A case of a spice allergy induced by a betulaceae pollen allergy in a 14-year-old girl

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  • カバノキ科花粉症により花粉-食物アレルギー症候群として発症したと考えられたセリ科のスパイスアレルギーの1例

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<p> Background : Mugwort and birch pollen allergies are frequently associated with immunoglobulin E (IgE) -mediated hypersensitivity to celery and spices. The phenomenon is known as the celery-birch-mugwort-spice syndrome and is well documented in Europe, but rare in Japan.</p><p> Patient : A 14-year-old girl with a history of seasonal rhinoconjunctivitis and runny nose in the spring experienced pruritus of the tongue and mouth when she consumed spaghetti bolognese with celery. She also developed coughs, wheezing, and a squeaky voice after consuming a curry and rice. We performed detailed questioning, measurement of specific IgE antibodies, a skin prick test, and an oral challenge test.</p><p> Result : Serum-specific IgE antibodies to Japanese cedar, cypress, birch, alder pollen, celery, and birch PR-10 (Bet v 1) were detected. On the other hand, serum-specific IgE antibodies to mugwort pollen and birch profilin (Bet v 2) were not detected. She showed positive reactions to several Apiaceous spices in the skin prick test. She also showed positive reactions to coriander and celery in the oral challenge test.</p><p> Conclusion : According to these results, we suspected an apiaceous spice allergy caused by cross-reactions with a Betulaceae pollen allergy in this case. Although it is well known that celery and mugwort profilin can generate cross-reactions with birch profilin (Bet v 2), Bet v 2 was not detected in this case. Thus, we suspect that there are unknown cross-reactive proteins between celery, Betulaceae pollen, and apiaceous spices. Since more children have Betulaceae pollen allergies, we should pay attention to spice allergies.</p>

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