scholarly journals Anaphylaxis following the consumption of pumpkin seeds in a two-year-old child tolerant to its pulp – a case study and a minireview

2020 ◽  
Author(s):  
Julia Gawryjołek ◽  
Hanna Ludwig ◽  
Magdalena Żbikowska-Gotz ◽  
Zbigniew Bartuzi ◽  
Aneta Krogulska
Keyword(s):  
Storage Proteins ◽  
Sesame Seed ◽  
Specific Ige ◽  
Elimination Diet ◽  
Cross Reactivity ◽  
Amino Acid Sequences ◽  
Pumpkin Seed ◽  
Potential Health ◽  
Prick Test ◽  
Pumpkin Seeds

Abstract BackgroundPumpkin and its seeds are increasingly consumed by children for their potential health benefits. Each day, around 30% of teenagers consume nuts and seeds, including pumpkin seeds. However, there is some evidence that pumpkin seeds may exert allergenic effects and induce severe life-threatening anaphylaxis. Allergy for melon, cucumber, and zucchini, which belong to the same Cucurbitaceae family as pumpkin, are well known, opposite to pumpkin allergy. Few descriptions of allergic reactions associated with pumpkin have been published, especially in children. To date, three cases of pumpkin pulp and two seed cases have been reported among children. Our case report describes a case of pumpkin seed anaphylaxis in a child with good tolerance of pulp.Case presentationIn the present study, a two-year-old child experienced anaphylaxis: generalized urticaria, swollen lips and increasing dyspnea following the consumption of pumpkin seeds. The history showed that although the child had been receiving elimination diet because of atopic dermatitis, the basic dietary element was pumpkin pulp. The skin-prick test was positive for pumpkin seeds (5 mm) but negative for pumpkin pulp (1 mm); allergen-specific IgE was 1.34 kUA/L for seed, and 0.37 kUA/L for pulp. The component resolved diagnosis found IgE to sesame seed, buckwheat and walnut (storage proteins). Based on these findings, severe anaphylactic reaction to pumpkin seeds was identified.ConclusionsIt is possible to develop pumpkin seed anaphylaxis in a child with a tolerance to pumpkin pulp. Pumpkin seeds allergens have not been well characterized. Homology between the amino acid sequences in storage proteins may indicate cross reactivity between different edible seeds and nuts.

Food antigen-specific IgE in dogs with suspected food hypersensitivity

2020 ◽  
Vol 48 (06) ◽  
pp. 395-402
Author(s):  
Sandra A. Baumann ◽  
Cornelius Fritz ◽  
Ralf S. Mueller
Keyword(s):  
Clinical Relevance ◽  
Specific Ige ◽  
Elimination Diet ◽  
Cross Reactivity ◽  
Food Hypersensitivity ◽  
Strong Correlations ◽  
Odds Ratios ◽  
Cross Reactions ◽  
Ige Reactivity ◽  
Food Specific Ige

Abstract Objective Knowledge of cross-reactions in food-sensitive dogs will influence the choice of elimination diets and the long-term management of those patients. The objective of this study was to evaluate food allergen-specific IgE tests of suspected allergic dogs for concurrent positive reactions as possible evidence for cross reactions between allergens. Material and methods Results of serum IgE tests from 760 suspected allergic dogs submitted to 2 laboratories were evaluated statistically. After the tested allergens were grouped by their phylogenetic relationship, odds ratios as well as a sensitivity analysis of the odds ratios were performed to evaluate if concurrent positive IgE results to 2 allergens occurred more often than expected. Results Within related allergen pairs 27% (laboratory 1) and 72% (laboratory 2) of the pairs could be considered as associated. For the unrelated allergen pairs only 6.8% and 10.6% of the analyzed pairs were considered associated respectively. Strong correlations were shown in the group of ruminant allergens, especially beef and lamb, and grain allergens. High rates of concurrent reactions were also detected in the poultry group, especially between chicken and duck, as well as between pork and ruminant allergens, and soy and grain allergens. Conclusion As our results showed not only correlations within related but also between non-related allergens, the possible relevance of carbohydrate moieties as well as panallergens for canine hypersensitivities warrants further study. Further investigations are necessary to distinguish co-sensitization from cross-reactions and determine the clinical relevance of food-specific IgE reactivity. Clinical relevance Due to possible cross reactivity related allergens, especially beef and lamb as well as grain allergens, should not be used for an elimination diet to avoid false results.

scholarly journals The effectiveness of oral immunotherapy in patients with Sesame anaphylaxis using Omalizumab

2021 ◽  
Author(s):  
Fereshteh Salari ◽  
Mohammad Hassan Bemanian ◽  
Morteza Fallahpour ◽  
Seyed Alireza Mahdaviani ◽  
Sima Shokri ◽  
...  
Keyword(s):  
Treatment Effectiveness ◽  
Sesame Seed ◽  
Food Challenge ◽  
Maintenance Phase ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Open Label ◽  
Prick Test ◽  
Wheal Diameter ◽  
History Of

