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Case Report
 

Recurrent Anaphylaxis Due to Lupin Flour: Primary Sensitization Through Inhalation
 

A Prieto,1 E Razzak,1 DP Lindo,2 A Álvarez-Perea,1 M Rueda,1 ML Baeza1

1Allergy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
2Allergy Service, Fundación Hospital de Alcorcón, Madrid, Spain

J Investig Allergol Clin Immunol 2010; Vol. 20(1): 76-79
 

 Abstract


Allergic reactions to lupin have increased in parallel with the growing use of lupin flour by food manufacturers. We studied a patient with recurrent anaphylaxis to manufactured foods and a history of rhinitis-asthma related to lupin inhalation and legume tolerance. Skin prick
tests with airborne and food allergens, specific immunoglobulin (Ig) E determinations, and an inhalation exposure test to ground lupin were carried out. Lupin allergens and cross-reactivity with other legumes were also studied using sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting/immunoblotting inhibition.
The skin tests and specifi c IgE were positive for lupin and vetchling and negative for other legumes. The presence of lupin flour in the implicated foods was confi rmed. Immunoblotting showed multiple IgE-binding bands (10-40 kDa) for lupin and vetchling but not for peanut, pea, or soy extracts. Immunoblotting inhibition demonstrated intense lupin-vetchling cross-reactivity.
We present a case of recurrent anaphylaxis due to lupin flour as a hidden food allergen with primary sensitization due to exposure to ground lupin via inhalation. We found cross-reactivity between lupin and vetchling but not other legumes.

Key words: Vetchling fl our. Food allergy. Hidden allergen. Lupin fl our.