An increasing number
of vegetables with
crossreactions to
latex are being
described in
patients with latex-vegetable
syndrome. We present
two of these
vegetables, custard
apple linked in two
previous cases with
latex sensitisation,
and aubergine, that
had not been
described up to now
in patients with
latex sensitisation.
The diagnosis of
both cases was based
on the clinical
history, positive
skin prick test (SPT)
and specific IgE to
the offending
vegetables, as well
as to positive SPT
and specific IgE
levels to latex and
the major fruits
involved in the
latex-fruit syndrome
(avocado, banana,
and chestnut).
Further, crude
extracts from latex,
custard apple and
aubergine, as well
as the purified
allergens Hev b 6.02
and Prs a 1 were
used in in vitro and
in vivo assays: IgE
immunodetection,
histamine release (HRT)
and basophil
activation (BAT)
tests and skin prick
tests.
In case 1, both
purified Hev b 6.02
and Prs a 1 induced
positive responses
in skin prick tests,
high levels of
basophil activation
and histamine
release. Specific
IgE immunodetection
uncovered a reactive
band of 45 kd in the
crude custard apple
extract, which was
also recognized by
anti-chitinase
monospecific
antibodies. The
serum
from patient 1 also
detected Prs a 1 in
immunodetection. Hev
b 6.02 produced
positive skin
responses and showed
high biological
activity in HRT and
BAT in the case of
patient 2. However,
Prs a 1 was reactive
neither in SPT nor
in IgE
immunodetection. In
fact, no band was
detected using the
serum of patient 2
in avocado or
aubergine extracts.
By contrast, Prs a 1
reached high values
of basophil
activation and over
10 % of histamine
release in case 2.
Key words:
Latex-vegetable
syndrome, Custard
apple, Aubergine,
Hevein.
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