Mite-contaminated foods as a cause of anaphylaxis1

Sánchez‐Borges, Mario; Capriles‐Hulett, Arnaldo; Fernández-Caldas, Enrique; Suárez-Chacón, Raúl; Caballero, Fernan; Castillo, Sleygh; Sotillo, Eliecer

doi:10.1016/s0091-6749(97)80005-x

Cited by 99 publications

(66 citation statements)

References 18 publications

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“…This striking elevation of total IgE, with much of the total comprised of specific IgE targeting a single antigen, is similar to the recently reported syndrome of adult-onset food anaphylaxis to mammalian meats associated with IgE to galactose-α-1,3-galactose. 25 OMA can occur regardless of whether or not the grain is cooked because the relevant allergens appear to be thermoresistant both clinically and by skin testing, as shown previously by Sánchez-Borges et al 16 Although not present in our case, there has been an association between OMA and NSAID hypersensitivity, which is thought to reflect the presence of components in dust-mite extracts capable of inhibiting cyclooxygenase pathways. 21,26 There has also been a presentation of the OMA associated with exercise.…”

Section: Discussionsupporting

confidence: 80%

A 71-year-old man with anaphylaxis after eating grits

Gewurz¹,

Posthumus²,

Borish³

2012

allergy asthma proc

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The allergist is frequently called on to evaluate patients after episodes of anaphylaxis to determine the cause and implement preventive measures that will reduce the patient's risk from future episodes. The etiology of anaphylaxis can be the result of numerous causes that may go undiagnosed if a thorough evaluation is not performed. We present a 71-year-old man with no history of food allergy or atopy who presented to the emergency room and then our allergy clinic for evaluation after suffering anaphylaxis after a meal of grits and shrimp. The underlying diagnosis, which was subsequently determined, requires a high index of suspicion and should be included in the differential diagnosis of any patient presenting with unexplained anaphylaxis. CASE PRESENTATION Chief ComplaintFood-induced anaphylaxis. History of Present IllnessA 71-year-old man with a history of hypertension, gastroesophageal reflux, and dyslipidemia presented to our clinic after an allergic reaction. His allergic reaction occurred within 1 hour of his evening meal, which consisted of shrimp with grits and bacon. The reaction started with his eyes becoming itchy and watery, followed by nasal congestion and clear rhinorrhea. His tongue and lip then became swollen and he had excessive drooling. He developed an itchy rash on his arms and full body flushing. Next, he experienced shortness of breath, which prompted him to seek emergency medical care. He denied nausea, diarrhea, abdominal cramps, light headedness, or syncope. After evaluation in the emergency room, he was treated with methylprednisolone, diphenhydramine, and nebulized epinephrine. He was admitted for observation but had no further symptoms and was discharged home with an epinephrine autoinjector device and a prednisone taper and told to avoid seafood.He presented to our clinic the next day. He had no similar prior episodes. He denied any history of atopic disease. He had eaten shrimp from the same bag and not had similar reactions. His wife consumed the same meal that he did and did not have similar symptoms. His review of systems was unremarkable. His medications had not changed recently. He had no known drug allergies and specifically no history of reactions to non-steroidal antiinflammatory drugs (NSAIDs).

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Section: Discussionsupporting

confidence: 80%

A 71-year-old man with anaphylaxis after eating grits

Gewurz¹,

Posthumus²,

Borish³

2012

allergy asthma proc

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“…[40][41][42] Some studies established that ingested mite allergens are heat stable and can still cause an allergic response after ingestion. 6,7 Although the recorded concentration of Blo t 5 is not very high, and the highest concentration was 790 ng/g, consumption of an amount of cereal-based food as little as 3 g may present a risk for a sensitized patient and an asthmatic attack might be induced if 25 g of contaminated food was consumed. This postulate was based on the suggestion of the Second International Meeting of Dust Mites and Asthma held in England in 1990, which indicated that exposure at a level of 2 μg/g of dust to group 1 and 2 allergens was a risk factor for sensitization in genetically predisposed individuals, while exposure at a level 10 μg of mite allergens per gram of dust was a risk factor for the onset of acute asthma.…”

Section: Discussionmentioning

confidence: 98%

“…5 Although the main source of mite allergens is believed to be exposure to indoor house dust mites, there is increasing evidence pointing to oral ingestion of mites as a source of allergen exposure. 6,7 Blomia tropicalis, a member of the Echimyopodidae family, is a common mite species found not only in tropical and subtropical regions but also in temperate regions. 8,9 This mite has been found in house dust from homes in Hong Kong, Brazil, Venezuela, Columbia, Taiwan, Malaysia, Spain, Egypt, and the United States.…”

Section: Introductionmentioning

confidence: 99%

Quantitation of Blomia tropicalis Allergen Blo t 5 in Cereal and Cereal-Based Foods Consumed in the Nile Delta, Egypt

Hussein

Elawamy

2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. The mite Blomia tropicalis has significant prevalence worldwide. Blo t 5 is a major B. tropicalis allergen that has been associated with sensitization and allergic symptoms in many asthmatic patients. Besides house dust, contaminated foodstuffs are an important source of exposure to B. tropicalis allergens. In this study, a double sandwich enzyme-linked immunosorbent assay (ELISA) using mAb 4D4 and biotinylated mAb 4G9 was done to detect Blo t 5 allergen in different types of raw and processed foods, including wheat, corn, rice, bean, wheat and corn flour, cake, and rusk, which were collected from retail stores in the Nile Delta of Egypt. Out of 88 samples, 38 (43.2%) were positive for Blo t 5 allergen with no significant statistical difference in positivity according to food type. In positive samples, the Blo t 5 concentration ranged from 10 ng/g to 790 ng/g. This study showed that Blo t 5 should be considered as an important allergen that presents a risk to the Egyptian population and should become a routine allergen in the skin prick test to improve the management of allergic disease.

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“…They are also risk factors for rhinitis [2] and food-induced anaphylaxis [3]. Some other potential activities have been suggested for HDM or their components, for example, oxidative damage to proteins, lipids, and DNA in lung cells [4] or induction of gastrointestinal inflammation by the enzymatic properties of Der p 1 [5].…”

Section: Introductionmentioning

confidence: 99%

Mite allergens

Caraballo

2017

Expert Review of Clinical Immunology

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Mite-contaminated foods as a cause of anaphylaxis1

Cited by 99 publications

References 18 publications

A 71-year-old man with anaphylaxis after eating grits

A 71-year-old man with anaphylaxis after eating grits

Quantitation of Blomia tropicalis Allergen Blo t 5 in Cereal and Cereal-Based Foods Consumed in the Nile Delta, Egypt

Mite allergens

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