An evaluation of banana allergy in children living in the Mediterranean region

Background/aim: We aimed to apply a double-blind placebo-controlled food challenge (DBPCFC) test to patients who reported a reaction to banana and showed positivity for banana-specific IgE in Turkey. Materials and methods: Medical data of patients who had been analyzed for banana allergy were reviewed, focusing on banana-specific IgE positivity at the Department of Pediatric Allergy-Immunology at the Akdeniz University Faculty of Medicine between the years 2004 and 2012. Patients were called to the clinic for a DBPCFC test. Results: A total of 47 patients participated. We determined reactions in 13% of DBPCFC patients. A cut-off value was determined as 0.66 kU/L for banana-specific IgE, and sensitivity and specificity were 83% and 51%, respectively. The positive predictive value for specific IgE was 20% while the negative predictive value was 96%. Sensitivity and specificity for banana prick-to-prick test (P + P) was 33% and 93%, respectively; positive predictive value was 40% and negative predictive value was 91%. Conclusion: This is the first study conducted in Turkey to use a DBPCFC test in the diagnosis of banana allergy. Up until now, the positive predictive value was not defined for banana-specific IgE. Our study showed that specific IgE or skin tests alone are not adequate for the diagnosis of food allergy; to define subjective symptoms related to food and to determine cross-reactions, DBPCFC tests should be done for confirmation.