Allergy Asthma Respir Dis.  2016 Nov;4(6):458-461. 10.4168/aard.2016.4.6.458.

Oral allergy syndrome associated with weed pollinosis

• Lee SC
• Son YW
• Sim DW
• Park KH
• Lee JH
• Park JW

• KMID: 2361263
• DOI: http://doi.org/10.4168/aard.2016.4.6.458

Abstract

Oral allergy syndrome (OAS) is caused by cross-reactivity between certain pollens and plant foods, including vegetables, nuts, or fruits. Here, we experienced 2 cases of OAS patients associated with mugwort pollinosis without sensitization to Fagales. A 54-year-old female repeatedly experienced skin rashes, perioral edema, nasal obstruction after eating fresh vegetables (celery, lettuce, chicory, radish sprouts, ginseng, etc.). She had suffered from allergic rhinitis worsening in autumn for 5 years. Specific IgE (sIgE) titers to ragweed and mugwort were elevated to 54.1 and 24.9 kU/L, respectively. With regard to the allergen component of pollens, sIgE to Art v 1 (mugwort) and Amb a 1 (ragweed) were elevated to 21.9 and 36.1 kU/L, respectively. Birch sIgE (including Bet v 1 and Bet v 2) was not detected. A 35-year-old male suffered from abdominal pain, skin rashes after eating mango and kiwi. In addition, systemic allergic reaction developed after consumption of tomato and ginseng. He had chronic rhinitis. The sIgE levels to ragweed, mugwort, and tomato were elevated to 0.55, 6.39, and 0.78 kU/L, respectively. The sIgE test results were all negative for Amb a 1, Bet v 1, and Bet v 2 sIgE. Specific IgE levels to Art v 1, Art v 2 sIgE were 3.51 and 4.46 kU/L, respectively. Based on the history and sIgE test results, 2 cases OAS were related to mugwort. We experienced 2 cases of weed pollinosis related to OAS. Culprit foods of OAS can vary depending on their cuisine cultures.

Keyword

Oral allergy syndromem; Food hypersensitivity; Mugwort; Celery; Tomato

MeSH Terms

Abdominal Pain
Adult
Ambrosia
Apium graveolens
Artemisia
Betula
Chicory
Eating
Edema
Exanthema
Female
Food Hypersensitivity
Fruit
Humans
Hypersensitivity*
Immunoglobulin E
Lettuce
Lycopersicon esculentum
Male
Mangifera
Middle Aged
Nasal Obstruction
Nuts
Panax
Plants
Pollen
Raphanus
Rhinitis
Rhinitis, Allergic
Rhinitis, Allergic, Seasonal*
Vegetables
Immunoglobulin E

Reference

1. Crespo JF, Rodriguez J. Food allergy in adulthood. Allergy. 2003; 58:98–113.

2. Egger M, Mutschlechner S, Wopfner N, Gadermaier G, Briza P, Ferreira F. Pollen-food syndromes associated with weed pollinosis: an update from the molecular point of view. Allergy. 2006; 61:461–476.

3. Wüthrich B, Dietschi R. The celery-carrot-mugwort-condiment syndrome: skin test and RAST results. Schweiz Med Wochenschr. 1985; 115:258–264.

4. Maeda N, Inomata N, Morita A, Kirino M, Ikezawa Z. Correlation of oral allergy syndrome due to plant-derived foods with pollen sensitization in Japan. Ann Allergy Asthma Immunol. 2010; 104:205–210.

5. Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the united states: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol. 2010; 126:1105–1118.

6. Cho YS, Lim YJ, Lee JC, Kim SH, Lim MK, Yoo B, et al. Oral allergy syndrome in pollen - sensitized patients. J Asthma Allergy Clin Immunol. 1998; 18:458–465.

7. Baek CH, Bae YJ, Cho YS, Moon HB, Kim TB. Food-dependent exercise-induced anaphylaxis in the celery-mugwort-birch-spice syndrome. Allergy. 2010; 65:792–793.

8. Ma S, Sicherer SH, Nowak-Wegrzyn A. A survey on the management of pollen-food allergy syndrome in allergy practices. J Allergy Clin Immunol. 2003; 112:784–788.

9. Nowak-Wegrzyn A, Fiocchi A. Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity. Curr Opin Allergy Clin Immunol. 2009; 9:234–237.

10. Rancé F. Mustard allergy as a new food allergy. Allergy. 2003; 58:287–288.

11. Rudeschko O, Fahlbusch B, Steurich F, Schlenvoigt G, Jäger L. Kiwi allergens and their cross-reactivity with birch, rye, timothy, and mugwort pollen. J Investig Allergol Clin Immunol. 1998; 8:78–84.

12. López-Matas MA, Ferrer A, Larramendi CH, Huertas AJ, Pagán JA, García-Abujeta JL, et al. In vitro cross-reactivity between tomato and other plant allergens. Ann Allergy Asthma Immunol. 2009; 103:425–431.

13. Paschke A, Kinder H, Zunker K, Wigotzki M, Steinhart H, Wessbecher R, et al. Characterization of cross-reacting allergens in mango fruit. Allergy. 2001; 56:237–242.

14. Lee YW, Choi SY, Lee EK, Sohn JH, Park JW, Hong CS. Cross-allergenicity of pollens from the Compositae family: Artemisia vulgaris, Dendranthema grandiflorum, and Taraxacum officinale. Ann Allergy Asthma Immunol. 2007; 99:526–533.

15. Kim SH, Lee SM, Park HW, Cho SH, Min KU, Kim YY, et al. Chinese bellflower root anaphylaxis: IgE-binding components and cross-reactivity with mugwort and birch. Korean J Intern Med. 2009; 24:279–282.

16. Wood RA. Food allergen immunotherapy: current status and prospects for the future. J Allergy Clin Immunol. 2016; 137:973–982.

17. Bucher X, Pichler WJ, Dahinden CA, Helbling A. Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut. Allergy. 2004; 59:1272–1276.