Abstract Objective Sesame allergy is the most prevalent allergy to seeds. Oral immunotherapy (OIT) is defined as continuous consumption of an allergen at special doses and time. Omalizumab (Anti-IgE) increases tolerance to allergens used in OIT. This study evaluated the effectiveness of a new sesame OIT protocol in patients with sesame anaphylaxis in combination with omalizumab. Methods In this prospective open-label interventional trial study, 11 patients with a history of sesame anaphylaxis were enrolled after approval by Oral Food Challenge (OFC) test. At baseline, skin prick test (SPT) and skin prick to prick (SPP) test were performed. Serum sesame-specific IgE (sIgE) levels were measured. The maintenance phase was continued at home with daily sesame intake for 4 months. At the end of month 4, the OFC and above-mentioned tests were repeated to evaluate the treatment effectiveness. Results All 11 patients who underwent sesame OIT after 4 months could tolerate a dietary challenge of 22 ml tahini (natural sesame seed, equal to 5,000 mg of sesame protein and higher) and the average of wheal diameter in the SPT and SPP tests significantly decreased after desensitization. Conclusion This OIT protocol may be a promising desensitization strategy for patients with sesame anaphylaxis. Also, omalizumab obviously reduced the severity of reactions.

scholarly journals Unexpected Cat Allergy in Infants with Persistent Atopic Dermatitis

2021 ◽  
Author(s):  
Serdar Al ◽  
Suna Asilsoy ◽  
Özden Anal ◽  
Dilek Tezcan ◽  
Seda Şirin Köse ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Allergic Diseases ◽  
Specific Ige ◽  
Elimination Diet ◽  
Severe Atopic Dermatitis ◽  
Barrier Dysfunction ◽  
Prick Test ◽  
Cat Allergy ◽  
History Of

Atopic dermatitis is a chronic, recurrent inflammatory skin disease usually caused by genetic predisposition, immune dysregulation, epidermal barrier dysfunction and interaction of environmental factors. Atopic dermatitis is part of atopic march and is often accompanied by food allergy. Aeroallergenic sensitization at early age is not an expected finding. Here, we present five cases with moderate-severe atopic dermatitis during infancy, in whom food allergy was detected and the symptoms improved only partially despite elimination and treatment. Sensitization was investigated in patients with a history of intense exposure to cats by specific IgE and skin prick test in infants with atopic dermatitis who had food allergy and persistant findings. Egg allergy was detected in four of the cases, wheat allergy in one. Cat allergy was present in all. Elimination diet was started in all cases. When exposure to cats was reduced, a marked improvement in the findings of atopic dermatitis was observed in all cases. Allergic diseases are increasing day by day. Unexpected aeroallergenic sensitization is now more common in the early stages of life. Allergic patients, regardless of age, should be questioned in detail for aeroallergen exposure. If it is detected; necessary preventive measures should be taken.

scholarly journals Comparison of Diagnostic Tests with Oral Food Challenge in a Clinical Trial for Adult Patients with Sesame Anaphylaxis

2020 ◽  
Author(s):  
Fereshteh Salari ◽  
Mohammad Hassan Bemanian ◽  
Morteza Fallahpour ◽  
Marzieh Tavakol ◽  
Sima Shokri ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Sesame Seed ◽  
Food Challenge ◽  
Good Alternative ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Adult Patients ◽  
Prick Test ◽  
Negative Results ◽  
The Poor

Sesame food allergy (SFA); especially anaphylaxis, is a life-threatening condition. The accurate diagnosis of SFA is done by skin prick test (SPT), skin prick to prick (SPP) or specific IgE (sIgE) and is confirmed by oral food challenge (OFC). Since there are few studies evaluating and comparing the utility of these methods for diagnosis of sesame anaphylaxis in adult patients, we aimed to compare OFC with diagnostic tests, including SPT, SPP, and sesames IgE; using ImmunoCAP considering the sensitivity and specificity issues in patients with sesame anaphylaxis. Twenty patients with sesame anaphylaxis were diagnosed based on OFC. Then SPT, SPP, and sIgE were evaluated. Sixteen patients had positive OFC; while 4 patients had negative results. Out of 16 OFC+ patients, 7 patients were SPT+, 15 patients were SPP+, and 2 patients had detectable sIgE. A positive SPT indicated 44% sensitivity and 50% specificity. A positive SPP showed 87.5% sensitivity and 75% specificity. A positive ImmunoCAP test demonstrated 12.5% sensitivity and 75% specificity. The AUC of SPP was significant for the diagnosis of sesame anaphylaxis (p=0.038). In conclusion, when the OFC is not possible, the SPP test with natural sesame seed may be applicable in patients with a convincing history instead of the artificial or commercial extracts of sesame used for SPT. Positive SPP is a good alternative diagnostic method for patients with sesame anaphylaxis. Also, the poor sensitivity of SPT and sIgE may indicate the poor discriminative capability of these tests.

