Thursday, 15 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)
Background: Curry spice allergy in children is extremely rare in Japan. In addition, food-dependent exercise-induced anaphylaxis (FEIAn) as a manifestation of spice allergy against curry powder is quite uncommon.Methods: We report a case of FEIAn due to curry spice allergy in a 14-year-old boy. The boy had a history of several episodes of exercise-induced anaphylaxis since the age of 12 years, which were suspected to be FEIAn. He developed pollinosis in spring and autumn, and had increased levels of specific IgE antibodies against many different kinds of allergens such as food and pollens, including, celery, white birch, and mugwort. Among several different foods consumed before the last three episodes of anaphylaxis, we found that curry powder was the common ingredient in all of them. Since the curry powder did not induce symptoms without exercise, we suspected FEIAn caused by curry spices.Results: The results of the exercise challenge test conducted after ingestion of curry were positive and accompanied by skin flare, itching, urticaria, and bulbar conjunctival hyperemia. We recorded a 10.0% decrease in forced vital capacity, and a 13.5% decrease in forced expiratory volume in 1 s on respiratory function testing. The patient was diagnosed as having FEIAn in response to curry powder. The patient was found to be sensitized to coriander, a curry powder ingredient, on ImmnoCAP. Sensitization to several other spices was also detected with skin-prick testing. The patient was instructed to refrain from exercise for 2 h after ingestion of curry powder and has not shown any symptoms since then.Conclusion: Based on history and investigation results, we suspected that the celery-birch-mugwort-spice syndrome was caused by IgE cross-reactivity between pollens and spices.