A five year old female preschooler attended our allergology clinic with chief complaint of generalized giant urticaria inmediately after ingestion of cooked lentils; clinical history revealed frequent (> 3) emergency visits, since the age of one year , with facial angioedema and generalized urticaria even from inhalation of vapors while cooking of lentils at home; moreover, also symptoms described ocurred while eating foods containing chick peas; Lentils , as other beans ( black, red, chick) , belong to the leguminosa family along with peanuts and coconut.
Methods: Prick lancetter skin tests ( H-S ) to a panel of 25 inhalant and food allergens ( Diater Labs, Argentina ) were performed along with Prick to Prick tests to raw and cooked lentils,chickpeas, black beans, navy beans and coconut. A papule > 3 mm and read at 10 minutes, was considered positive.
Results: papules size (mm) erythema ( mm)
Mite (50/50) 3 mm 10 mm
Blomia negative negative
Chickpeas 5 mm 15 mm
Navy Beans 3 mm 5 mm
Lentils (raw /cooked) 10 mm 20 mm
Peanut 3 mm 5 mm
All other allrgens tested were negative i.e. : epithelia, molds, cockroach,grasses,mosquito,milk,egg,wheat,fishmix,shrimp and other seafood,nuts,hazelnut,almond,coconut and blackbeans.
Conclusions: 1.Prick to Prick testing confirms specific IgE presence to Lentils; our patient could tolerate peanuts and cocunut. Positive Prick test to peanuts likely represent a cross reaction ( 1 ) ; 2. Lupin flour ( Lupinus Albus) , from the Leguminosa family , is found increasingly used in undustrially prepared foods and could elicit symptoms due to cross reactions ,and advice to family was given accordingly (2); 3. This is the first case report from Venezuela.
References: 1. Monneret-Vautrin DA,Gyuerin L, Kanny G et al. Croos allergenicity of peanut and lupine: the risk of lupine allergy in patients allergic to peanuts. J Allerg Clin Immunol 1999; 104 : 883-888. 2. Wassenberg J, Hofer M. Lupine induced anaphylaxis in a child without known food allergy. Case report . Ann Allerg Asthma Immunol 2007; 98:589-590