SELECTED ARTICLES FROM THE RECENT LITERATURE 2004

12/22/04

Mustard allergy

Summary
Background - Seed products are considered to be among the most common types of food incriminated in food allergy (FA). However, extracts of mustard (Mu) seeds are rarely described as a cause of FA despite the extensive use of Mu worldwide.

Findings - Figueroa et al of the Hospital de Gran Canario in Spain reported studies of 24 individuals with histories of Mu allergy (10% of reactions with characteristics of anaphylaxis). In 14 of these 24 a double blind, placebo-controlled oral challenge with Mu elicited allergic reactions. Those with positive oral challenge had greater immediate skin prick test responses to Mu than those with negative oral challenges (8 mm diameter whealing reaction to Mu had a specificity of 90 % and sensitivity of 50% in predicting a positive oral challenge). Almost all those with positive oral challenges were mugwort sensitive with partial cross inhibition seen in in vitro IgE tests. There was also in vitro evidence of cross-reactivity between Mu and certain nuts, legumes and corn. In 40% of such cases, there was evidence of clinical sensitivities to these other foods.

Reference
Allergy 2005; 60:45-55

Editor's Comments
These findings suggest that Mu allergy may not be as rare as implied by the dearth of previous reports of such sensitivity. I have seen evidence of repeated allergic reactions to Mu in 2 children, both of whom lost the clinically manifest sensitivity during adolescence. One has to look for other food sensitivities in those with strong allergic reactivity to Mu.

 

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