Oral allergy syndrome associated with weed pollinosis

Sang Chul Lee; Young Woong Son; Da Woon Sim; Kyung Hee Park; Jae-Hyun Lee; Jung-Won Park

doi:10.4168/aard.2016.4.6.458

Journal List > Allergy Asthma Respir Dis > v.4(6) > 1059227

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Lee, Son, Sim, Park, Lee, and Park: Oral allergy syndrome associated with weed pollinosis

Case Report

Allergy, Asthma & Respiratory Disease 2016; 4(6): 458-461.

Published online: 30 November 2016

DOI: https://doi.org/10.4168/aard.2016.4.6.458

Oral allergy syndrome associated with weed pollinosis

Sang Chul Lee¹, Young Woong Son¹, Da Woon Sim^1,², Kyung Hee Park^1,², Jae-Hyun Lee^1,², Jung-Won Park^1,²

¹Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

²Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to: Jung-Won Park. Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-1961, Fax: +82-2-393-6884, parkjw@yuhs.ac

Received 14 May 2016 Revised 2 July 2016 Accepted 18 July 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Oral allergy syndrome (OAS) is caused by cross-reactivity between certain pollens and plant foods, including vegetables, nuts, or fruits. Here, we experienced 2 cases of OAS patients associated with mugwort pollinosis without sensitization to Fagales. A 54-year-old female repeatedly experienced skin rashes, perioral edema, nasal obstruction after eating fresh vegetables (celery, lettuce, chicory, radish sprouts, ginseng, etc.). She had suffered from allergic rhinitis worsening in autumn for 5 years. Specific IgE (sIgE) titers to ragweed and mugwort were elevated to 54.1 and 24.9 kU/L, respectively. With regard to the allergen component of pollens, sIgE to Art v 1 (mugwort) and Amb a 1 (ragweed) were elevated to 21.9 and 36.1 kU/L, respectively. Birch sIgE (including Bet v 1 and Bet v 2) was not detected. A 35-year-old male suffered from abdominal pain, skin rashes after eating mango and kiwi. In addition, systemic allergic reaction developed after consumption of tomato and ginseng. He had chronic rhinitis. The sIgE levels to ragweed, mugwort, and tomato were elevated to 0.55, 6.39, and 0.78 kU/L, respectively. The sIgE test results were all negative for Amb a 1, Bet v 1, and Bet v 2 sIgE. Specific IgE levels to Art v 1, Art v 2 sIgE were 3.51 and 4.46 kU/L, respectively. Based on the history and sIgE test results, 2 cases OAS were related to mugwort. We experienced 2 cases of weed pollinosis related to OAS. Culprit foods of OAS can vary depending on their cuisine cultures.

Keywords: Oral allergy syndromem, Food hypersensitivity, Mugwort, Celery, Tomato

Figures and Tables

Table 1

Clinical manifestations and sensitization profiles of the two patients

Manifestations and sensitization	Patient 1	Patient 2
Culprit food	Celery, lettuce, chicory, radish-sprouts, and ginseng	Mango, kiwi, tomato, ginseng
Clinical manifestations	Skin rash, edema of oral area, nasal obstruction after eating fresh vegetables	Abdominal pain, skin rash after eating tomato
		Skin rash and dyspnea after intake of ginseng
		Perioral swelling and pruritis after ingestion of mango and kiwi
Specific IgE titers of allergen
Tree
Birch	0.01 kU/L	0.00 kU/L
rBet v 1 (PR-10)	0.00 kU/L	0.00 kU/L
rBet v 2 (Profilin)	0.01 kU/L	0.01 kU/L
Oak	0.06 kU/L	0.07 kU/L
Weed
Ragweed	54.1 kU/L	0.55 kU/L
nAmb a 1	36.1 kU/L	0.00 kU/L
Mugwort	24.9 kU/L	6.39 kU/L
nArt v 1	21.9 kU/L	3.51 kU/L
nArt v 3 (LTP)	0.03 kU/L	4.46 kU/L

PR-10, pathogenesis-related protein10; LTP, lipid transfer protein.

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ORCID iDs: Jung-Won Park
https://orcid.org/http://orcid.org/0000-0003-0249-8749
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