PMID- 32605699
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20210624
IS  - 1539-6304 (Electronic)
IS  - 1088-5412 (Linking)
VI  - 41
IP  - 4
DP  - 2020 Jul 1
TI  - What is in your pantry? Entomologic anaphylaxis.
PG  - 290-295
LID - 10.2500/aap.2020.41.200030 [doi]
AB  - Background: The booklouse, Liposcelis bostrychophila, is a potent environmental 
      allergen clinically associated with rhinoconjunctivitis and asthma. Despite its 
      known infestation of grain products, anaphylaxis from ingestion of this organism 
      has, to our knowledge, not been previously reported. We present the case of a 
      44-year-old woman who developed anaphylaxis to ingested oats and rice shown to be 
      contaminated with L. bostrychophila. Objective: The objective was to isolate a 
      distinct antigen from L. bostrychophila implicated in a case of unexplained 
      anaphylaxis. Methods: In vitro studies were obtained for relevant ingested 
      materials and aeroallergens. Skin-prick testing (SPT) was performed with standard 
      extracts, contaminated oats, fresh oats, and crushed L. bostrychophila. Western 
      blots were conducted using subject and control serum to detect specific 
      immunoglobulin E (IgE) against the grains and L. bostrychophila extract. 
      Competitive inhibition immunoblotting was used to assess specificity of IgE 
      binding. Results: In vitro studies and SPT were notable for positive responses to 
      dust mite and flour contaminated by L. bostrychophila, along with contaminated 
      oats. Testing results for fresh oat and rice were negative. Immunoblots that used 
      the subject's serum revealed a strongly positive band in the contaminated oat and 
      rice extracts at 24 kD, whereas dust-mite extract yielded a single 14-kD band. 
      Isolated L. bostrychophila extract also yielded a 24-kD band. Competitive 
      inhibition experiments demonstrated that the 24-kD band in the contaminated oat 
      extract was immunologically distinct from the 14-kD dust-mite band. Conclusion: 
      Our case highlights the importance of considering L. bostrychophila as a 
      potential culprit for unexplained anaphylaxis due to ingested grain products. 
      Given the ubiquitous presence of this insect, we suspect that this may be a more 
      common problem than previously recognized.
FAU - Galant-Swafford, Jessica
AU  - Galant-Swafford J
AD  - From the Department of Internal Medicine, Division of Rheumatology, Allergy & 
      Immunology, University of California San Diego, San Diego, CA.
FAU - Zuraw, Bruce L
AU  - Zuraw BL
AD  - From the Department of Internal Medicine, Division of Rheumatology, Allergy & 
      Immunology, University of California San Diego, San Diego, CA.
FAU - Herschbach, Jack
AU  - Herschbach J
AD  - From the Department of Internal Medicine, Division of Rheumatology, Allergy & 
      Immunology, University of California San Diego, San Diego, CA.
FAU - Mahata, Manjula
AU  - Mahata M
AD  - From the Department of Internal Medicine, Division of Rheumatology, Allergy & 
      Immunology, University of California San Diego, San Diego, CA.
FAU - Mockford, Edward L
AU  - Mockford EL
AD  - Department of Biology, Illinois State University, Normal, Il.
FAU - Christiansen, Sandra C
AU  - Christiansen SC
AD  - From the Department of Internal Medicine, Division of Rheumatology, Allergy & 
      Immunology, University of California San Diego, San Diego, CA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 0 (Insect Proteins)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adult
MH  - Anaphylaxis/*chemically induced
MH  - Animals
MH  - Avena
MH  - Female
MH  - *Food Contamination
MH  - Humans
MH  - Immunoblotting
MH  - Immunoglobulin E
MH  - Insect Proteins/*adverse effects
MH  - Insecta
MH  - Oryza
MH  - Skin Tests
EDAT- 2020/07/02 06:00
MHDA- 2021/06/25 06:00
CRDT- 2020/07/02 06:00
PHST- 2020/07/02 06:00 [entrez]
PHST- 2020/07/02 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
AID - 10.2500/aap.2020.41.200030 [doi]
PST - ppublish
SO  - Allergy Asthma Proc. 2020 Jul 1;41(4):290-295. doi: 10.2500/aap.2020.41.200030.