A Case of Systemic Anaphylaxis after Ingestion of “Okonomiyaki” Contaminated with Dermatophagoides Farinae

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  • SUZUKI Shintaro
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • HOMMA Tetsuya
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • MANABE Ryo
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • KIMURA Tomoyuki
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • KUWAHARA Naota
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • TANAKA Akihiko
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • SAGARA Hironori
    Department of Medicine, Division of Respiratory Medicine, and Allegology, Showa University School of Medicine
  • YANAGAWA Yoko
    Department of Microbiology, Showa University School of Medicine

Bibliographic Information

Other Title
  • コナヒョウヒダニが混入したお好み焼きを経口摂取したことによるPancake Syndromeの1例
  • 症例報告 コナヒョウヒダニが混入したお好み焼きを経口摂取したことによるPancake Syndromeの1例 : ダニアレルゲン簡易型検査キット有用性の検討
  • ショウレイ ホウコク コナヒョウヒダニ ガ コンニュウ シタ オコノミヤキ オ ケイコウ セッシュ シタ コトニ ヨル Pancake Syndrome ノ 1レイ : ダニアレルゲン カンイガタ ケンサ キット ユウヨウセイ ノ ケントウ
  • ―ダニアレルゲン簡易型検査キット有用性の検討―

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Abstract

A 32-year-old man experienced tickling of the throat, dyspnea and ocular hyperemia while he ingested “okonomiyaki” （a Japanese pancake made of cabbage, flour and other ingredients）. He was transferred to emergency division and was thought to have a food allergy; he visited our department for examination to identify the allergen. He had severe allergic rhinitis caused by house dust mite allergy. The blood test and skin prick test did not show any positive results to the food contents of okonomiyaki which he had ingested. A detailed interview indicated that he had cooked okonomiyaki using old flour which had been stored for over six months in the damp environment of Japan without being sealed within a dry food storage chamber. A microscopic examination with the flour the patient used for cooking showed a high concentration of Dermatophagoides farina （Der. f）. Dani Scan® （Asahi Group Foods, Ltd., Tokyo, Japan）, a portable kit to inspect the presence of allergen of house dust mite in carpet and bedding, showed large quantities of mite allergens in the flour. Finally the patient was diagnosed with an anaphylaxis due to the ingestion of mite-contaminated okonomiyaki. In recent years, case reports of anaphylaxis caused by ingestion of mite-contaminated flour products are increasing. Both a detailed interview on the condition of the storage of the flour products which the patient used for the cooking of the causative food and the proof of prevalence of mite allergen in the food and seasoning are necessary for the diagnosis. Dani Scan® is a kit that can also be available for a patient’s use at home. Therefore, patients who have mite allergy can detect Der. f in the flour by themselves before its ingestion using Dani Scan®. It might be useful tool for both the prevention and the diagnosis of “pancake syndrome”.

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