Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series

Abstract

Background It is a putatively understood phenomenon that the overall prevalence of allergic disease has been increasing in recent decades—particularly in industrialized nations. Despite this, there is a relative scarcity of data concerning the development of food-related allergic disease in the adult population. In addition, the paucity of data as it pertains to the Canadian population is particularly marked when compared to other nations. We sought to determine common culprit foods and the reactions they elicited in a series of 14 patients seen in the Winnipeg allergy and immunology clinic. Methods We conducted a retrospective review of patients identified by academic allergists in Winnipeg, Manitoba as fitting criteria for adult-onset IgE-mediated food allergy from May 2018–July 2020. We included patients with IgE-mediated symptoms, including the pollen-food syndrome which developed at the age of 16 or later. We collected data regarding the food which induced the reaction, what the reaction was, and any concomitant atopic disease. Results The most common culprit food identified was shellfish, followed by finfish, pollen-food syndrome, and wheat/flour. The most common reaction experienced was anaphylaxis, followed by food-dependent exercise-induced anaphylaxis and isolated (muco)cutaneous symptoms. With regard to concomitant atopic disease, allergic rhinitis/rhinoconjunctivitis stood out as the most prevalent. Conclusions Adult-onset food allergy—particularly with resultant anaphylaxis—is an important phenomenon to recognize, even when patients have previously tolerated the food in question.

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…Like AR, food allergy may be driven by an IgE‐mediated response and as a result may sometimes lead to anaphylactic reactions 3112 . There is an abundance of consistent evidence, largely in the form of large sample cross‐sectional and retrospective analyses, that the occurrence of food allergy is independently associated with AR 766,855,857,3107,3110,3111,3113–3122 (Table XIII.E.2). In an analysis of over 8000 families, Alm et al 857 .…”

Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management

“…Details of IgE-mediated fruit allergy are summarized in Table 2. However, the most common presentation involves mild and localized symptoms known as oral allergy syndrome (OAS) [38].…”

Síndrome polen-alimento. Revisión con un toque

“…25,26,27 Las profilinas provenientes de las gramíneas son los inductores más potentes de sensibilización a estas proteínas, como el pasto Timoteo (Phl p12), Artemisia (Art v4) y Ambrosia (Amb v8). 28,29,30 Bet v2, la profilina perteneciente al abedul, es un alérgeno menor, ya que la sensibilización es menor a 20 % en Europa del Norte. 31 Proteínas de transferencia de lípidos no específicas (ns-LTP) Las ns-LTP son prolaminas que pertenecen a la familia de proteínas relacionadas con defensa PR-14.…”