Real-World Data Evaluation Of Total IgE, Specific IgE And Omalizumab Therapy In A Cohort Of Allergic Asthma Patients Treated In A Community-Based Practice

2020 ◽  
Author(s):  
Fortune O Alabi
Keyword(s):  
Allergic Asthma ◽  
Specific Ige ◽  
Forced Expiratory Volume ◽  
Act Scores ◽  
Asthma Control Test ◽  
Real World Data ◽  
Total Ige ◽  
Prick Test ◽  
Negative Results ◽  
Asthma Patients

Objective: In this study, we: (1) evaluated the correlation between total IgE and the presence of specific IgE; (2) compared the characteristics of patients with positive specific IgE to those with negative specific IgE; and, (3) analyzed the allergic testing results of patients on omalizumab and reported the effect of omalizumab on forced expiratory volume (FEV1) and asthma control test (ACT) results. Methods: Data from patients diagnosed with allergic asthma and seen at Florida Lung, Asthma & Sleep Specialists (FLASS) between January 2016 and June 2019 were analyzed. Parameters evaluated were total IgE, and levels of specific IgE to antigens in the ImmunoCAP test and skin prick test (SPT). Additional parameters for patients on omalizumab therapy for at least 6 months were FEV1, % predicted FEV1 and ACT results. Results: A total of 475 patients (114 males, 361 females) met the inclusion criteria. The mean age was 53 years (range: 17 to 89 years). Of these, 36 patients were not included in the analysis due to incomplete data. Mean total IgE was higher in patients with positive ImmunoCAP results compared to those with negative results (396 KU/L vs. 81.3 KU/L). There was a significant positive correlation between total IgE and levels of positive specific IgE in the ImmunoCAP test (p<0.0001, r=0.36, n=213 patients). The correlation between total IgE and levels of positive allergens in SPT was not significant (p=0.15, n=44 patients) Two positive reactions to allergens were seen in 22% of ImmunoCAP tests and 13% of SPT tests. There was no statistically significant improvement in FEV1 (p=0.097, CI -0.17 to 0.02) and % predicted FEV1 (p=0.109, CI -6.63 to 0.70) in patients who used omalizumab for at least 6 months. There was a statistically significant improvement in ACT scores (p=0.031, CI -4.21 to -0.21) in patients who used omalizumab for at least 6 months. Conclusion: Allergic asthma could be seen in patients who had an absence of specific IgE in ImmunoCAP and a negative reaction to SPT. The benefit of omalizumab therapy is not limited to allergic asthma patients with positive specific IgE.

scholarly journals Peanut-specific IgE antibodies in asymptomatic Ghanaian children possibly caused by carbohydrate determinant cross-reactivity

2013 ◽  
Vol 132 (3) ◽  
pp. 639-647 ◽  
Author(s):  
Abena S. Amoah ◽  
Benedicta B. Obeng ◽  
Irene A. Larbi ◽  
Serge A. Versteeg ◽  
Yvonne Aryeetey ◽  
...  
Keyword(s):  
Specific Ige ◽  
Cross Reactivity ◽  
Ige Antibodies ◽  
Specific Ige Antibodies

scholarly journals Food allergy: nuts and tree nuts

2006 ◽  
Vol 96 (S2) ◽  
pp. S95-S102 ◽  
Author(s):  
Jesus F. Crespo ◽  
John M. James ◽  
Consuelo Fernandez-Rodriguez ◽  
Julia Rodriguez
Keyword(s):  
Food Allergy ◽  
Dietary Habits ◽  
Storage Proteins ◽  
Seed Storage ◽  
Seed Storage Proteins ◽  
Cross Reactivity ◽  
Severe Reaction ◽  
Immunological Mechanism ◽  
Pathogenesis Related Protein ◽  
The Usa

Nuts are a well-defined cause of food allergy, which affect approximately 1 % of the general population in the UK and the USA. There do appear to be differences in the frequency of nut allergy between different countries because of different dietary habits and cooking procedures. For example, in the USA and France, peanuts are one of the most frequent causes of food allergy, but in other countries, it seems to be less common. Genetic factors, in particular, appear to play a role in the development of peanut allergy. While the majority of nut allergens are seed storage proteins, other nut allergens are profilins and pathogenesis-related protein homologues, considered as panallergens because of their widespread distribution in plants. The presence of specific IgE antibodies to several nuts is a common clinical finding, but the clinical relevance of this cross-reactivity is usually limited. Allergic reactions to nuts appear to be particularly severe, sometimes even life-threatening, and fatal reactions following their ingestion have been documented. Food allergy is diagnosed by identifying an underlying immunological mechanism (i.e. allergic testing), and establishing a causal relationship between food ingestion and symptoms (i.e. oral challenges). In natural history investigations carried out in peanut-allergic children, approximately 20 % of the cases outgrew their allergy or developed oral tolerance. The treatment of nut allergies should include patient and family education about avoiding all presentations of the food and the potential for a severe reaction caused by accidental ingestion. Patients and families should be instructed how to recognise early symptoms of an allergic reaction and how to treat severe anaphylaxis promptly.

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