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


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.

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