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Annatto hypersensitivity after oral ingestion confirmed by placebo-controlled oral challenge.
Sadowska, B, Sztormowska, M, Chełmińska, M
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2021;(4):510-511
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2.
[Flagellate dermatitis caused by the intake of shiitake mushrooms. A case report and review of the literature].
Rojas-Mejía, DV, Serrano, C
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993). 2020;(1):79-82
Abstract
BACKGROUND Flagellate dermatitis caused by the intake of shiitake mushrooms is characterized by linear erythematous lesions that are intensely pruritic. It is common in countries where the consumption of mushrooms is high, but it is rare in Latin America. It can be difficult to diagnose as there is a delay between the intake of the mushroom and the eruption. CASE REPORT A 49-year-old Caucasian woman with a history of hypothyroidism who, 48 hours after the intake of shiitake mushrooms, developed intense itching associated with the appearance of linear and erythematous lesions, in a "flagellate-like" pattern, predominantly on the trunk, without other signs or symptoms. There was no history of recent exposure to drugs. She was treated with oral antihistamine and topical corticosteroid, however, without improvement, which is why a short cycle of oral corticosteroid was required, with which her lesions were resolved. A shiitake-free diet was indicated. CONCLUSIONS Flagellate dermatitis is a toxicoderma that is associated with the intake of shiitake mushrooms among other things. Its clinical presentation is characteristic, although its exact pathophysiology is not fully understood. The boom of Asian food in Latin America might lead to an increase in the number of cases; hence the importance of knowing about its existence.
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3.
Food-Dependent, Exercise-Induced Anaphylaxis: Diagnosis and Management in the Outpatient Setting.
Feldweg, AM
The journal of allergy and clinical immunology. In practice. 2017;(2):283-288
Abstract
Food-dependent, exercise-induced anaphylaxis is a disorder in which anaphylaxis develops most predictably during exercise, when exercise takes place within a few hours of ingesting a specific food. IgE to that food should be demonstrable. It is the combination of the food and exercise that precipitates attacks, whereas the food and exercise are each tolerated independently. Recently, it was demonstrated that exercise is not essential for the development of symptoms, and that if enough of the culprit food is ingested, often with additional augmentation factors, such as alcohol or acetylsalicylic acid, symptoms can be induced at rest in the challenge setting. Thus, food-dependent, exercise-induced anaphylaxis appears to be more correctly characterized as a food allergy syndrome in which symptoms develop only in the presence of various augmentation factors, with exercise being the primary one. However, additional factors are not usually present when the patient exercises normally, so ongoing investigation is needed into the physiologic and cellular changes that occur during exercise to facilitate food-induced anaphylaxis.
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4.
New perspectives in the treatment of hidradenitis suppurativa: surgery and brewer's yeast-exclusion diet.
Cannistrà, C, Finocchi, V, Trivisonno, A, Tambasco, D
Surgery. 2013;(5):1126-30
Abstract
BACKGROUND Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin disease characterized by abscesses, fistulating sinus tracts, and scarring. The exact pathogenesis of this disease remains unclear. We present our experience with HS and a possible cause of the disease and offer a surgical and clinical treatment that allows for disease resolution. METHODS We studied 12 patients who presented with axillary and perineal fistulas and underwent surgical excision (repaired by skin grafts or healing by secondary intention) or localized treatments followed by diet modification. All patients were found to have a specific immunology IgG reaction to brewer's yeast and wheat and were put on a controlled brewer's yeast-free diet for 12 months and followed monthly. RESULTS The diet demonstrated immediate stabilization of their clinical symptoms, and the skin lesions regressed over the 12-month treatment period. Similarly, all the patients demonstrated an immediate recurrence of skin lesions following accidental or voluntary consumption of beer or other foods containing brewer's yeast or wheat. The patients also demonstrated a return of their quality of life and activities, including the reestablishment of sexual activity in the patients with inguinal and perigenital lesions. CONCLUSION The results of the investigation suggested that the patients had severe reactions to brewer's yeast. Surgery followed by the elimination of the foods containing or made with the yeast resulted in a rapid stabilization of the dermatologic manifestation and a slow, but complete, regression of the skin lesions within a year. Despite the small number of patients in our study, our study could provide the basis for extensive and multicentric studies in order to better investigate this disabling and rare disease.
