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[豆类引起的过敏反应:病例报告]

[Anaphylaxis due to legumes: case report].

作者信息

Alzate-Pérez Leidy Johana, Aguirre-Morales Natalia, Diez-Zuluaga Libia Susana

机构信息

Residente en Alergología Clínica, Universidad de Antioquia. Grupo de Alergología Clínica y Experimental (GACE), Universidad de Antioquia, Medellín, Colombia.

Médica, especialista en Alergología Clínica, Universidad de Antioquia. Grupo de Alergología Clínica y Experimental (GACE), Universidad de Antioquia, Medellín, Colombia. Alergo SAS Y IPS CIGE.

出版信息

Rev Alerg Mex. 2024 Feb 1;71(1):63. doi: 10.29262/ram.v71i1.1358.

Abstract

BACKGROUND

Legumes belonging to the family of the order are a widely consumed source of protein. IgE-mediated hypersensitivity reactions to legumes have been described, the most studied allergens being peanuts and soybeans. In the Mediterranean region and India, lentils, chickpeas and peas have been considered important allergens and legumes have been reported to represent the fifth most common cause of food allergy in children under 5 years of age in Spain. In Latin America, there are few reports of allergy to legumes other than peanuts, and these are especially in the paediatric population.

OBJECTIVE

To describe a case of IgE-mediated legume allergy in an adult female patient.

CASE REPORT

We describe the case of a 65-year-old female patient who reports a 20-year history of generalized urticaria, accompanied by angioedema and dyspnea occurring immediately after consumption of lentils, beans, chickpeas, soya beans and cold meats, requiring admission to the emergency department for this cause. Tolerates peanuts. She does not report anaphylaxis in any context other than those described. He has presented generalized pruritus with exposure to fumes from cooking beans. : Hypertension, type II diabetes mellitus, hypothyroidism. : Anaphylaxis due to penicillin at the age of 30. : extensive local reaction to hymenoptera sting. Prick test trophoallergens: soya 3 mm. Prick to prick protein based on commercial soybean 7mm, chickpea 5mm, lentil 6mm and bean 7mm. He was negative for wheat and peanut (Image 1) (Attached in separate file). It has a normal tryptase report. Indication was given for adequate adrenaline and strict avoidance of legumes, except peanuts.

CONCLUSIONS

Legume allergy is little known in our environment and mainly affects children. Clinical manifestations include mild reactions and anaphylaxis. A high degree of cross-reactivity among legumes has been reported. Lentils have cross-reactivity with chickpeas and beans. Peanut allergy may also be associated with allergy to lentils, chickpeas, and peas, but is less frequently reported.

摘要

背景

豆科植物是广泛食用的蛋白质来源。已经描述了IgE介导的对豆科植物的过敏反应,研究最多的过敏原是花生和大豆。在地中海地区和印度,小扁豆、鹰嘴豆和豌豆被认为是重要的过敏原,据报道,在西班牙5岁以下儿童中,豆类是食物过敏的第五大常见原因。在拉丁美洲,除花生外,很少有对豆类过敏的报道,且这些报道尤其集中在儿科人群中。

目的

描述一例成年女性患者的IgE介导的豆类过敏病例。

病例报告

我们描述了一名65岁女性患者的病例,该患者有20年全身性荨麻疹病史,食用小扁豆、豆类、鹰嘴豆、大豆和冷肉后立即出现血管性水肿和呼吸困难,为此需入住急诊科。她对花生耐受。除上述情况外,她在任何情况下均未发生过敏反应。她在接触煮豆的烟雾时出现全身性瘙痒。病史:高血压、II型糖尿病、甲状腺功能减退。既往史:30岁时因青霉素发生过敏反应。个人史:对膜翅目昆虫叮咬有广泛局部反应。点刺试验营养过敏原:大豆3毫米。基于市售大豆的蛋白点刺试验:大豆7毫米、鹰嘴豆5毫米、小扁豆6毫米、豆类7毫米。小麦和花生点刺试验结果为阴性(图1)(单独文件附件)。她的类胰蛋白酶报告正常。给予了适当的肾上腺素,并指示严格避免食用豆类,但花生除外。

结论

在我们的环境中,豆类过敏鲜为人知,且主要影响儿童。临床表现包括轻度反应和过敏反应。据报道,豆类之间存在高度交叉反应。小扁豆与鹰嘴豆和豆类有交叉反应。花生过敏也可能与小扁豆、鹰嘴豆和豌豆过敏有关,但报道较少。

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