Cedar elm

Further Reading

Elm t8

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Code: t45
Latin name: Ulmus crassifolia
Source material: Pollen
Family: Ulmaceae
Common names: Cedar elm, Texas cedar elm

See also: Elm (White elm or American elm, Ulmus americana) t8

Closely related species:
White elm or American elm (U. americana)
Siberian elm (U. pumila)

Allergen Exposure

The elm family, Ulmaceae, contains 6 genera, the most important being Ulmus, Planera, and Zelkova. (Hackberries [Celtis spp.] used to be included in the Elm family but are more closely related to Urticaceae, and have been placed in a separate family, Celtidaceae. ( 1)) There are about 45 species of elm worldwide, found within the temperate Northern Hemisphere, with about 4 introduced species in the USA, and six native to the North American continent east of the Rocky Mountains. There are 25 species of Ulmus. (1, 2, 3)

In the 1930s, Dutch elm disease devastated white elm trees in North America, as well as in Europe. The disease, a fungal blight, was caused by the Ascomycete Ophiostoma ulmi, and transmitted through the native elm bark beetle Hylurgopinus rufipes. (4) All elms are susceptible to the fungus to some degree, in particular American elm (U. americana) and September elm (U. serotina). Chinese elm (U. parvifolia), Siberian elm (U. pumila) and red or slippery elm (U. rubra) are highly or modestly resistant. (1, 3)

Cedar elm is a deciduous tree native to south-central North America. It grows mainly in southern and eastern Texas, eastern Oklahoma, Arkansas and Louisiana, with small populations in western Mississippi, south-western Tennessee and north-western Florida. (5, 6, 7) It also occurs in north-eastern Mexico. It is the most prevalent elm in Texas. Typically, it grows well in flat river bottom areas referred to as cedar elm flats.

The cedar elm is a medium-sized to large tree, growing to 24-27 m tall, with a rounded crown. The trunk is about 75 cm in diameter. Twigs have corky wings. The leaves are small (2.5 - 5 cm long and 1.3 - 2 cm broad) and elliptical, with serrated edges, asymmetric leaf take-off on either side of the leaf stem, and a leathery, sandpapery upper surface. Cedar elm has the smallest leaves of all native North American elms.

Elm flowers are produced in the late summer or early autumn. They are greenish, small and inconspicuous, with a reddish-purple colour and short stalks at the leaf base. All elms are wind-pollinated and are prolific pollen producers. Pollination is intense over a short period of time. Individual trees may release their pollen load over a 2- to 3-day period. Cedar elm pollinates from July to October. (1) The fruit is a small winged samara 8 to 10 mm long, maturing quickly in late autumn, after the flowering.

Elms are also grown for shade and ornament. Commercially, they are used in a variety of industries for their heavy, exceedingly hard wood.

Allergen Description

No allergens have been characterised.

Potential Cross-Reactivity

Extensive cross-reactivity between the different individual species of the genus could be expected, as well as to a certain degree among members of the family Ulmaceae. (8) However, to date this has not been documented.

In a Spanish study, individuals with melon allergy were found to have a higher prevalence of asthma and an increased frequency of sensitisation to several tree and weed pollens, predominantly Ulmus and Ambrosia. (9)

Clinical Experience

IgE-mediated reactions

Intense hay fever, but not asthma, has been described. (6, 10) Although only very few reports document sensitisation to pollen from this tree, anecdotal evidence from areas where the tree is commonly found suggests that allergic sensitisation is common following exposure to the pollen. Furthermore, because of the close family relationship with white elm tree, which induces asthma, allergic rhinitis and allergic conjunctivitis, (11, 12) clinical inferences may be drawn. (See White elm t8.)

In a Canadian study that evaluated the impact of different trees on asthma, along with the association between daily hospitalisations for asthma and daily concentrations of different tree pollens in 10 large Canadian cities, it was reported that for an interquartile increase in daily tree pollen concentration, the percentage increase in daily hospitalisation for asthma was 2.63% for Ulmus. (13)

Aerobiology studies often do not draw distinctions between the various species of Ulmus, but this may not be problematic; considering the close relationship between species of elm, cross-sensitisation or cross-reactivity to Ulmus is possible, and hence inferences can be drawn, including that individuals sensitised to cedar elm may be affected in areas where white elm or other members of the genus produce pollen.

