1 - Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E., Lisboa, Portugal
2 - CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School Lisboa, Portugal
- EAACI Congress 2020, reunião internacional, apresentação sob a forma de poster
Resumo:
Introdução: Buckwheat is commonly consumed in Asian countries and has become more popular in western countries because buckwheat flour is used to replace wheat in the production of gluten free food products. A very few cases of buckwheat allergy have been reported in Europe and it can behave as a hidden food allergen. The authors present a case with several severe reactions before the identification of the culprit allergen.
Relato do caso: A 41-year-old female patient was referred to our department for assessment of recurrent anaphylactic reactions without a clear trigger. Her first reaction occurred in 2011 while eating bread with butter and cheese and drinking a juice of mixed fruits (apple, orange, mango and others she didn’t remember). She developed angioedema of the lips and upper airway with dyspnea and was admitted to emergency department, where she received parental therapy, which resolved the symptoms. Two years later, after eating cookies, she developed pharyngeal itching and dyspnea and once more needed emergency parenteral therapy. In 2016, in the end of the second pregnancy (37 weeks), she developed angioedema of the upper airway and dyspnea while eating homemade pancakes. She was admitted to the emergency department, where she received hydrocortisone IV. After 5-10 minutes, dyspnea worsened and she started vomiting, which led to an emergency caesarean. She was then referred to our clinic for suspected allergy to whole wheat flour and hydrocortisone. In the first visit, she said that she was regularly eating wheat with no symptoms. For the pancakes, she had used a newly opened package of whole wheat flour and while opening it she had sneezing and nasal pruritus. Because she had often rhinitis symptoms we thought of a wheat contamination by dust mites, but the skin prick tests to aeroallergens and wheat extract were negative. On the next visit she brought the package of flour to do prick- prick tests and only then we found that it was buckwheat flour. Skin prick testing with this flour was positive and skin tests and oral challenge with corticosteroids were negative. The patient was advised to avoid buckwheat and was provided with a written emergency plan including adrenaline.
Conclusões: Buckwheat is an emerging potent allergen. Due to its uncommon use in our country and because its presence in foods is not always evident, it could easily be missed during an investigation of food allergy, with potentially severe adverse consequences.
Palavras Chave: Anaphylaxis, Buckwheat, Food allergy