Anaphylaxis to Sunflower Seed With Tolerance to Other Nuts: The Role of Lipophilic Allergens

González-Bravo, L.; Laiseca-García, J; Pineda, Fernando; Rosado, A.

doi:10.18176/jiaci.0710

Cited by 5 publications

(5 citation statements)

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“…3 Others case reports of anaphylactic reactions to sunflower seed have been published. 1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] Garcia Ortiz et al 10 reported 15 reactions to sunflower seed ranging from OAS to anaphylaxis in a series of 84 patients monosensitized to Artemisia pollen. Comparing to our series, they found a lower proportion of severe reactions, only 2/15 (13%) of the patients reporting anaphylaxis after sunflower seed ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…Despite frequent consumption, since first sunflower seed allergy reported by Noyes et al 1 in 1979, publications on sunflower seed allergy have been limited to case reports or case series with small number of patients. 1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] This study was conducted to evaluate the clinical and immunological features of IgE-mediated hypersensitivity to sunflower seed as well as other food allergies present in sunflower seed allergic patients.…”

Section: Introductionmentioning

confidence: 99%

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Untitled Document

Galleani

Diéguez

Arroba

et al. 2023

Preprint

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Sunflower seed is one of the most common edible seeds and its consumption is growing worldwide. Case reports of sunflower seed allergy have been described in the medical literature since the 1970s. However, there are few data on the overall prevalence and clinical manifestations of sunflower seed allergy. We evaluated the clinical and immunological features of 47 patients with sunflower seed allergy diagnosed in the Allergy Department of a tertiary hospital in Madrid over a 5-years period. All of them reported adverse reactions after ingestion of sunflower and had specific sensitization to sunflower seed determined by skin prick test (median 7mm) or specific IgE (median 1.07KU/L). Most had an adult-onset reaction to sunflower seed preceded by a history of atopy and other food allergies diagnosis, predominantly to peach, peanut and nuts. Clinical presentation of sunflower seed allergy in our sample ranged from mild to severe, with a high proportion of patients suffering severe reactions, often undertreated. A variability in the severity of symptoms was seen on repeated exposures to sunflower seed on a same patient. Levels of sunflower seed IgE were strongly correlated with levels of IgE to non specific lipid transfer proteins, while no significant differences were found in the severity of the reactions according sensitization to those proteins. With sunflower seed as a potential severe allergen, further study on the allergenic content and clinical cross reactivity of sunflower seed allergy is required in order to prevent life threatening reactions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Untitled Document

Galleani

Diéguez

Arroba

et al. 2023

Preprint

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show abstract

“…Other case reports of anaphylactic reactions to sunflower seed have been previously published. 1,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] Garcia Ortiz et al 12 reported 15 reactions to sunflower seed ranging from OAS (oral allergy syndrome) to anaphylaxis in 11 patients from a series of 84 patients monosensitized to Artemisia pollen. Compared to our series, they found a lower proportion of severe reactions, with only 2 anaphylaxis after sunflower seed ingestion.…”

Section: Discussionmentioning

confidence: 99%

Sunflower (Helianthus annuus) Seed Allergy

Galleani,

Diéguez,

Cabanillas

et al. 2023

J Investig Allergol Clin

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Background: Sunflower seed is one of the most common edible seeds and its consumption is growing. Case reports of sunflower seed allergy have been described since the 1970s. However, there are few data on the prevalence and clinical manifestations of sunflower seed allergy. Objective: To improve understanding of sunflower seed allergy. Methods: We evaluated the clinical and immunological features of patients with sunflower seed allergy diagnosed in the Allergy Department of a tertiary hospital in Madrid over a 5-years period. Results: Forty-seven patients reported adverse reactions after ingestion of sunflower seed and had specific sensitization to sunflower seed determined by skin prick test (median 8 mm) or specific IgE (median 1.10 kUA/L). Most had an adult-onset reaction to sunflower seed preceded by a history of atopy and other food allergies, predominantly to peach, peanut and nuts. Clinical presentation of sunflower seed allergy ranged from mild to severe, with a high proportion of patients suffering severe reactions, often undertreated. A variability in the severity of symptoms was seen on repeated exposures to sunflower seed on a same patient. Levels of sunflower seed IgE were strongly correlated with levels of IgE to non-specific lipid transfer proteins, while no significant differences were found in the severity of the reactions according to sensitization to those proteins. Conclusion: Our findings reveal a variability of clinical presentations of sunflower seed allergy on repeated exposures and an underuse of epinephrine in anaphylaxis. We highlight the importance of strict avoidance of sunflower seed and accurate prescription and administration of epinephrine in allergic patients.

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“…A review of four patients reacting to pumpkin seeds but not the pulp, identified two allergens, although only Cuc ma 5 (2S albumin) was positive in all four cases [54]. Sunflower seeds contain both 2S Albumins and nonspecific Lipid Transfer Protein (nsLTP) allergens, but a lipoprotein such as an oleosin could also be responsible for severe reactions, especially to roasted seeds and in the absence of sensitisation or reactions to other foods [55,56]. A recent review by Majsiak and colleagues suggests oleosins could also be responsible for reactions to sunflower seeds when allergy tests were negative [57].…”

Section: Seedsmentioning

confidence: 99%

New arrivals in anaphylaxis to foods

Olivieri

Skypala

2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens. Recent findings There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods. Insects can be a sustainable source of protein, but mealworm could provoke symptoms in individuals sensitized or allergic to shellfish or house dust mite. Novel plant food allergens such as gibberellin-regulated proteins and thaumatin-like proteins are increasingly being reported as significant causes of severe reactions to fruits. Summary these findings make it even more imperative to take a full dietary history to ensure apparent idiopathic anaphylaxis is not in reality due to a novel food, especially in cases where other forms of the food are tolerated. Given the lack of diagnostic tests for these novel foods, a prick-to-prick skin prick test should be performed with the suspected food. There is currently more work needed to define and sequence many of the allergens involved.

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Anaphylaxis to Sunflower Seed With Tolerance to Other Nuts: The Role of Lipophilic Allergens

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 5 publications

References 10 publications

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Sunflower (Helianthus annuus) Seed Allergy

New arrivals in anaphylaxis to foods

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