Cases reported "Food Hypersensitivity"

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11/56. Severe oral allergy syndrome and anaphylactic reactions caused by a Bet v 1- related PR-10 protein in soybean, SAM22.

    BACKGROUND: Anaphylactic reactions to soy products have been attributed to stable class 1 food allergens. OBJECTIVE: IgE- mediated reactions to a soy-containing dietary food product in patients allergic to birch pollen were investigated. methods: Detailed case histories were taken from 20 patients. Their sera were analyzed for IgE (UniCAP) specific for birch, grass, mugwort, the recombinant birch allergens rBet v 1 and rBet v2, and soy protein. Extracts from birch pollen, soy isolate, rBet v 1, and the recombinant PR-10 soy protein rSAM22 were coupled to paper disks or nitrocellulose for IgE measurements (enzyme allergosorbent test) or Western blot analysis. Enzyme allergosorbent testing, Western blot inhibition, and histamine release studies were performed with the same allergens. RESULTS: Most patients (17/20) experienced facial, oropharyngeal, and/or systemic allergic symptoms within 20 minutes after ingesting the soy product for the first time. Birch pollen allergy (16/20) was common, along with oral allergy syndrome to apple (12/20) or hazelnut (11/20). IgE levels to birch and Bet v 1 but not to other inhalants were high in 18 of 20 patients. Significant IgE binding to rSAM22 occurred in 17 of 20 patients. Blot experiments with the soy isolate revealed IgE-binding bands at 17 kd (15/20), 22 kd (1/20), and 35 to 38 kd (2/20); the former was inhibited by preincubation of the sera with rBet v 1 or rSAM22. Birch extract and soy isolate, rBet v 1, and rSAM22 induced dose-dependent histamine release in the nanomolar range. CONCLUSION: Immediate-type allergic symptoms in patients with birch pollen allergy after ingestion of soy protein-containing food items can result from cross-reactivity of Bet v 1 -specific IgE to homologous pathogenesis-related proteins, particularly the PR-10 protein SAM22.
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keywords = histamine
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12/56. Food-dependent, exercise-induced anaphylaxis: first case report in thailand.

    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.
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keywords = headache
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13/56. anaphylaxis to Linum.

    BACKGROUND: flax (Linum usitatissimum) seeds are increasingly used in bread and as laxatives. hypersensitivity to linseeds has been infrequently described, and we report a case of anaphylaxis induced by linseed ingestion in a 39-year-old woman. methods AND RESULTS: The clinical course, as well as positive skin prick tests and histamine release tests performed with linseed extracts, suggested a type I hypersensitivity as the underlying cause for the patient's multisystemic involvement. The presence of linum-specific IgE in her serum was confirmed by immunoCAP assay. CONCLUSION: Linum seeds might be a source of allergic sensitization that should be taken into account due to its widespread distribution at health food stores.
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keywords = histamine
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14/56. Occupational asthma due to freeze-dried raspberry.

    OBJECTIVE: To investigate the possibility that inhalation of raspberry powder at work can cause occupational asthma. methods: We report the case of a 35-year-old, nonsmoking woman who complained of hay fever symptoms, wheezing, and shortness of breath two or three times a month exclusively in association with coating chewing gum with raspberry powder. Prick test extracts with the five types of fruit powder were produced. peak expiratory flow rate monitoring five times daily was performed for an 8-week period while the patient was at work. Specific IgE and histamine release tests for raspberry powder were performed. Breathing zone dust measurements were taken. RESULTS: Baseline lung function and histamine provocation test results were normal. During the 8-week monitoring period, 5 episodes of reduced peak expiratory flow rate were demonstrated. Each period was directly related to working with raspberry powder. A 9-mm prick test result positive for raspberry powder was seen (histamine control, 9 mm). In addition, the result of a radioallergosorbent test for raspberry was positive (0.84 kUA/L). The result of a histamine release test with raspberry powder from work was negative. Breathing zone total dust measurement was 5.9 mg/m3. CONCLUSIONS: To our knowledge, this is the first description of occupational asthma due to the inhalation of raspberry powder. The symptoms of the patient described herein disappeared after she was moved to another part of the factory. Hygienic improvements were performed at the workplace to reduce the sensitization risk of other workers.
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keywords = histamine
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15/56. Grape anaphylaxis.

    Grape allergy is particularly rare in spite of the vast extension of vitis vinifera cultivation on all continents. We report on the case of a 28-year-old woman who presented with allergic systemic reaction after eating white grapes (vitis vinifera). She complained of two severe episodes of anaphylaxis after eating grapes, with generalized pruritus, acute generalized urticaria, facial swelling, lip and oropharingeal angioedema, and dysphagia. Both the episodes were treated at the Emergency Room level, with parenteral administration of corticosteroids and antihistamines. skin prick tests with commercial extract of grapes provided a negative result, while prick by prick procedure performed with white grapes and white grape juice yielded a positive result. Grape-specific serum IgE were also detected. We conclude that in the diagnosis of grape allergy the currently available commercial extracts might not be completely reliable and the prick-by-prick procedure with fresh grapes should always be performed.
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keywords = histamine
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16/56. Oral disodium cromoglycate and ketotifen for a patient with eosinophilic gastroenteritis, food allergy and protein-losing enteropathy.

