |
21% of patients were clinically symptomatic | Enberg et al. 1988 |
| IgE, IgG Subtypes
29 watermelon sensitive patients |
Neither levels or binding patterns of IgE, IgG1, or IgG4 specific for watermelon allergens in IEF-PAGE immunoblot were predictive of symptomatic or asymptomatic subjects | Enberg et al. 1988 |
| IgE and Clinical Relevance
13 patients with clinical symptoms to watermelon, cucumber, carrot, and/or celery |
6 patients had detectable specific IgE to one or more of the 4 foods | Jordan-Wagner et al. 1993 |
| SPT, Fresh Food and Commercial Extracts
10 watermelon allergic patients |
Positivity in SPT:
Fresh food 60% Commercial extract 20% |
Garcia-Ortiz et al. 1995 |
| Proteins / Glycoproteins | Allergen Nomenclature | References |
| Allergens: 15, 28, 29, 30, 37, 40, 70, and 90 kDa | Jordan-Wagner et al. 1993 |
| Extract / Purified Allergens | Methods | References |
| Protein extract | Fresh watermelon was diced, liquified in a blender, and centrifuged | Enberg et al. 1987 |
| Protein extract | Fresh watermelon without rind and seeds was blenderized, added to ammonium hydrogencarbonate buffer (1:1, v/v), and stirred overnight at 4°C; afterwards centrifuged, filtered, dialyzed, frozen and freezedried | Jordan-Wagner et al. 1993 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Watermelon: (fruits,
vegetables, pollen)
cucumber, carrot, celery, and mountain cedar pollen |
Pooled serum from 6 patients allergic to watermelon,
cucumber, carrot, and/or celery: EAST inhibition
Almost identical inhibition curves of IgE binding between the 4 foods as inhibitors or solid phase bound extracts; lower maximal inhibition of 60 to 70% by mountain cedar pollen; immunoblot inhibition Mutual inhibition of IgE binding to a 15 kDa allergen present in all 4 food extracts and inhibition of all other IgE binding proteins by all food extracts with the exception of a 28 kDa allergen in watermelon (which was detected by only one serum in SDS-PAGE immunoblot); no inhibition by mountain cedar pollen extract |
Jordan-Wagner et al. 1993 |
| Watermelon: (vegetables)
zucchini |
4 zucchini allergic patients: Approximately 45% inhibition
of IgE binding by watermelon extract to zucchini extract with 2 sera (EAST
inhibition)
With 2 sera most of zucchini proteins above 29 kDa were inhibited by watermelon extract; with 1 serum 2 zucchini proteins with approximately 15 kDa were inhibited completely by watermelon extract (immunoblot inhibition) |
Reindl et al. 2000 |
| Watermelon: (pollen)
ragweed pollen |
Pooled serum from watermelon allergic
patients: Strong inhibition of IgE binding to watermelon extract by ragweed
pollen extract and vice versa, but significant differences in slopes of
inhibition curves of watermelon and ragweed pollen indicating only partial
identity of allergens (RAST inhibition)
6 watermelon allergens with identical pI to ragweed allergens were detected (IEF-PAGE immunoblot) |
Enberg et al. 1987 |
| Reported Adverse Reactions | References |
| Food / Food additives
After ingestion of fresh fruits (1) |
(1) see 2 Symptoms of Watermelon Allergy |