Article

Coriander anaphylaxis in a spice grinder with undetected occupational allergy. Acta Clin Belg

Dept. Immunology-Allergology-Rheumatology, University Antwerpen.
Acta clinica Belgica (Impact Factor: 0.59). 05/2006; 61(3):152-6. DOI: 10.1179/acb.2006.025
Source: PubMed

ABSTRACT Anaphylaxis after ingestion of spices as a result from occupational sensitization remains anecdotal. We describe a patient, working in a spice factory, with anaphylaxis from coriander in a meal. He also demonstrated urticaria, angio-edema, rhinoconjunctivitis and bronchospasm during handling coriander and fenugreek.
To determine the mechanism of the anaphylactic reaction and to evaluate cross-reactivity between both botanically unrelated spices.
Investigations comprised quantification of total and specific IgE by Immuno-CAP FEIA, skin testing, basophil activation experiments by flow-assisted determination of CD63 expression in the patient and 3 healthy controls. Immuno-CAP inhibition experiments were applied to investigate cross-reactivity.
Specific IgE, skin tests and basophil activation tests were clearly positive in the patient, whereas they remained negative in controls. No cross-reactivity between fenugreek and coriander was demonstrable by inhibition experiments.
The clinical manifestations in temporal relationship to ingestion of coriander and handling of coriander and/or fenugreek, the positive specific IgE results, skin tests and basophil activation assays support the diagnosis of allergy to both spices. History suggests sensitization by occupational exposure.

Download full-text

Full-text

Available from: Didier Ebo, Aug 20, 2015
0 Followers
 · 
118 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The diagnosis of allergic reactions in clinical practice rests upon both clinical history and the demonstration of specific immunoglobulin E (sIgE), either in the serum or via skin tests. However, for various reasons, identification of the offending allergen(s) is not always possible. Moreover, not all allergies are IgE-mediated. In an attempt to find reliable methods to investigate hypersensitivity reactions, histamine and sulfidoleukotriene release tests have long been introduced. However, relatively few comprehensive quality reports have been published so far. Upon challenge with a specific allergen, basophils not only secrete quantifiable bioactive mediators but also upregulate the expression of different markers which can be detected efficiently by flow cytometry using specific monoclonal antibodies. This review addresses the principals, particular technical aspects and pitfalls as well as the clinical and research applications of flow-assisted analysis of in vitro activated basophils.
    Cytometry Part B Clinical Cytometry 07/2008; 74(4):201-10. DOI:10.1002/cyto.b.20419 · 2.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fenugreek is an ingredient in Indian-style spiced foods. Reports of adverse reactions reflect a trend toward a more international cuisine. Fenugreek allergy has not been systematically investigated so far. Study the allergenicity and antigenicity of fenugreek proteins using patient sera and a newly developed polyclonal antifenugreek antibody. Allergenic fenugreek proteins were identified by immunoblotting, using sera from 29 patients with specific IgE to peanut and other legumes. In addition, 2 patients were evaluated by skin prick test and open food challenge with native fenugreek powder. Spiced and flavored food products were analyzed for fenugreek by semiquantitative IgE and IgG immunoblotting. High levels of specific IgE to both peanut and fenugreek were seen in most sera. Fenugreek sensitization is believed to be a consequence of cross-reactivity in patients with peanut allergy. Primary fenugreek allergy was suspected in only 1 case. The fenugreek dose eliciting objective symptoms was about 2 mg in the open food challenge. Major fenugreek allergens were identified at 50, 52, and 74 kd and peanut proteins at 22, 36, and 40 kd. A specific polyclonal antifenugreek antibody was found suitable for food analysis. In a food survey, about 1/3 of the fenugreek-containing products were labeled correctly. Fenugreek seed powder, an ingredient in spiced foods, contains several potential allergens. There is evidence for a high rate of cross-reactivity to peanut.
    The Journal of allergy and clinical immunology 11/2008; 123(1):187-94. DOI:10.1016/j.jaci.2008.09.012 · 11.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Food flavorings and colorings are a heterogeneous group of compounds that are often derived from potential allergens. This chapter will discuss non-synthetic food colorings and flavorings that have been implicated in adverse food reactions. Many of these items are derived from plants or other biogenic sources and may contain allergenic epitopes or haptens, which can be recognized by specific IgE or T cells. The overall prevalence of reactions attributable to food colorings and flavorings is unknown, but thought to be low. Labeling of natural food coloring and flavor is often problematic. Natural colorants are not subject to the Food, Dye, and Cosmetic (FD&C) labeling regulations. Flavorings are exempted from labeling unless widely suspected to cause allergy (e.g., sulfites). Spices used as additives but not ingredients are also exempted. The exemption for carmine/cochineal extract was recently changed and must now be declared by name on product labels. This chapter will review known mechanisms of reaction, treatment strategy, and labeling regulations. Synthetic color additives are discussed elsewhere in this book.
    Food Allergy: Adverse Reactions to Foods and Food Additives, Fourth Edition, 01/2009: pages 403 - 428; , ISBN: 9781444300062
Show more