    We present a case report of a 10 years old boy with protein-losing enteropathy and eosinophilic gastroenteritis who had positive histamine release tests, increased allergen-specific IgE antibodies to some food items, and low levels of total serum protein and albumin. Upper gastrointestinal endoscopy revealed a number of polyps and diffuse gastritis. biopsy specimens of the stomach and duodenum showed widespread eosinophilia and neutrophilia. Although a restricted diet was recommended, a diet which excluded foods with positive results to both histamine release test and allergen-specific IgE antibodies was poorly tolerated, and the patient rejected systemic administration of corticosteroids. Thus, we initiated an oral disodium cromoglycate (DSCG) and ketotifen therapy. After oral DSCG and ketotifen administration, the patient's condition improved gradually. Therefore, oral DSCG and ketotifen therapy might be considered as treatment option in patients with eosinophilic gastroenteritis and protein-losing enteropathy caused by food allergy.
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keywords = histamine
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17/56. Late-onset anaphylaxis to fermented soybeans: the first confirmation of food-induced, late-onset anaphylaxis by provocation test.

    BACKGROUND: Late-onset anaphylactic reactions without early-phase reactions are rarely reported. The hypothesized mechanism of late-onset anaphylaxis to fermented soybeans is delayed absorption or release into the bowel rather than an immunologic phenomenon. OBJECTIVES: To investigate the mechanisms of late-onset anaphylaxis to fermented soybeans in 2 patients and to characterize the allergens involved in anaphylaxis caused by fermented soybeans. methods: Two patients underwent skin prick-by-prick tests with fermented soybeans as is. We used an open challenge for the provocation test of anaphylaxis and measured changes in plasma histamine, plasma tryptase, serum eosinophil cationic protein, and plasma leukotriene b4 levels in 1 patient. In addition, specific IgE against fermented soybeans and the allergens of fermented soybeans were detected by enzyme-linked immunosorbent assay and immunoblotting, respectively. RESULTS: The results of the prick-by-prick tests with fermented soybeans as is were positive in both patients and negative in control subjects. The challenge with 50 g of fermented soybeans caused generalized urticaria and dyspnea 13 hours after ingestion of fermented soybeans in 1 patient. In addition, his plasma histamine and tryptase levels transiently elevated during the anaphylactic event. In enzyme-linked immunosorbent assay, the patients showed elevated IgE levels to the proteins of fermented soybeans. serum IgE antibodies of patients 1 and 2 were bound to approximately 5- and 26-kDa proteins in immunoblotting of fermented soybeans, respectively. CONCLUSION: To our knowledge, this is the first report of late-onset anaphylaxis provoked by the challenge test half a day after ingestion of fermented soybeans.
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ranking = 1
keywords = histamine
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18/56. Allergy to sunflower seeds.

    A case of oral syndrome after eating sunflower seeds is reported. Sensitization has been probably through inhalant route when using these seeds to feed birds. skin prick tests with a fresh macerate of sunflower seeds has been clearly positive (greater than histamine control) but commercial extracts have given borderline positivity and specific IgE to sunflower was strongly positive.
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keywords = histamine
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19/56. urticaria associated with parenteral nutrition.

    We report a 53-year-old female patient with short bowel syndrome who developed urticaria after administration of cyclic parenteral nutrition (PN). The urticaria occurred 2 hours into the 12-hour nocturnal infusion and resolved completely 1 hour after discontinuation of the PN infusion. The urticaria occurred despite removing lipids from the 3-in-1 PN solution. The urticaria did not occur when the multivitamin preparation was removed from the PN. Upon rechallenge with a PN solution containing a multivitamin, the urticaria reoccurred. Prick skin testing using the multivitamin in increasing aliquots was negative. serum tryptase and 12-hour urinary histamine level during PN infusion containing the multivitamin was unchanged compared with baseline measurements. The patient had no allergic reaction using a similar dose of an oral multivitamin. This case illustrates that allergic reactions from PN infusion may occur and that the multivitamin preparation can be the cause.
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ranking = 0.5
keywords = histamine
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20/56. latex-vegetable syndrome due to custard apple and aubergine: new variations of the hevein symphony.

    An increasing number of vegetables with crossreactions to latex are being described in patients with latex-vegetable syndrome. We present two of these vegetables, custard apple linked in two previous cases with latex sensitisation, and aubergine, that had not been described up to now in patients with latex sensitisation. The diagnosis of both cases was based on the clinical history, positive skin prick test (SPT) and specific IgE to the offending vegetables, as well as to positive SPT and specific IgE levels to latex and the major fruits involved in the latex-fruit syndrome (avocado, banana, and chestnut). Further, crude extracts from latex, custard apple and aubergine, as well as the purified allergens Hev b 6.02 and Prs a 1 were used in in vitro and in vivo assays: IgE immunodetection, histamine release (HRT) and basophil activation (BAT) tests and skin prick tests. In case 1, both purified Hev b 6.02 and Prs a 1 induced positive responses in skin prick tests, high levels of basophil activation and histamine release. Specific IgE immunodetection uncovered a reactive band of 45 kd in the crude custard apple extract, which was also recognized by anti-chitinase monospecific antibodies. The serum from patient 1 also detected Prs a 1 in immunodetection. Hev b 6.02 produced positive skin responses and showed high biological activity in HRT and BAT in the case of patient 2. However, Prs a 1 was reactive neither in SPT nor in IgE immunodetection. In fact, no band was detected using the serum of patient 2 in avocado or aubergine extracts. By contrast, Prs a 1 reached high values of basophil activation and over 10% of histamine release in case 2.
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keywords = histamine
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