Wojas O, Krzych-Fałta E, Samel-Kowalik P, Żalikowska-Gardocka M, Majsiak E, Mari A, Samoliński B
1Deprtament of Environmental Hazard Prevention and Allergology, Medical University of Warsaw, Warsaw, Poland.
2Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Allergy Asthma Clin Immunol. 2020 Apr 15;16:23. doi: 10.1186/s13223-020-00421-5. eCollection 2020.
This paper presents a peculiar first case of an allergy to Silybum marianum (milk thistle) and Eragrostis tef (teff). Both teff and milk thistle have been presented in the literature (both domestic and foreign) in a positive light, the former as a new part of gluten-free diet, and the latter as a treatment for a number of conditions, particularly those of the liver.
A 29-year-old male presented at our clinic due to an episode of itching and burning in his mouth, swollen tongue, and difficulty swallowing following ingestion of teff flakes. He also reported sneezing, runny nose, watering and burning eyes, and wheezing following inhalation exposure to ground milk thistle. The patient's occupation is associated with exposure to these allergens. The patient underwent comprehensive allergy diagnostic assessments (including skin-prick testing, serum specific IgE levels, Faber test, spirometry, and acoustic rhinometry) and gastroenterological assessments. The diagnosis was established on skin tests with native allergens (milk thistle 16/35, teff flour 22/60, negative control 0/0, histamine 3/5) provided by the patient. There are no commercially available (standardized) tests for milk thistle or teff either in Poland or anywhere else in the world.
Milk thistle is available in the form of dry, finely-ground preparations (which are used as additives to bread, soups, and yoghurts) and extracts (which are used as ingredients in over-the-counter herbal remedies). Teff is a gluten-free cereal whose grains are rich in methionine, calcium, iron, folic acid, and antioxidants. This case report presents milk thistle and teff as potentially new allergens. A literature review revealed no similar allergy cases in Poland or elsewhere in the world.
本文介绍了一例对水飞蓟（奶蓟）和画眉草（埃塞俄比亚画眉草）过敏的特殊病例。国内外文献均对埃塞俄比亚画眉草和水飞蓟持肯定态度，前者是无麸质饮食的新选择，后者则用于治疗多种疾病，尤其是肝脏疾病。
一名29岁男性因食用埃塞俄比亚画眉草片后出现口腔瘙痒、灼痛、舌头肿胀及吞咽困难前来我院就诊。他还报告说，吸入磨碎的水飞蓟后出现打喷嚏、流鼻涕、眼睛流泪、灼痛及喘息症状。患者的职业与接触这些过敏原有关。患者接受了全面的过敏诊断评估（包括皮肤点刺试验、血清特异性IgE水平检测、法伯试验、肺活量测定及鼻声反射测定）和胃肠病学评估。根据患者提供的天然过敏原皮肤试验结果（水飞蓟16/35、埃塞俄比亚画眉草面粉22/60、阴性对照0/0、组胺3/5）确诊。在波兰或世界其他任何地方，均没有市售的（标准化）水飞蓟或埃塞俄比亚画眉草检测试剂。
水飞蓟有干燥的细粉制剂（用作面包、汤和酸奶的添加剂）和提取物（用作非处方草药的成分）两种形式。埃塞俄比亚画眉草是一种无麸质谷物，其谷粒富含蛋氨酸、钙、铁、叶酸和抗氧化剂。本病例报告表明水飞蓟和埃塞俄比亚画眉草可能是新的过敏原。文献综述显示，波兰或世界其他地方均未发现类似的过敏病例。