In Tampa, Florida, in the USA, where the major tree-pollen season occurs from December until May, with a minor season occurring from October to November, elm tree pollen is important during the minor season. (14)

In Cordoba, Spain, aerobiology studies have reported pollen grains from the closely related species Ulmus minor in the air. (15) In Siena, in central Italy, elm tree pollen was found to be an important aeroallergen in March, but not during the rest of the tree-pollen season, (16) whereas in Modena, in northern Italy, the elm family contributed little pollen to the air (about 1% of the total recorded). (12)

In aerobiology studies of 9 districts of northern China, the most common aeroallergens in spring were often Ulmus, Populus and Salix. (17) Elm has also been reported to be an important tree pollen in Tehran, Iran. (18)

Pollen concentrations in the atmosphere of Lublin (eastern Poland) were reported to be the highest for Betula, Pinaceae and Alnus; and the lowest for Ulmus, Fagus and Corylus. Significantly, total pollen grains for Ulmus varied almost twofold between successive years. (19) Pollen from the Ulmus species has been reported to be an important allergen in Zagreb, Poland. (20)

Compiled by Dr Harris Steinman, harris@allergyadvisor.com 


  1. Weber RW. Cedar elm. Ann Allergy Asthma Immunol 2006;96(4):A6.
  2. Simpson BJ. A Field Guide to Texas Trees. Houston, Gulf Publishing Co., 1999:332-6.
  3. Duncan WH, Duncan MB. Trees of the Southeastern United States. Athens, Georgia, University of Georgia Press. 1988:234-8.
  4. Kendrick B. The Fifth Kingdom. Waterloo, Ontario, Canada, Mycologue Publications, 1985:55,178-9.
  5. Little EL. The Audubon Society Field Guide to North American Trees: Eastern Region. New York, Alfred A. Knopf, 1980:412-27.
  6. Lewis WH, Vinay P, Zenger VE. Airborne and Allergenic Pollen of North America. Baltimore, Johns Hopkins University Press,1983:90-100,210-1.
  7. Wikipedia contributors, ‘Ulmus crassifolia’, Wikipedia, The Free Encyclopedia, http://en.wikipedia.org/wiki/Ulmus_crassifolia. Accessed 15 January 2013.
  8. Yman L. Botanical relations and immunological cross-reactions in pollen allergy. 2nd ed. Pharmacia Diagnostics AB. Uppsala. Sweden. 1982: ISBN 91-970475-09.
  9. Figueredo E, Cuesta-Herranz J, De-Miguel J, Lázaro M, Sastre J, Quirce S, Lluch-Bernal M, De las Heras M. Clinical characteristics of melon (Cucumis melo) allergy. Ann Allergy Asthma Immunol 2003;91(3):303-8.
  10. Wodehouse RP. Hayfever Plants, 2nd Ed. New York, Hafner Press. 1971:99-101.
  11. Jung K, Schlenvoigt G, Jäger L. Allergologic-immunochemical study of tree and bush pollen. II--Study of the sensitization spectrum of patients with seasonal rhinitis in the spring. [German] Allerg Immunol (Leipz) 1987;33(4):215-21.
  12. Torri P, Accorsi CA, Bandini Mazzanti M, Zagni AM. A study of airborne Ulmaceae pollen in Modena (northern Italy). J Environ Pathol Toxicol Oncol 1997;16(2-3):227-30.
  13. Dales RE, Cakmak S, Judek S, Coates F. Tree pollen and hospitalization for asthma in urban Canada. Int Arch Allergy Immunol 2008;146(3):241-7.
  14. Bucholtz GA, Lockey RF, Wunderlin RP, Binford LR, Stablein JJ, Serbousek D, Fernandez-Caldas E. A three-year aerobiologic pollen survey of the Tampa Bay area, Florida. Ann Allergy 1991;67(5):534-40.
  15. Ruiz de Clavijo E, Galán C, Infante F, Domínguez E. Variations of airborne winter pollen in southern Spain. Allergol Immunopathol (Madr) 1988;16(3):175-9.
  16. Murgia M, De Dominicis V, Cresti M. The pollen calendar of Siena (Central Italy). Allergol Immunopathol (Madr)1983;11(5):361-5.
  17. Li WK, Wang CS. Survey of air-borne allergic pollens in North China: contamination with ragweed. N Engl Reg Allergy Proc 1986;7(2):134-43.
  18. Shafiee A. Atmospheric pollen counts in Tehran, Iran, 1974. Pahlavi Med J 1976;7(3):344-51.
  19. Weryszko-Chmielewska E, Piotrowska K. Airborne pollen calendar of Lublin, Poland. Ann Agric Environ Med 2004;11(1):91-7.
  20. Peternel R, Culig J, Mitić B, Vukusić I, Sostar Z. Analysis of airborne pollen concentrations in Zagreb, Croatia, 2002. Ann Agric Environ Med 2003;10(1):107-12.


As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.