Persimmon (Kaki fruit, Sharon fruit) is a food which may result in allergy symptoms in sensitised individuals.

Allergen Exposure

The persimmon tree is native to China and Japan, where it has been cultivated for centuries. It was introduced to Europe and California in the mid-19th century. It is commercially grown in Italy, Spain and the south of France, where it is known as kaki, but it is still most common in the Far East.

Persimmon fruits are eaten fresh, dried, cooked, and canned. They are high in glucose and protein, and also have various medicinal and chemical uses.

Allergen Description

Various allergens present in persimmon have been characterised including a Bet v 1 homologue, a profilin, an isoflavone reductase, as well as a pectin methylesterase inhibitor of unknown allergenic potential.

Potential Cross-Reactivity

Cross-reactivity with pollen allergens as a result of the presence of a profilin and Bet v 6-like and Bet v 1-like allergens has been reported.

A study suggested that homologous allergens may be present in many plant foods, such as apple, peach, orange, lychee, strawberry, persimmon, zucchini, and carrot.

Pollen-allergic patients frequently present allergic symptoms after ingestion of several kinds of plant-derived foods. The majority of these reactions are caused by structures similar to those found in many plant foods such as apple, peach, orange, lychee, strawberry, persimmon, zucchini, and carrot.

Clinical Experience

Anecdotal evidence suggests that persimmon can occasionally induce symptoms of food allergy in sensitised individuals; however, few studies have been reported to date.

Oral allergy to persimmon has been reported. One study of 3 patients reported that after the ingestion of persimmon, the first reacted with pruritus, penis oedema, urticaria, and asthma; the second with nausea and vomitus; and the third with rhinoconjunctivitis, asthma, and stomachache.

A 13-month-old Japanese male infant was seen following a reaction to persimmon upon first ingestion. Symptoms included skin rash and itching on the face and soles of the feet. The symptoms had appeared immediately after biting a fresh persimmon and the itching on the soles persisted for more than 13 hours, despite treatment with oral antihistamines.

A case was reported of a 33-year-old man with an anaphylactic reaction immediately after ingestion of persimmon fruit. A skin-prick test with persimmon fruit was positive.

In another case of anaphylaxis, a 20-year-old man reported itching, generalised urticaria, facial oedema, asthma, gastrointestinal symptoms and diarrhoea 10 minutes after eating a fresh persimmon fruit. Prick-to-prick and SPT were positive.

Other reactions

Some patients complain of abdominal distension and excessive flatus after ingesting persimmon, and these reactions were attributed to fructose intolerance.

Persimmon phytobezoar, although in general an infrequent entity, is not rare in some countries. Most patients with bezoars have ingested unpeeled fruits. Small bowel obstruction in children due to persimmon phytobezoars may occur.

Lycopenaemia is a benign condition, secondary to an excessive dietary intake of lycopene-rich fruits. It was described in a 68-year-old Caucasian woman who presented with red-orange-tinged skin on her palms and soles. Her diet included about 1 kg of persimmon daily. The discolouration of the palms and soles resulted from pigment deposits, due to the slow conversion of carotene to vitamin A. This condition resolved after changes in her dietary habits.