Hidden Causes of Anaphylaxis

Nanagas, Vivian C.; Baldwin, James L.; Karamched, Keerthi R.

doi:10.1007/s11882-017-0713-2

Cited by 5 publications

(4 citation statements)

References 95 publications

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“…The various symptoms of mustard allergy that have been observed over the years are mainly mucocutaneous manifestations (urticaria, angioedema, hoarse voice); respiratory symptoms (wheezing, bronchospasm, recurrent cough, nasal congestion, chest tightness, angioedema); gastrointestinal manifestations (epigastralgia, nausea, vomiting, diarrhea, abdominal pain); cardiovascular manifestations (tachycardia, hypotension, chest pain) [4]. Mustard includes irritants such as isothiocyanates that can cause contact dermatitis following non-immunological basophil degranulation without IgE involvement; a reaction with superficial necrosis has been observed in 5% of cases [6]. The best resource for determining the likelihood of a hidden allergen causing an allergic reaction is to take a detailed history of the allergic reaction, the presence of cofactors (medication, physical exertion), the suspected food, the type of food and where it was consumed.…”

Section: Discussionmentioning

confidence: 99%

“…The best resource for determining the likelihood of a hidden allergen causing an allergic reaction is to take a detailed history of the allergic reaction, the presence of cofactors (medication, physical exertion), the suspected food, the type of food and where it was consumed. Skin testing as a first line of defense; using native foods such as ground and suspended mustard seed or mustard oil; a papule at 8 mm would have a sensitivity of 50% and specificity of 90% [6]. Mustard seeds may be contaminated with moulds or mites and therefore a risk of false-positive results [4].…”

Section: Discussionmentioning

confidence: 99%

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Mustard Allergy in Children and Cross-reaction: Case Report

Aminou

Jellali

Mahraoui

2023

AJPR

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Aims: Food allergy to mustard is often unrecognised in children; however, it deserves early recognition as a potentially severe immunoglobulin e (IgE)--mediated allergy with a risk of anaphylaxis. The aim of this work is to show the value of performing an oral challenge test to confirm the diagnosis of mustard allergy. Presentation of Case: We report the observation of a child who presented with allergy to yellow mustard with all the allergological work-up performed. Discussion: The diagnosis of mustard allergy is delicate; on the basis of the clinical history and the food investigation, as mustard is consumed mainly in a masked form. Cross-allergies are common with mugwort, nuts and rosacea. No threshold value for skin tests or specific IgE can be considered sufficient to confirm or not the diagnosis of food allergy or the secondary acquisition of tolerance to mustard. Conclusion: Oral challenge test is the gold standard for confirming the diagnosis of food allergy; reducing the risk of accidental exposure; validating or not the avoidance diet; and improving quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mustard Allergy in Children and Cross-reaction: Case Report

Aminou

Jellali

Mahraoui

2023

AJPR

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“…Los informes de anafilaxia a animales peludos son extremadamente raros, con pocos casos reportados en la literatura, especialmente a caballo y gato (57). El látex es más comúnmente conocido como un alérgeno de contacto en el ámbito ocupacional, sin embargo se han documentado casos de anafilaxia por exposición al látex, ya sea en el contexto peri-anestésico (58) o incluso por alimentos preparados con guantes de látex (59).…”

Section: Causasunclassified

Anafilaxia: estado del arte

Londoño

Raigosa

Vásquez

et al. 2018

iatreia

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La anafilaxia se define como una reacción de hipersensibilidad, sistémica, de instauración rápida y potencialmente fatal, con manifestaciones clínicas y severidad variable, que resulta de la liberación súbita de mediadores de mastocitos y basófilos. El diagnóstico de esta entidad es fundamentalmente clínico, basándose en los patrones de manifestación y la exposición a un posible detonante. Actualmente varios estudios indican deficiencias en la identificación y manejo de esta enfermedad, lo que genera un riesgo elevado de mortalidad. En esta revisión presentamos puntos prácticos del manejo e identificamos las principales consideraciones a tener en cuenta en el primer nivel de atención.

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“…The authors reported these as examples of “hidden” allergens in composite foods, and linked their occurrence to their relatively recent introduction into the Norwegian diet. Nanagas et al undertook a wide-ranging review of hidden allergens, which included non-foods including such as aluminum and also some so-called exotic foods such as crocodile, sago worms (8). New foods and food trends mean that many meals eaten are composite meals, the composition of which might be difficult to elicit.…”

Section: Introductionmentioning

confidence: 99%

Food-Induced Anaphylaxis: Role of Hidden Allergens and Cofactors

Skypala

2019

Front. Immunol.

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Food anaphylaxis is on the increase, with those who have an allergy to peanuts, tree nuts, milk, and seafood at the highest risk of developing such a reaction. However, the diet in many societies is increasingly varied, much of the food consumed is prepared outside the home, and meals are often composed of many different ingredients. Anaphylaxis may occur to a composite food, and it may be unclear whether the reaction is due to contamination or to a culprit allergen present in an added ingredient. Composite foods can contain many allergic proteins present in small amounts, which do not always have to be labeled, unless they feature in European or US labeling regulations. These “hidden” allergens include mustard, celery, spices, lupine, pea, natural food colourings, and preservatives, but can occasionally include allergenic material from contaminants such as cereal mites. Hidden allergens can provoke severe reactions to seemingly unconnected foods which might then lead to a diagnosis of idiopathic anaphylaxis. The same problem can arise with two well-known types of food allergy; wheat-dependant exercise induced anaphylaxis and allergy to non-specific Lipid Transfer Protein allergens, both of which might only manifest when linked to a cofactor such as exercise. Many of these risk factors for food anaphylaxis have a common link; the public's engagement with popular concepts of health and fitness. This includes the development of a food and exercise culture involving the promotion and marketing of foods for their health-giving properties i.e., meat substitutes, wheat substitutes, supplements and alternative, or “natural” remedies for common ailments. Some of these foods have been reported as the cause of severe allergic reactions, but because they are often viewed as benign unlikely causes of severe allergic reactions, could be considered to be hidden allergens. The best resource to elicit the likelihood of a hidden allergen provoking an allergic reaction is to take a detailed history of the allergic reaction, presence of co-factors, foods suspected, type of food and where it was consumed. A good knowledge of commonly used ingredients, and list of potential hidden allergen suspects are essential tools for the food allergy detective.

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Hidden Causes of Anaphylaxis

Cited by 5 publications

References 95 publications

Mustard Allergy in Children and Cross-reaction: Case Report

Mustard Allergy in Children and Cross-reaction: Case Report

Anafilaxia: estado del arte

Food-Induced Anaphylaxis: Role of Hidden Allergens and Cofactors

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