Q:

2/6/2013
This question is regarding a possible anaphylaxis to honey. Recently an eleven year-old boy was seen in our office. He ingested a small amount of honey and within minutes began complaining of throat tightness, difficulty breathing, facial redness and swelling. He was taken to the ER and treated there. On his visit today he was allergy tested for the most common environmental allergens including all local pollens. Allergy testing was negative. He will be avoiding all honey but the Doctor was wondering if there are any additional recommendations or documentations of similar reactions. Thank you.

A:

Thank you for your inquiry.

IgE-mediated reactions to honey are well described in the literature. It has been thought that the majority of these reactions were due to pollen, mostly of the Compositae family. However, not all reactions have been found to be due to pollen. Other components of honey have also been thought to produce reactions on occasion. Honey is a complex substance with many potential allergens intrinsic to its own components, and it has been thought in the past that allergens from the bee have caused reactions.

One of the things that you might consider is skin testing to the honey itself. You can do this by epicutaneous skin test, and there is also an in vitro anti-honey specific IgE available. If you do skin test, you should use the preparation of honey that was eaten by your patient since it could contain unique allergens not found in another source of honey.

Here is a website describing allergens in honey and reactions to honey in detail. This is also the site where you can order a serum-specific IgE to honey.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology