Sesame oil allergy
Question:
Reviewed: February 24, 2020
3/4/2015
I have a 2 year-old boy who recently ate a sesame seed cracker twice without any issues but has a history of anaphylaxis to hummus (it was confirmed it was due to the sesame in the past). I know anecdotally there are patients who can tolerate the sesame seed but not the oil. IgE sesame is 13 which is actually higher than what it was at the time of his anaphylaxis. Do you think it is okay to allow this patient to continue to eat sesame seed but not processed in other products or the oil?
Answer:
I have asked for the help of Dr. Wesley Burks, Curnen Distinguished Professor and Chair of Department of Pediatrics at the University of North Carolina and internationally recognized expert in food allergy. His response is:
“Thank you for the excellent question; hummus often contains chickpeas and tahini (consisting mostly of sesame seeds generally). Patients will react to the protein in the seed and generally not to the oil in a food. The only exception to that is cold pressed oil, which will contain some amounts of protein not found in heat processed oil.
Also to consider is the fact that some patients have to ingest larger amounts of the protein or sesame seed in this case before they will react. You would have to be sure they had ingested sufficient quantities of the sesame seed to make sure they are really not allergic to the food.”
In summary, I would suggest your patient continue to eat sesame seed but avoid hummus. You specified the hummus reaction was to sesame but you might consider the reaction was to chickpea or garlic. Sesame oil has been reported to cause reactions but I am not aware of this occurring in an individual who can eat sesame seed crackers. We always must keep in mind there may be a dose threshold resulting in a reaction with ingestion of larger amounts of protein. I would doubt the oil has more protein that the seeds on crackers.
Allergy to sesame oil
Q: 9/25/2012
Do you know if sesame oil contains any clinically-significant amount of sesame allergen? I could not find any answers. Sesame oil is used a fair amount in food products. Sesame seed allergy is not all that rare. I am not referring to homemade sesame oil that an artisan gourmet cook may decide to make from scratch one day in the kitchen. I am referring to "normal" food that are bought in a grocery store or consumed at popular restaurants (such as chain-Asian restaurants or Americanized Chinese restaurants, etc)
A: There is a wealth of evidence that anaphylactic reactions can occur to the ingestion of sesame oil (Reference Numbers 1 through 5). In looking through these references, one gets the sense that these reactions can occur after the ingestion of commercial sesame oil preparations.
Thank you again for your inquiry and we hope this response is helpful to you.
References:
1. Chiu JT, Haydik IB. Sesame seed oil anaphylaxis. J Allergy Clin Immunol 1991;88:414-15.
2. Kanny G et al: Sesame seed and sesame seed oil contain masked allergens of growing importance. Allergy 1996: 51: 952-957.
3. Diagnosing IgE-mediated hypersensitivity to sesame by an immediate-reading “contact test” with sesame oil. Cristiana Alonzi, Paolo Campi, Francesco Gaeta, Fernando Pineda, Antonino Romano et al. Short communication June 2011; Journal of Allergy and Clinical Immunology Vol. 127, Issue 6, Pages 1627-1629.
4. Anaphylaxis to sesame (Sesamum indicum) seed and sesame oil. WJ Stevens, DG Ebo, CH Bridts, LS De Clerck - Abstract- January 2002
5. Sesame allergy: a growing food allergy of global proportions? Venu Gangur, Caleb Kelly, Lalitha Navuluri - Review article, July 2005; Annals of Allergy, Asthma & Immunology Vol. 95.
Sincerely,
Phil Lieberman, M.D.
I hope this information is of help to you and your patient.
All my best.
Dennis K. Ledford, MD, FAAAAI