Sesame allergy: current perspectives

Abstract

Sesame is an important global allergen affecting ~0.1% of the North American population. It is a major cause of anaphylaxis in the Middle East and is the third most common food allergen in Israel. We conducted a systematic review of original articles published in the last 10 years regarding the diagnosis and management of sesame allergy. Skin prick testing appears to be a useful predictor of sesame allergy in infants, although data are less consistent in older children and adults. The diagnostic capacity of serum-specific immunoglobulin E is poor, especially in studies that used oral food challenges to confirm the diagnosis. Double-blind, placebo-controlled food challenge thus remains the diagnostic gold standard for sesame allergy. The cornerstone of sesame allergy management is allergen avoidance, though accidental exposures are common and patients must be prepared to treat the consequent reactions with epinephrine. Novel diagnostic and treatment options such as component-resolved diagnostics, basophil activation testing, and oral immunotherapy are under development but are not ready for mainstream clinical application.

Successful Oral Desensitization in Sesame Allergy in an Adult Woman

“…Chronic urticaria (CU) is characterized by recurrent hives lasting more than 6 weeks, either alone or in combination with angioedema, and may persist for months to years [1]. It is classified as spontaneous or inducible and can be further classified into subtypes such as dermographic, cholinergic, aquagenic, solar, and cold-, heat-, or pressure-induced.…”

“…It is classified as spontaneous or inducible and can be further classified into subtypes such as dermographic, cholinergic, aquagenic, solar, and cold-, heat-, or pressure-induced. The various triggers proposed include foods, drugs, infections, autoimmune comorbidities (including autoimmune thyroid disease), and cancer [1]. Recent reports indicated associations with hematological malignancies such as leukemia, lymphoma, and myeloma, as well as with carcinoma of the lung, bladder, testis, ovary, and thyroid gland, in particular papillary thyroid carcinoma.…”

“…IgE-mediated sesame allergy affects 0.1%-2.8% of the population depending on genetic and environmental factors [1]. Affected patients present a wide spectrum of clinical manifestations that span from wheals to anaphylaxis [2].…”

A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

“…40 PFS is caused by cross-reactions between pollen allergens and allergens in plant foods, which occurs in some individuals with pollen allergies. 40 PFS is caused by cross-reactions between pollen allergens and allergens in plant foods, which occurs in some individuals with pollen allergies.…”

“…Sesame allergy is frequently encountered in the Middle East and Israel, but sesame allergy is infrequently encountered outside of these countries and Europe. 40 Although many clinicians make the decision about OFC location on clinical experience, 55 introduction of BM or BHE at home may pose a risk, particularly with IgE-mediated allergy and some forms of non-IgE-mediated food allergy such as severe food protein-induced enterocolitis syndrome (FPIES). 63,67 In the USA, a recent death associated with a physician-supervised baked milk challenge in a child with IgE-mediated cow's milk allergy highlights the risk.…”