Asthma and contact urticaria caused by rice in a housewife

Abstract

We report the case of an atopic housewife who presented with rhinoconjunctivitis-asthma and contact urticaria from handling rice and other cereals. She tolerated cooke cereals. Both skin prick tests with a rice extract (20% w/v) and a rub test with raw rice gave positive results. Bronchial challenge test with methacholine revealed a PC20 of 0.45 mg/ml. The challenge test with raw rice resulted in immediate and late clinical and spirometric responses; pretreatment with DSCG inhibited both responses. The histamine release test (HRT) with rice was positive, and we detected rice-specific IgE antibodies by REIA in the patient's serum. Skin prick tests, HRT, and RAST with a battery of cereals gave positive results. Finally, the rice REIA was inhibited by rice (75%), rye (63%), corn (64%), and wheat (51%) extracts.

Immunological Characterization of Polyclonal Antisera Prepared Against Recombinant Rice RAG2 and Its Application in Detection of 14-16kDa .ALPHA.-amylase/trypsin Inhibitors from Processed Foods

“…It is noteworthy that members of this family in rice grains have been identified as major allergens associated with atopic dermatitis (Ikezawa et al, 1992;Uchio et al, 1998) and asthma (Arai et al, 1998;González-Mendiola et al, 2003;Lezaun et al, 1994). In daily life, rice is widely consumed as a staple food or ingredient in foods.…”

“…The association between rice and allergic reactions was first reported in Japanese patients with a history of asthma induced by exposure to rice flour and eczema exacerbated by rice ingestion (Shibasaki et al, 1979). Rice-induced allergy is IgE-mediated in the case of bronchial asthma (Arai et al, 1998;González-Mendiola et al, 2003;Lezaun et al, 1994) or atopic dermatitis (Di Lernia et al, 1992;Ikezawa et al, 1992) associated with the ingestion of cooked rice or inhalation of vapor during its cooking. Although rice is commonly thought of as a "hypoallergenic" food, the clinical importance of rice allergy has been demonstrated by a report in which a high radioallergosorbent test (RAST) score for rice allergens had a close relationship to the development of severe atopic dermatitis (Ikezawa et al, 1992).…”

Three cases of rice-induced occupational asthma

“…There have been several case reports [1][2][3][4] and one immunologic study 5 of IgE-mediated rice allergy. However, occupational asthma and rhinitis induced by inhalation of rice powder are not common.…”

“…1,2,4 In addition, the occupational exposure of rice millers and farmers may affect their respiratory health. A cross-sectional study in rice farmers reported the prevalence of respiratory symptoms, such as chronic bronchitis (6.3%), physiciandiagnosed asthma (7.1%), and persistent wheezing (8.8%).…”

Rice-Induced Anaphylaxis: IgE-Mediated Allergy against a 56-kDa Glycoprotein

“…Most symptoms reported were rhinoconjunctivitis, bronchial asthma or generalized urticaria after inhalation of rice flour [2,3] or steam of cooked rice [4,5]. Other case reports were on contact urticaria after direct skin contact with raw rice [6,7,8]. Notably, there have been only few reports on immediate hypersensitivity reactions after ingestion of rice [2,9,10,11,12] leading to rhinoconjunctivitis [11,12], bronchial asthma [9,10,11] and acute gastrointestinal symptoms [2].…”