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5.
The diagnosis of food allergy.
Lieberman, JA, Sicherer, SH
American journal of rhinology & allergy. 2010;(6):439-43
Abstract
BACKGROUND Food allergy is increasingly common; however, there is a discrepancy between the large number of people who believe they or their children are affected and the actual number with true food allergies. It is therefore imperative that physicians evaluating patients with possible adverse reactions to foods understand the current modalities used to diagnose food allergies. METHODS Simple tests including skin-prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests have pitfalls and their usefulness must be appreciated to avoid over- and underdiagnosis. RESULTS A firm diagnosis is imperative because a misdiagnosis could lead to life-threatening reactions and overdiagnosis will lead to unnecessary elimination diets with nutritional and social implications. Physician-supervised oral food challenges (OFC) remain the gold standard for food allergy diagnosis; however, a careful medical history and simple tests can often provide a reliable diagnosis. CONCLUSION In this review, we examine the usefulness and pitfalls of SPT used by allergists and serum food-specific IgE levels that are available to all practitioners. We also review the OFC as a diagnostic modality in food allergy. Finally, we describe emerging tests, such as the basophil activation test, atopy patch testing, and component-resolved diagnostics, that may be of benefit in the future.
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6.
[A case of "late-onset" anaphylaxis caused by fermented soybeans; Natto].
Suzuki, S, Nakamura, Y, Kawano, Y, Nishioka, K
Arerugi = [Allergy]. 2006;(7):832-6
Abstract
Natto is a Japanese traditional food made from fermented soybeans. We report a case of anaphylaxis caused by natto and review the literature. The patient was a 22-year-old man who showed systemic eruption with itching and pectoralgia about 10 hours after eating a meal containing natto. Results of skin tests for soybean allergen were negative, and the allergen remained unidentified. We then used a food elimination trial to confirm the allergy. However the patient did not refrain from eating natto, and he had three anaphylactic reactions might have been caused by natto. Each event occurred 10 to 14 hours after he ate a meal containing natto. We performed detailed examinations to determine the allergen. First, the prick-by-prick tests with natto and its characteristic viscous yarn-like surface were done and yielded positive results. Next, a provocation test with commercial natto (50 g) was performed and caused systemic eruption and pectoralgia about 9 hours after ingestion of the natto. The patients'plasma histamine level was elevated during the anaphylactic event. Anaphylaxis caused by natto was diagnosed. Recent studies have shown that the anaphylaxis caused by natto is of late-onset. Late-onset anaphylaxis can be considered one of IgE-mediated allergic reactions. The viscous surface of natto contains poly-gamma-glutamic acid (PGA). The hypothesized mechanism of late-onset anaphylaxis is delayed absorption or release of PGA into the bowel. In our case, the patient ate heated natto, we therefore speculate that suspect allergens were heat resistant. Patients with natto allergy must not eat natto, whether or not it is cooked or heated. Natto may induce allergic reactions up to a half-day after ingestion; thus, the clinical course and patient's diet must be considered during medical examination. Natto has recently gained popularity as a health food in foreign countries. The existence or natto allergy should be more widely recognized.
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7.
Anaphylaxis to sesame paste.
Panizzolo, C, Tura, M, Barbato, A
European annals of allergy and clinical immunology. 2005;(1):34-5
Abstract
Anaphylaxis reaction to sesame paste could be a possible complication of vegetarian diet. This paper presents a case of a 6-year-old child who developed anaphylactic reaction after eating bread and sesame paste (obtained by grinding sesame seeds). The child suffered atopic dermatitis and had no incidence of anaphylaxis before. Because the sesame, as seeds, oil or paste is mostly used in bakery and in different foods, by non diagnosing this allergy in children with atopic dermatites could be life-threatening.
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Cereal-induced anaphylaxis in an adult after eating a baby cereal formula.
