Cases reported "Food Hypersensitivity"

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1/12. Anaphylactic reaction to young garlic.

    BACKGROUND: garlic is well known to cause contact dermatitis and asthma. However, it is a very rare cause of food allergy. We present the case of a 23-year-old woman with previous history of allergy to pollen and dried fruit, and food-dependent, exercise-induced anaphylaxis for which no specific food could be identified as responsible, who experienced an anaphylactic reaction after eating young garlic. methods: Skin prick tests and specific IgE immunoassay with several pollens and foods were performed, as well as the prick-prick test with young garlic and SDS-PAGE followed by immunoblotting IgE to young garlic and other liliaceae species, mustard, sesame, parsley, celery, hazelnut, almond, and pollen of birch and mugwort. RESULTS: Skin prick tests and specific IgE were mainly positive for grass, plane tree, and mugwort pollen; peanut; hazelnut; walnut; almond; and mustard. Prick-prick tests with young garlic and garlic were positive. Total IgE was 113 U/ml. SDS-PAGE immunoblotting showed IgE-binding bands at 12 kDa to young garlic, garlic, onion, and leek extracts. Similar bands could also be detected with mugwort pollen and hazelnut extract. CONCLUSIONS: We describe IgE-mediated reaction to young garlic in a patient sensitized to pollen and dried fruit.
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2/12. Fennel, cucumber, and melon allergy successfully treated with pollen-specific injection immunotherapy.

    BACKGROUND: In subjects with both pollinosis and vegetable food allergy, most allergenic epitopes of fruits and vegetables are present in pollen. A recent study showed a marked reduction or a total disappearance of apple-induced oral allergy syndrome in patients receiving injection immunotherapy with birch pollen extracts. OBJECTIVE: To assess whether vegetable food allergy following other kinds of primary pollinosis may be successfully treated with pollen-specific immunotherapy. methods: A 34-year-old woman with long-standing pollinosis and typical oral allergy syndrome (OAS) with the ingestion of both fennel and cucumber and whose OAS was associated with immediate laryngeal edema after the ingestion of melon, was treated with two commercial depot aluminum hydroxide-adsorbed extracts of 1 grass pollen and 2 mugwort pollen 50% ragweed pollen 50%. RESULTS: After 36 months of injection specific immunotherapy, the patient was able to tolerate both fresh fennel and cucumber without consequence on open oral challenge tests. After 43 months of immunotherapy, the patient tolerated fresh melon as well on open oral challenge. She has re-introduced these vegetables in her normal diet. skin tests showed no reactivity to fresh fennel and there was a reduction of the wheal induced by fresh cucumber. CONCLUSION: Vegetable food allergy following primary sensitization to pollens, other than birch, may also be effectively reduced by pollen-specific injection immunotherapy.
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keywords = mugwort
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3/12. Occupational rhinoconjunctivitis and food allergy because of aniseed sensitization.

    BACKGROUND: Aniseed is a spice frequently used in Mediterranean cooking and, as with other Umbelliferae, it has been involved in clinical allergy. OBJECTIVE: This investigation was undertaken to study the allergens implicated in a case of occupational allergy to aniseed associated with rhinoconjunctivitis and gastrointestinal symptoms. methods: Skin prick tests were performed to inhalant allergens, spices used in the patient's workplace (aniseed and cinnamon), and 12 other Umbelliferae spices, birch, and mugwort. A nasal challenge test to aniseed and cinnamon and a double-blind placebo-controlled oral food challenge test to aniseed were also performed. The molecular weights of the allergens were studied by sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting and cross-reactivity among Umbelliferae species by enzyme immunoassay inhibition. RESULTS: Skin prick tests showed a positive immediate response to aniseed, asparagus, caraway, coriander, cumin, dill, and fennel extracts, and an intense late response to aniseed. Skin prick tests to celery, carrot, birch pollen, and mugwort pollen extracts were negative. Results of a nasal challenge test were positive to aniseed and negative to cinnamon; an aniseed oral food challenge test yielded a positive response. The molecular weights of the main immunoglobulin (Ig)E-binding proteins in aniseed extracts were approximately 48, 42, 39, 37, 34, 33, and 20 kD. Caraway, fennel, cumin, and coriander extracts showed similar IgE-binding patterns. Enzyme immunoassay inhibition studies with the patient's serum revealed cross-reactivity among the IgE components from aniseed, caraway, coriander, fennel, and dill extracts. CONCLUSIONS: We demonstrate the presence of aniseed allergens in a case of occupational rhinoconjunctivitis and food allergy, with molecular weights for this spice that differed from those previously reported.
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keywords = mugwort
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4/12. food allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy).

