Allergy Asthma Immunol Res.  2012 Mar;4(2):110-111. 10.4168/aair.2012.4.2.110.

A Case of Korean Ginseng-Induced Anaphylaxis Confirmed by Open Oral Challenge and Basophil Activation Test

• Lee JY
• Jin HJ
• Park JW
• Jung SK
• Jang JY
• Park HS

• KMID: 2260369
• DOI: http://doi.org/10.4168/aair.2012.4.2.110

Abstract

Two case reports discussing Korean ginseng-induced allergic reactions have been published; both were inhalation-induced respiratory allergies in occupational settings. In this report we discuss the first case of anaphylaxis that developed after an oral intake of ginseng, confirmed by an open oral challenge, a skin prick test (SPT), and a basophil activation test (BAT). A 44-year-old man experienced rhinorrhea and nasal stiffness, followed by respiratory difficulty with wheeze and abdominal pain 10 minutes after oral intake of fresh ginseng. He had suffered from episodes of allergic rhinitis during the spring season for several years. Upon presentation, a physical examination, chest radiograph, and routine laboratory tests were unremarkable. Total serum IgE level was 41 IU/mL. The SPT results showed strong positive responses to alder, birch pollens, and ginseng extracts (1:500 w/v). The methacholine bronchial challenge test revealed a positive result at PC20 of 5.83 mg/mL. The open oral challenge was performed using 50 g of fresh ginseng and showed immediate onset of facial flushing, cough, respiratory difficulty with wheeze, and abdominal pain combined with a significant decrease in FEV1 levels (54% from the baseline). Serum-specific IgE and IgG4 antibodies were not detectable by enzyme-linked immunosorbent assay. BAT showed a remarkable increase in the expression of CD203c and CD63 with the addition of ginseng extract in a dose-dependent manner, while no changes were noted in the controls. In conclusion, oral intake of Korean ginseng could induce anaphylaxis, which is mediated by non-IgE-dependent direct activation of basophil/mast cells.

Keyword

Anaphylaxis; basophil; flow cytometry; Panax

MeSH Terms

Abdominal Pain
Adult
Alnus
Anaphylaxis
Antibodies
Basophils
Betula
Bronchial Provocation Tests
Cough
Enzyme-Linked Immunosorbent Assay
Flow Cytometry
Flushing
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulin G
Methacholine Chloride
Panax
Physical Examination
Pollen
Rhinitis
Rhinitis, Allergic, Perennial
Seasons
Skin
Thorax
Antibodies
Immunoglobulin E
Immunoglobulin G
Methacholine Chloride

Figure

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  Figure Increase in the expression of CD203c and CD63 on basophils after incubation with Ginseng extracts in the patient [CD203c (), CD63 ()] and an atopic control [CD203c () CD63 ()].

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