Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.
Nutrition. 2021 Sep;89:111272. doi: 10.1016/j.nut.2021.111272. Epub 2021 Apr 20.
Pumpkin and its seeds are increasingly consumed by children for their potential health benefits. Each day, approximately 30% of teenagers consume nuts and seeds, including pumpkin seeds. However, there is some evidence that pumpkin seeds may exert allergenic effects and induce severe life-threatening anaphylaxis. Allergy to melon, cucumber, and zucchini, which belong to the same Cucurbitaceae family as pumpkin, are well known, opposite to pumpkin allergy. Few descriptions of allergic reactions associated with pumpkin have been published, especially in children. To date, three cases of pumpkin pulp and two seed cases have been reported among children. Our case report describes a case of pumpkin seed anaphylaxis in a child with good tolerance of pulp.
In the present study, a 2-y-old child experienced anaphylaxis, presenting with generalized urticaria, swollen lips, and increasing dyspnea after consuming pumpkin seeds.
The patient's history showed that, although the child had been receiving an elimination diet because of an immunoglobulin E (IgE)-mediated food allergy to cow's milk and eggs, the basic dietary element was pumpkin pulp. The skin-prick test was positive for pumpkin seed (5 mm) but negative for pumpkin pulp (1 mm), and allergen-specific IgE was 1.34 kUA/L for seed and 0.37 kUA/L for pulp. The component-resolved diagnostics (CRD) found IgE to sesame seed, buckwheat, and walnut (storage proteins). Based on these findings, severe anaphylactic reaction to pumpkin seeds was identified.
Pumpkin seed anaphylaxis can develop in a child with a tolerance to pumpkin pulp. Pumpkin seed allergens have not been well characterized. Homology between amino-acid sequences in storage proteins may indicate cross reactivity between different edible seeds and nuts.
南瓜及其种子因其潜在的健康益处而越来越受到儿童的喜爱。每天，约 30%的青少年食用坚果和种子，包括南瓜子。然而，有一些证据表明南瓜子可能具有致敏作用，并引发严重的危及生命的过敏反应。对属于葫芦科的甜瓜、黄瓜和西葫芦的过敏是众所周知的，与南瓜过敏相反。与南瓜相关的过敏反应的描述很少，尤其是在儿童中。迄今为止，已有 3 例儿童食用南瓜果肉和 2 例食用南瓜子的过敏反应报告。我们的病例报告描述了一例儿童食用南瓜子引起的过敏反应，该儿童对果肉有良好的耐受性。
本研究中，1 名 2 岁儿童在食用南瓜子后出现全身性荨麻疹、嘴唇肿胀和呼吸困难加重，诊断为过敏反应。
患儿病史显示，尽管因免疫球蛋白 E（IgE）介导的牛奶和鸡蛋食物过敏而接受饮食排除治疗，但基本饮食元素为南瓜果肉。皮肤点刺试验对南瓜子呈阳性（5 毫米），对南瓜果肉呈阴性（1 毫米），过敏原特异性 IgE 为种子 1.34 kUA/L，果肉 0.37 kUA/L。成分解析诊断（CRD）发现对芝麻、荞麦和核桃（储存蛋白）的 IgE。根据这些发现，确定对南瓜子发生严重过敏反应。
对南瓜果肉耐受的儿童可能会发展为南瓜子过敏。南瓜子过敏原尚未得到很好的描述。储存蛋白中氨基酸序列的同源性可能表明不同可食用种子和坚果之间存在交叉反应。
