| A forty-year-old military personnel presented with generalized urticaria, syncope, shortness of breath and headache associated with jogging after ingestion of a taro-filled bun and a red bean-filled bun. skin prick test was positive for bread, taro and wheat but negative for red bean and preservative. exercise challenge tests were performed. exercise alone failed to induce any allergic reaction but exercise following ingestion of a taro-filled bun and a red bean-filled bun induced generalized urticaria. Since the patients stopped taking these types of food, the urticaria has not returned. This is the first case report of food-dependent, exercise-induced anaphylaxis in thailand. ( info) |
| BACKGROUND: Despite its worldwide and abundant consumption, beer has rarely been found to cause anaphylaxis. Barley malt contained in lager beers seems to be an important elicitor. OBJECTIVE: To report the unusual case of severe anaphylaxis following the ingestion of wheat beer. methods: A 59-year-old man experienced angioedema, generalized urticaria, and unconsciousness after ingestion of wheat beer. He tolerated lager beer well. For diagnostic evaluation, skin prick tests, oral challenge tests, and identification of specific IgE antibodies were performed. RESULTS: skin prick test results with standard series of common aeroallergens and food allergens were negative with the exception of a 1 reaction to wheat flour. The results of skin prick tests with native materials were positive for 2 brands of wheat beer and wheat malt shred but negative for baker's yeast, hops, and a brand of lager beer. Oral challenges with wheat beer or wheat flour elicited urticaria. By CAP-FEIA, specific IgE antibodies to wheat and barley flour but not to hops or baker's yeast were found in serum. Immunoblot analysis revealed that patient's IgE was bound to a protein of approximately 35 kDa in wheat extract. CONCLUSIONS: This is the first report, to our knowledge, on anaphylaxis to beer attributable to wheat allergy. ( info) |
3/5. Systemic urticaria in an infant after ingestion of processed food that contained a trace quantity of wheat. BACKGROUND: Wheat is a food allergen that occasionally causes a systemic allergic reaction; however, little is known about the quantities of wheat allergen required to evoke allergic symptoms. OBJECTIVE: To report the case of a wheat allergic boy who experienced systemic urticaria and angioedema within 40 minutes after the ingestion of 9 g of packed rice crackers. methods: A skin prick test and IgE immunoblotting with wheat proteins were performed. Contamination of wheat protein in the offending rice cracker and other processed rice crackers from local food retail outlets, with labels that did not mention wheat, was examined with enzyme-linked immunosorbent assaying. RESULTS: A skin reaction to wheat was positive. IgE-bound bands were observed with water- and salt-soluble wheat protein and ethanol-soluble wheat gliadin in immunoblotting. A trace quantity of wheat protein, 1.50 microg/g, was determined in the offending rice cracker. In addition, 3 of 8 other kinds of processed rice crackers were contaminated by wheat protein, with levels ranging from 0.26 to 1.13 microg/g. CONCLUSIONS: Approximately 13.5 microg of wheat protein can elicit a systemic adverse reaction in highly sensitive, wheat allergic individuals. The present study confirms the need for control of contamination of food by nondeclared proteins. ( info) |
4/5. Occupational asthma: a case of Baker's asthma. asthma is one of the most prominent respiratory diseases worldwide. It is defined by airflow limitation and/or airway hyperresponsiveness and can be exacerbated by a number of environmental allergens. When allergic asthma exacerbations are attributed to stimuli in a particular work environment, then occupational asthma must be considered. incidence estimates vary, but in 1999 the Surveillance of work-Related and Occupational Respiratory disease in the United Kingdom estimated 4293 incident cases of occupational respiratory disease, an increase of 1427 cases over the previous year. Occupational asthma represented 26% of these cases. Baker's asthma is one of the most frequently reported types of occupational asthma in several countries. Diagniostic steps include thorough history, careful exam, and demonstration of functional reversible airflow obstruction. Treatment modalities used for occupational asthma are similar to those used in the management of other forms of asthma, with particular attention to reducing the level of exposure to the inciting allergen. ( info) |
5/5. A woman with daily headaches. headache, and migraine in particular, is the main neurological reason for consultation. We present the case of a 48-year-old woman who experienced a transformation of her episodic migraine attacks into daily headache episodes due to the ingestion of biscuits containing wheat as their main ingredient. This experience emphasises that a good clinical interview remains the most important point in the diagnosis and management of headache. ( info) |