Lipid transfer protein allergy

LTP allergy is a type of food allergy. Food allergy happens when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals such as histamine in response. It is the release of these chemicals that causes the allergic symptoms.

Most LTPs are in the peel and pips of plant foods. Whilst fresh or raw foods can cause a reaction, the following foods are likely to contain higher levels of LTPs as they contain the peel and pips.

• Concentrated, processed, preserved, or fermented fruits or vegetables.
• Dried fruit peel.
• Foods made using whole unpeeled fruits or vegetables such as smoothies, juices, jams, desserts.

If you are diagnosed with LTP allergy, you only need to avoid the foods which cause your symptoms. Not all LTP-containing foods will cause an allergic reaction for you and it’s important not to cut them out of your diet if you don’t need to. You may be able to tolerate certain foods if they are peeled or the pips have been removed. Discuss this with your allergy specialist and follow their advice.

Unfortunately, the amount of LTP in foods may vary so it can be hard to predict when a reaction may happen. Common foods involved in LTP allergy in the UK include:

• peanuts
• hazelnuts
• almonds
• walnuts
• apples
• stone fruits
• dried fruit
• lettuce
• tomatoes
• foods containing concentrated forms of tomato such as pizza.

If you think you may have LTP allergy, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI)

It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious.

Once you get a referral, the consultant will discuss your medical history and symptoms with you. They might suggest skin prick, blood tests, and food challenge tests to help diagnose the allergy and work out how serious it may be.

If you have mild allergic symptoms, you may be prescribed antihistamine tablets. If you are at higher risk of anaphylaxis, you may be prescribed adrenaline to use in an emergency.

Adrenaline comes in pre-loaded adrenaline auto-injectors (AAIs) that are designed to be easy to use. Make sure you know how and when to use them. Ask your healthcare professional to show you how to use your specific brand of AAI. You can also find help and training videos on the manufacturer’s website and get a free trainer device to practise with.

You must carry two AAIs with you at all times, as you may need to use a second one if your symptoms don’t improve after five minutes or get worse.

The uncertainty about which foods might cause a reaction, and what might make a reaction worse, can make managing your LTP allergy particularly difficult. Always carry your prescribed medicine and make a clear allergy action plan with your allergy specialist.