Kahn in 1942 was the first to document immediate hypersensitivity to mango in a female patient, who also suffered from hay fever. Allergic reaction to mango was first described in 1939, by Zakon in a 29-year-old female who developed acute vesicular dermatitis involving lips and circumoral area, 24 h after eating a mango. the immediate hypersensitivity reaction presenting as anaphylaxis, angioedema, erythema, urticaria, wheezing dyspnoea and the late reaction presenting as contact dermatitis and periorbital edema. Allergy to mango can manifest in two forms viz. Despite the large consumption of mangoes, especially in India, hypersensitivity reactions to mango are distinctly rare. By the 10th century AD, cultivation of mango had begun in East Africa and later in Brazil, the West Indies and Mexico and is now cultivated in most frost-free tropical and warmer subtropical climates including Spain and Australia. Nearly half of the world's mangoes are cultivated in India alone and is the country's national fruit. Native to southern Asia, especially India and Burma, mango has been cultivated in the Indian subcontinent for thousands of years. During season, it is eaten as fresh fruit, shakes and ice creams while off season, it is available as pickles, juices and jams. It is partaken in many forms, both during as well as off season. The fruit mango ( Mangifera indica) belongs to the family Anacardiacae and is often, regarded as the 'king of fruits'. It is imperative to recognize such a phenomenon early so as to avoid potentially severe clinical reactions in susceptible patients. Reactions may even occur in individuals without prior exposure to mango, owing to cross reactivity. Although rare, it can even result in a life threatening event.
The fruit mango can cause immediate and delayed hypersensitivity reactions, as also "oral allergy syndrome". The clinical features, pathogenesis and diagnostic modalities of both these presentations are highlighted. Ten of these patients (four with immediate reaction six with delayed reaction) were from geographical areas cultivating mango, whereas twelve patients (six with immediate reaction six with delayed reaction) were from the countries where large scale mango cultivation does not occur. A total of 17 reports describing 22 patients were documented, including ten patients with immediate hypersensitivity reaction and twelve patients with delayed hypersensitivity reaction to mango. The bibliographies of all papers thus located were searched for further relevant articles. An extensive search of the literature was performed in Medline/PubMed with the key terms "mango", "anaphylaxis", "contact dermatitis", "cross-reactivity", "food hypersensitivity", "oral allergy syndrome" and "urticaria". The objectives of this study are 1) To review the published data and document the current knowledge on allergic manifestations to the fruit mango 2) To highlight the two distinct clinical presentations of hypersensitivity reactions caused by mango 3) To discuss the role of cross-reactivity 4) To increase awareness of potentially life threatening complications that can be caused by allergy to mango.
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