    BACKGROUND: spices originate in various botanical families: apiaceae, lamiaceae, lauraceae, Leguminosae, liliaceae, myristicaceae, myrtaceae, piperaceae, solanaceae, zingiberaceae.... METHODOLOGY: Prick-tests to native spices have been carried out in patients suspected of food allergies to spices. The CICBAA data bank includes 589 cases of food allergies, a part of which has benefited from investigations for spices. Data about the rate of sensitization and food allergy are available. RESULTS: Frequent sensitization to apiaceae is observed: coriander, caraway, fennel, celery: 32% of prick-tests in children, 23% of prick-tests in adults. Sensitization to liliaceae: garlic, onion, chive, is observed in 4.6% of prick-tests in children, 7.7% of prick-tests in adults. Rare cases of sensitization to paprika and saffron are recorded. Prick-tests to nutmeg, ginger and clove are currently negative. 10 food allergies related to the mugwort-celery-spices syndrome are reported: coriander: 1, caraway: 2, fennel: 3, garlic: 3, onion: 1. food allergy to spices is unfrequent: 2% of the totality of food allergies. However, only adults are allergic to spices and allergy to spices accounts for 6.4% of food allergies in adults. Tiny amount of proteins are usually ingested. patients at risk of spice allergy are young adults sensitized to mugwort and birch allergens, sharing cross-sensitization with various food vegetal allergens. The clinical suspicion raises from frequent post-prandial systemic reactions. Other allergens of vegetal origin have to be cleared. diagnosis can be established by DBPCFC using powdered spices in capsules.
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5/12. 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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6/12. Inhalant allergy to fresh asparagus.

    BACKGROUND: Two patients experienced itching conjunctivitis, running nose, tightness of the throat and coughing during preparation of fresh asparagus. Eating asparagus after cooking did not provoke any allergic symptoms. Both patients were atopic, sensitized additionally to pollens of grasses and trees as well as to onion. OBJECTIVE: To assess the hypersensitivity reactions to fresh and heated asparagus and to investigate any crossreactivities among the allergens. methods: Skin-prick tests were performed with commercial allergens and native asparagus and the patients were tested with Pharmacia CAP system for specific IgE antibodies against asparagus, onion, garlic, birch pollen, mugwort pollen and two recombinant birch pollen allergens, Bet v I and profilin. Inhibition of IgE antibody binding to solid phase homologous and unrelated allergens by increasing doses of liquid allergens (inhibitors) was studied. RESULTS: Skin-prick tests with native green and white asparagus were strongly positive, but negative with cooked asparagus. Both patients had measurable levels of IgE antibodies against asparagus (3.0 and 6.2 kU/L respectively) and several other allergens. One patient was highly sensitive to birch and Bet v I. Both were positive to profilin, mugwort and onion. In all cases the antibody uptake could be extensively and specifically inhibited by homologous allergen. The asparagus-specific IgE antibodies of the two patients could only be inhibited by asparagus. No inhibition was obtained after heating of the asparagus extract to 100 degrees C. CONCLUSIONS: The patients were specifically sensitized by asparagus. No immunological crossreactions could be observed. The measurements of IgE antibodies to other allergens were also specific, representing parallel multiple sensitivity. Profilin inhibited profilin-specific IgE binding but did not react with the asparagus-specific IgE antibodies of these patients. The asparagus allergen recognized by the specific IgE antibodies of these patients was thermolabile.
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keywords = mugwort
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7/12. hypersensitivity to carrot associated with specific IgE to grass and tree pollens.