Asensio, T, Armentia, A, Lombardero, M, Callejo, A, Martín, G, Castrodeza, J
Allergologia et immunopathologia. 2004;(5):310-1
Abstract
Ingestion of infant cereal formula as a cause of anaphylaxis has been exclusively described in children. We report the case of a man who experienced an anaphylactic reaction after eating his son's cereal formula. We believe that cereals constitute a rising problem and a hidden allergen that can cause severe reactions. Although these reactions are not fully understood, they may possibly be a life-long event.
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9.
Bread eating induced oral angioedema due to alpha-amylase allergy.
Moreno-Ancillo, A, Domínguez-Noche, C, Gil-Adrados, AC, Cosmes, PM
Journal of investigational allergology & clinical immunology. 2004;(4):346-7
Abstract
Inhalation of dust from different enzymes can be the cause of occupational asthma in exposed workers. Enzymes from different sources are being increasingly used in food. Few cases of food allergy to alpha-amylase induced by eating bread have been reported. Those cases were reported in bakery-related patients and in a pharmaceutical-industry worker. A 25-year-old farmer suffered sneezing, rhinorrhea, oropharyngeal itching, hoarseness, cough, and non-wheezy dyspnea after eating white bread. Skin prick tests (SPT) with common aeroallergens and food allergens revealed only sensitization to Olea europaea pollen. SPT response was positive to Aspergillus oryzae alpha-amylase. Specific IgE against alpha-amylase was positive. A double-blind placebo-controlled challenge with 5 mg of uncooked -amylase induced sneezing, cough, oral angioedema within 10 minutes. The provocation test with 50 g of white bread gave similar findings. This case indicates that alpha-amylase contained in bread may provoke IgE-mediated food allergy. It is worth noting that in this case, the only source of alpha-amylases sensitization was bread.
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10.
Immediate-type hypersensitivity reaction to ingestion of mycoprotein (Quorn) in a patient allergic to molds caused by acidic ribosomal protein P2.
Hoff, M, Trüeb, RM, Ballmer-Weber, BK, Vieths, S, Wuethrich, B
The Journal of allergy and clinical immunology. 2003;(5):1106-10
Abstract
BACKGROUND Quorn is the brand name for a line of foods made with so-called "mycoprotein," which springs from the mold Fusarium venenatum. Since the introduction on the food market, there have been complaints from consumers reporting adverse gastrointestinal reactions after ingestion of mycoprotein. To date, it is not clear whether the reported symptoms are IgE-mediated. OBJECTIVE The aim of the study was to describe for the first time a case history of an asthmatic patient with severe hypersensitivity reactions to ingested mycoprotein and to identify and characterize the potential allergen that might be responsible for this. METHODS The sensitization pattern of the asthmatic subject was characterized, and food allergy to mycoprotein was assessed by double-blinded placebo-controlled food challenge. Afterward, specific IgE antibodies of the serum of this patient were used to screen a Fusarium culmorum cDNA expression library. The coding sequence of one enriched cDNA-clone was expressed in Escherichia coli to produce a recombinant protein that was further purified and immunologically characterized. RESULTS The patient showed high sensitization to many known aeroallergens but apart from Quorn not to any other tested food samples. The deduced amino acid sequence of the enriched cDNA-clone (Fus c 1) showed large identity to the 60S acidic ribosomal protein P2 which is highly conserved among several species and also described as minor allergen in other mold species. The frequency of IgE reactivity of sera from F culmorum -sensitized subjects to rFus c 1 was approximately 35%. By enzyme allergosorbent test inhibition, we found 65% inhibition of mycoprotein IgE reactivity by rFus c 1. On the opposite we found reduced IgE reactivity of rFus c 1 of 68% by using mycoprotein as inhibitor. CONCLUSIONS Sensitization to mold allergens by the respiratory tract and subsequent oral ingestion of cross-reactive proteins may lead to severe food-allergic reactions. Thus, the 60S acidic ribosomal protein P2 of F venenatum probably is the reason for the described severe hypersensitivity reactions of the patient to Quorn-mycoprotein because of its potential cross-reactivity to the F culmorum allergen Fus c 1.