Indian jujube (Ziziphus Mauritiana Lam) is a sweet fruit from a tree native to tropical and subtropical regions of Asia and India. A few case reports have implicated Indian jujube to cause latex-fruit syndrome. We present the first case of an anaphylactic reaction to this fruit in a patient with no latex allergy. A 55-year-old male was referred to the Outpatient Allergy Clinic at Queen’s University for evaluation of anaphylaxis caused by ingestion of Indian jujube. He presented to the Emergency Department (ED) with scalp pruritus, dyspnea and generalized urticaria, which occurred two hours after he had consumed a homemade candied fruit cocktail consisting of Indian jujube, water, Thai and Indian sweetener. In the ED, he was treated with epinephrine, intravenous diphenhydramine and steroids. He did not have any previous history of environmental or food allergies but had consumed this fruit frequently since childhood. In clinic, he underwent skin-prick testing with a saline slurry of candied jujube, which resulted in a positive wheal and flare response with appropriate controls. On subsequent visit, skin-prick tests were performed with saline slurries of the Thai and Indian sweetener used to make the cocktail. Both tests were negative when applied to a healthy volunteer. Skin-prick testing to latex allergen and latex specific IgE were both negative. He was diagnosed with an IgE-mediated anaphylactic reaction to the Indian jujube fruit. He was advised to avoid consumption of Indian jujubes and carry an epinephrine autoinjector. Anaphylaxis secondary to Indian jujube ingestion is an extremely rare phenomenon in patients without a latex allergy. A possible allergy to Indian jujube should be taken into consideration when working up anaphylaxis, especially in patient of Asian and Indian descent who have ceased regular consumption of the fruit.

中文翻译：

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印度枣（Ziziphus Mauritiana Lam）过敏反应的罕见病例。

印度枣 (Ziziphus Mauritiana Lam) 是一种甜果，来自原产于亚洲和印度热带和亚热带地区的树。一些病例报告表明印度枣会引起乳胶果综合征。我们在没有乳胶过敏的患者中介绍了对这种水果的第一例过敏反应。一名 55 岁男性因摄入印度枣引起的过敏反应被转诊至皇后大学过敏门诊部。他在食用由印度枣、水、泰国和印度甜味剂组成的自制蜜饯鸡尾酒两小时后，因头皮瘙痒、呼吸困难和全身性荨麻疹而到急诊室就诊。在急诊室，他接受了肾上腺素、静脉注射苯海拉明和类固醇治疗。他以前没有任何环境或食物过敏史，但从小就经常食用这种水果。在临床上，他用蜜枣盐水浆进行了皮肤点刺测试，在适当的对照下，结果显示阳性风团和耀斑反应。在随后的访问中，对用于制作鸡尾酒的泰国和印度甜味剂的盐浆进行了皮肤点刺测试。当应用于健康志愿者时，这两项测试均为阴性。乳胶过敏原和乳胶特异性 IgE 的皮肤点刺试验均为阴性。他被诊断出对印度枣果实有 IgE 介导的过敏反应。建议他避免食用印度枣并携带肾上腺素自动注射器。继发于印度枣摄入的过敏反应在没有乳胶过敏的患者中是一种极为罕见的现象。在进行过敏反应时，应考虑可能对印度枣过敏，尤其是对于已停止经常食用该水果的亚洲和印度血统的患者。