    This study deals with a 34-year-old female cook with no previous history of atopy, who was studied because of allergic rhinoconjunctivitis and contact urticaria in both hands associated with severe itching when she handled raw carrot. The patient had had anaphylactic episodes after accidental ingestion of raw carrots, but she tolerated cooked carrots. Skin prick tests with carrot, celery, and olive, and birch, grass, and mugwort pollens were positive. Total IgE was 411 UI/ml. Specific IgE to olive, grass, and weed pollens were 10.92, 6.17, and 2.4 AU/ml, respectively. The histamine release test was positive for carrot, celery, celeriac, and olive pollen up to a dilution of 1/10(6). Immunoblot of raw carrot showed a single IgE-binding 18-kDa band. IgE reactivity for raw carrot immunoblot was completely inhibited by carrot and by celery, but not by olive or grass pollens. Specific IgE to olive pollen was not inhibited by carrot. The existence of monosensitization to an 18-kDa protein in carrot and specific IgE to olive pollen has not been reported in the celery-carrot-mugwort-spice syndrome.
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keywords = mugwort
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8/12. Inhalative occupational and ingestive immediate-type allergy caused by chicory (Cichorium intybus).

    We report a first case of occupational allergy to chicory (Cichorium intybus) in a vegetable wholesaler. Symptoms occurred after oral, cutaneous or inhalatory exposure. The patient also reported reactions after ingestion of botanically related endive (Cichorium endivia) and lettuce (Lactuca sativa). We identified the responsible allergen by SDS-PAGE and immunoblot to be a 48-kDa protein, confined to the non-illuminated parts of the plants. No cross-reactivity was found with mugwort (artemisia vulgaris), ryegrass (lolium perenne), and birch (betula verrucosa) pollen, which suggests that the vegetable is the primary allergenic material.
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ranking = 0.33333333333333
keywords = mugwort
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9/12. Occupational allergic rhinoconjunctivitis and asthma due to fennel seed.

    BACKGROUND: A patient with complaints of rhinitis and asthma occurring at work presented for consultation. OBJECTIVES: To evaluate the role of the foods and spices with which he worked, in the causation of his complaints, and to evaluate his immune reactivity to these materials. methods: Allergy skin testing and in vitro RAST assays were carried out. After demonstrating specific reactivity to fennel, SDS-PAGE electrophoreses was carried out. RESULTS: Positive skin tests to grass, ragweed, and freshly prepared fennel seed were found. serum IgE antibodies to fennel were quite high. immunoblotting studies showed reactions to two components in fennel extract as well as to components in mugwort, paprika, short ragweed and black pepper. CONCLUSION: This case of occupational rhinitis and asthma in an atopic individual involves sensitivity to unique allergens in fennel, with molecular weights of 67 to 75 KD.
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keywords = mugwort
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10/12. Oral allergy syndrome to a jackfruit (artocarpus integrifolia).

    A 30-year-old man from the philippines with pollen allergy noted the appearance of oral allergy syndrome (OAS) after eating raw apple, raw peach, raw celery, and recently, jackfruit (artocarpus integrifolia), a tropical fruit which belongs to the moraceae family (mulberry) and to the genus artocarpus (breadfruit tree). Despite the patient's multiple sensitization in skin prick tests and in the Pharmacia CAP System to birch, grass, mugwort pollen, related fruits and vegetables, and jackfruit, in RAST-inhibition studies neither rBet v 1 nor rBet v 2 (profilin), the well-known cross-reacting allergenic components in OAS, could inhibit the specific IgE response to jackfruit. Whether the reaction to jackfruit is specific or whether other pollen-related, cross-reacting allergenic components exist should be investigated further.
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keywords = mugwort
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