Anaphylaxis caused by linseed (flaxseed) intake

Alonso, Lidia; Marcos, María Luisa Fernández; Blanco, J.; Navarro, J. A.; Juste, S.; Garcés, Mauricio; Pérez, Reyes Pascual; Carretero, P

doi:10.1016/s0091-6749(96)70175-6

Cited by 35 publications

(20 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LTPs are highly stable during thermal processing and digestion [1,2]. Reactivity of IgE to LTPs is often associated with severe systemic symptoms [3].…”

Section: Conflicts Of Interestmentioning

confidence: 99%

See 1 more Smart Citation

Anaphylaxis Induced by Conlinin, a 2S Storage Protein in Flaxseed

Basagaña

Miquel

Micozzi

et al. 2018

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

Palabras clave: Alergia a semillas de lino. Diagnóstico por componentes. Alergia a alimentos. Anafilaxia.The prevalence of allergy to seeds is highly influenced by the geographical area and eating habits. In Spain, according to data from Alergologica 2015 [1], allergy to tree nuts and seeds accounts for 28.4% of all cases of food allergy.Flaxseed is the seed of the plant Linum usitatissimum. It is consumed as a nutritional supplement because it is rich in dietary fiber, polyunsaturated fatty acids, and lignans.Flaxseed has rarely been reported to be a sensitizer [2], and there are few reports of anaphylaxis caused by flaxseed in the literature [3][4][5][6]. However, it is an increasingly common source of allergens as a result of its use in diets for its nutritional benefits and anticancer properties.Flaxseed contains many potential allergens. The storage protein content ranges from 10% to 37%, and has been reported to be as high as 20%-42% for conlinin (the low-molecularmass fraction [2S]) and 58%-66% for linin (the major protein fraction [12S]) [7]. A 56-kDa IgE-binding protein reported in 1 case [5] is thought to correspond to malate dehydrogenase-1. Other authors have recently suggested that the lipid transfer protein (LTP) was the relevant allergen in a case of flaxseed anaphylaxis [8].We present 2 cases of flaxseed-induced anaphylaxis. Patient 1 was a 46-year-old white woman with a personal history of bronchial asthma and rhinoconjunctivitis who presented with pharyngeal pruritus, lingual and palpebral angioedema, dyspnea, and profuse diarrhea immediately after eating multicereal biscuits (oat, rice, flaxseeds, egg, almonds, and raisins). Patient 2 was a 64-year-old white woman with a personal history of breast cancer, allergy to ceftriaxone, and allergic rhinoconjunctivitis due to pollens and pet dander. She presented palmoplantar itching, generalized urticaria, lip angioedema, and throat tightness immediately after eating a

show abstract

“…LTPs are highly stable during thermal processing and digestion [1,2]. Reactivity of IgE to LTPs is often associated with severe systemic symptoms [3].…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…Flaxseed has rarely been reported to be a sensitizer [2], and there are few reports of anaphylaxis caused by flaxseed in the literature [3][4][5][6]. However, it is an increasingly common source of allergens as a result of its use in diets for its nutritional benefits and anticancer properties.…”

mentioning

confidence: 99%

Anaphylaxis Induced by Conlinin, a 2S Storage Protein in Flaxseed

Basagaña

Miquel

Micozzi

et al. 2018

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

show abstract

“…Flaxseed, commonly used as a laxative, is often added to baked foods and cereals. Anaphylaxis to flaxseed has been reported as early as 1930 (30) followed by sparse reports (31)(32)(33)(34)(35). Pumpkin seeds have been reported in only five cases of hypersensitivity: anaphylaxis in four and oropharyngeal swelling with pruritus in one (18,36,37).…”

Section: Anaphylaxis and Other Ige-mediated Reactions By Ingestionmentioning

confidence: 99%

Hypersensitivities to sesame and other common edible seeds

Patel

Bahna

2016

Allergy

View full text Add to dashboard Cite

Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1-0.2%. In this review, we summarize the information relevant to each of the six seeds and their oils regarding the manifestations, routes of exposure, identified major allergens, and cross-reactivity with other seeds or other foods. We also addressed the important role of a thorough history taking in suspecting seed allergy, the limited reliability of routine diagnostic procedures, and the importance of verification by appropriate challenge tests. At present, management is basically dietary avoidance and the use of symptomatic medications that may include epinephrine auto-injectors. We did not encounter any well-designed studies on immunotherapy for seed allergy, but it is hoped that such a gap be filled by the development of safe effective protocols in the near future.With the growing trend of incorporating seeds in diet, hypersensitivity reactions have been increasingly occurring but are rarely suspected. The problem is compounded by the difficulty in identifying the culprit and the apparent underreporting. MethodsIn this article, we review the English literature from January 1930 to March 2016 using PubMed and Google Scholar. Special attention was directed to hypersensitivity reactions to commonly consumed seeds, namely sesame, sunflower, poppy, flaxseed, and pumpkin seed, and their respective oils. We also summarize the studies on the identified allergens and the cross-reactivities among these seeds and with other foods.

show abstract

“…For a full safety assessment, also the exposure to cyanogenic glycosides and possible anaphylaxis resulting from this intake should be evaluated (Alonso et al, 1996). Long-term consumption of flaxseed has been shown to increase plasma levels and urinary excretion of thiocyanate.…”

Section: Further Testing And/or Data Required For the Assessment (Levmentioning

confidence: 99%

ESCO report: Advice on the EFSA guidance document for the safety assessment of botanicals and botanical preparations intended for use as food supplements, based on real case studies

Dusemund¹

2009

EFS3

View full text Add to dashboard Cite

SUMMARYIn June 2008, after an initial public consultation, the Scientific Committee of EFSA published a guidance document for the safety assessment of botanicals and botanical preparations intended for use as ingredients in food supplements. Recommendation was made at the same time to test the proposed approach for safety assessment with a number of examples, and consider amending the Compendia i) of botanicals reported to contain toxic, addictive or psychotropic substances and ii) of botanicals reported to have also a medicinal use.An EFSA Scientific Cooperation (ESCO) Working Group composed of experts identified by the members of the Advisory Forum, and by the Scientific Committee was created to fulfill this request, and advise on the adequacy of the proposed approach for the safety assessment of botanicals and botanical preparations for EFSA and the European Member States" needs. In addition the Working Group was asked to update the Compendia.The ESCO Working Group considered six botanical preparations to test the science-based framework described the guidance document: i) hydroalcoholic extract of dried peel of Citrus aurantium L. ssp. aurantium L., ii) dried green tea extract of Camellia sinensis (L.) Kuntze, iii) dried leaves extract of Ocimum tenuiflorum L., iv) dried fruits water extract of Foeniculum vulgare Mill. ssp. vulgare var. vulgare, v) dried ripe seeds of Linum usitatissimum L., and vi) wheat bran from Triticum aestivum L. These examples were selected in order to address various safety issues, such as misidentification / adulteration, liver toxicity, possible presence of genotoxic and carcinogenic compounds. Based on the experience acquired through the examples, the ESCO Working Group identified a number of possible amendments and additions for the guidance document of the Scientific Committee.

show abstract

Anaphylaxis caused by linseed (flaxseed) intake

Cited by 35 publications

References 3 publications

Anaphylaxis Induced by Conlinin, a 2S Storage Protein in Flaxseed

Anaphylaxis Induced by Conlinin, a 2S Storage Protein in Flaxseed

Hypersensitivities to sesame and other common edible seeds

ESCO report: Advice on the EFSA guidance document for the safety assessment of botanicals and botanical preparations intended for use as food supplements, based on real case studies

Contact Info

Product

Resources

About