Anafilaxia por leguminosas: reporte de un caso

Abstract

ABSTRACT

Keywords:  Food Hypersensitivity,  Fabaceae,  Anaphylaxis

INTRODUCTION

Legumes belonging to the family Fabaceae of the order Fabales 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.

RESULTS

We describe the case of a 65-year-old female patient who reports a 20-year history of generalised urticaria, accompanied by angioedema and dyspnoea 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 generalised pruritus with exposure to fumes from cooking beans.

Pathological history: Hypertension, type II diabetes mellitus, hypothyroidism.

Allergic: Anaphylaxis due to penicillin at the age of 30.

Other history: 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 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.