Allergy to kiwi fruit appears increasingly common, but few studies have evaluated its clinical characteristics.

273 subjects with a history suggestive of allergy to kiwi completed a questionnaire. 45 were investigated by double blind placebo controlled food challenge (DBPCFC), prick-to-prick skin testing with fresh kiwi pulp, and measuring CAP specific IgE. 19 subjects were also skin tested using a commercially available solution.

The most frequently reported symptom was oral pruritus (65%), but severe symptoms (wheeze, cyanosis or collapse) were reported by 18% of subjects. Young children were significantly more likely than adults to react on their first known exposure (p<0.001), and to report severe symptoms (p=0.008). 23 of 45 subjects (50%) had allergy confirmed by DBPCFC. Prick to prick skin test with fresh kiwi was positive in 95% of subjects who had allergy confirmed by DBPCFC, but also in 69% of subjects with a negative food challenge. The commercial extract was significantly less sensitive, but with fewer false positive reactions. CAP sIgE was only positive in 60% of subjects who had a positive challenge.

DBPCFC confirmed allergy to kiwi fruit in 50% of the subjects tested, who had a previous history suggestive of kiwi allergy. Skin testing with fresh fruit has good sensitivity (95%), but poor specificity (31%) in this population. CAP sIgE and a commercially available skin test solution were both much less sensitive (60%; 72%) but had better specificity (83%; 67%). Kiwi fruit should be considered a significant food allergen particularly for young children.