Anaphylaxis from ingestion of mites: Pancake anaphylaxis

Sánchez‐Borges, Mario; Chacón, Raúl Suárez; Capriles‐Hulett, Arnaldo; Caballero‐Fonseca, Fernan; Fernández-Caldas, Enrique

doi:10.1016/j.jaci.2012.09.026

Cited by 82 publications

(59 citation statements)

References 19 publications

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“…17,18 Musken et al 19 studied the frequency of skin test sensitivity to D. pteronyssinus, A. siro, L. destructor, and T. putrescentiae in 512 consecutive patients (children and adults) with rhinitis and/or asthma living in urban or rural areas in Germany. They reported that 20.1% reacted to at least one of the storage mites.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity to Five Types of House Dust Mite in a Group of Allergic Egyptian Children

Hossny

El-Sayed

Abdul-Rahman

2014

Pediatric Allergy, Immunology, and Pulmonology

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Background: The published data on house dust mite (HDM) sensitization from Egypt are scanty. We sought to investigate the sensitization to five different types of HDM among a group of allergic children in a trial to outline the most frequent sensitizing strains in the Cairo Province. Methods: We consecutively enrolled 100 asthmatic patients, aged 1-7 years, of whom 22 had concomitant skin allergy. Skin prick testing was performed using allergen extracts of Dermatophagoides pteronyssinus, Dermatophagoides farinae, Lepidoglyphus destructor, Tyrophagus putrescentiae, and Acarus siro. Results: Twenty-four patients (24%) were sensitized to one or more strains of HDM. Sensitization to one strain was revealed in 12% of the studied sample, while sensitization to two or three strains was detected in 8% and 4% respectively. Twelve percent of the enrolled children were sensitive to D. pteronyssinus, 11% to D. farinae, 7% to L. destructor, 6% to T. putrescentiae, and 4% to A. siro. Eight out of the 12 (66%) children sensitive to one strain had mild intermittent asthma, while five out of eight (62.5%) sensitive to two strains had moderate persistent asthma. All children sensitized to three strains of HDM had persistent rather than intermittent asthma. HDM sensitization did not correlate significantly to the history of sun exposure, bed mattresses and pillows, living in farms, or exposure to stored grains. The co-existence of atopic dermatitis tended to have a higher rate of HDM sensitization. Conclusion: D. pteronyssinus and D. farinae represent the most common sensitizing strains in the studied sample. Wider-scale population-based studies are needed to assess the prevalence of HDM allergy and its clinical correlates in our country.

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Section: Discussionmentioning

confidence: 99%

Sensitivity to Five Types of House Dust Mite in a Group of Allergic Egyptian Children

Hossny

El-Sayed

Abdul-Rahman

2014

Pediatric Allergy, Immunology, and Pulmonology

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“…In tropical climates, orally ingested mites that contaminate wheat flour can trigger anaphylaxis even after cooking (the so-called ‘pancake syndrome') and also play a role in food-dependent exercise-induced anaphylaxis [24]. …”

Section: Triggers and Mechanismsmentioning

confidence: 99%

World Allergy Organization Anaphylaxis Guidelines: 2013 Update of the Evidence Base

Simons

Ardusso

Dimov

et al. 2013

Int Arch Allergy Immunol

242

181

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The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis are a widely disseminated and used resource for information about anaphylaxis. They focus on patients at risk, triggers, clinical diagnosis, treatment in health care settings, self-treatment in the community, and prevention of recurrences. Their unique strengths include a global perspective informed by prior research on the global availability of essentials for anaphylaxis assessment and management and a global agenda for anaphylaxis research. Additionally, detailed colored illustrations are linked to key concepts in the text [Simons et al.: J Allergy Clin Immunol 2011;127:593.e1-e22]. The recommendations in the original WAO Anaphylaxis Guidelines for management of anaphylaxis in health care settings and community settings were based on evidence published in peer-reviewed, indexed medical journals to the end of 2010. These recommendations remain unchanged and clinically relevant. An update of the evidence base was published in 2012 [Simons et al.: Curr Opin Allergy Clin Immunol 2012;12:389-399]. In 2012 and early 2013, major advances were reported in the following areas: further characterization of patient phenotypes; development of in vitro tests (for some allergens) that help distinguish clinical risk of anaphylaxis from asymptomatic sensitization; epinephrine (adrenaline) research, including studies of a new epinephrine auto-injector for use in community settings, and randomized controlled trials of immunotherapy to prevent food-induced anaphylaxis. Despite these advances, the need for additional prospective studies, including randomized controlled trials of interventions in anaphylaxis is increasingly apparent. This 2013 Update highlights publications from 2012 and 2013 that further contribute to the evidence base for the recommendations made in the original WAO Anaphylaxis Guidelines. Ideally, it should be used in conjunction with these Guidelines and with the 2012 Guidelines Update.

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“…It is known that the oral ingestion of mites can cause immediate allergic reactions and that in most cases, symptoms developed immediately after ingesting foods prepared with wheat flour contaminated with dust mites [1]. However, in this case, severe allergic symptoms occurred while jogging 1.5 h after the consumption of mite-contaminated foods.…”

Section: Discussionmentioning

confidence: 94%

“…Oral mite anaphylaxis is a unique food allergy that is characterized by severe allergic reactions which occur after consuming foods prepared with mite-contaminated wheat flour, such as pancakes [1]. Although in the majority of cases, symptoms develop immediately after eating mite-contaminated foods, they can occur during physical exercise after the oral ingestion of the mites [2].…”

Section: Introductionmentioning

confidence: 99%

A Case of Mite-Ingestion-Associated Exercise- Induced Anaphylaxis Mimicking Wheat-Dependent Exercise-Induced Anaphylaxis

Adachi

Itazawa

Okabe

et al. 2013

Int Arch Allergy Immunol

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We present a case of mite-ingestion-associated exercise-induced anaphylaxis mimicking wheat-dependent exercise-induced anaphylaxis (WDEIA). A 17-year-old boy was referred for an episode of anaphylaxis while jogging, 1.5 h after having eaten okonomiyaki (a Japanese pancake). Laboratory measures revealed a slightly elevated specific immunoglobulin E (IgE) antibody against omega-5 gliadin (0.41 kU_A/l) and a marked elevation of specific IgE antibody against house-dust mite, Dermatophagoides farinae (142 kU_A/l). A detailed interview revealed that, in spite of the referring doctor's advice to discontinue postprandial exercises, he continued his jogging routine after consuming foods containing wheat and also that his younger brother, who had mild intermittent asthma, had suffered a mild asthma attack 2 h after eating the same food. We therefore examined the okonimiyaki mix, which had been stored for several months after opening the package until this episode, under a microscope, and we found an abundant number of live mites, D. farinae. Finally, a diagnosis of mite-ingestion-associated exercise-induced anaphylaxis was made. This clinical entity should be excluded when making a diagnosis of WDEIA.

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Anaphylaxis from ingestion of mites: Pancake anaphylaxis

Cited by 82 publications

References 19 publications

Sensitivity to Five Types of House Dust Mite in a Group of Allergic Egyptian Children

Sensitivity to Five Types of House Dust Mite in a Group of Allergic Egyptian Children

World Allergy Organization Anaphylaxis Guidelines: 2013 Update of the Evidence Base

A Case of Mite-Ingestion-Associated Exercise- Induced Anaphylaxis Mimicking Wheat-Dependent Exercise-Induced Anaphylaxis

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