PMID- 33651455
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1097-0274 (Electronic)
IS  - 0271-3586 (Linking)
VI  - 64
IP  - 5
DP  - 2021 May
TI  - Occupational IgE-mediated psyllium allergy in contemporary gluten-free and vegan 
      baking: A case of allergic rhinitis.
PG  - 431-434
LID - 10.1002/ajim.23238 [doi]
AB  - Psyllium (from Plantago ovata; ispaghula) is used as a dietary supplement and is 
      supplied in the form of husk, granules, capsules, or powder. Consumers using 
      psyllium-containing laxatives, healthcare workers handling these, and 
      pharmaceutical workers in laxative-manufacturing plants are known to be at risk 
      of sensitization and subsequent rhinitis, asthma, contact urticaria, and even 
      anaphylaxis. To our knowledge, the case we present here is the first of baker's 
      immunoglobulin E (IgE)-mediated occupational allergy due to psyllium exposure. 
      Our patient, a 24-year-old female baker with no previous allergies, was referred 
      to our clinic with suspected occupational rhinitis. After 1 year of baking with 
      cereal flour or gluten-free flour-mix, she began to suffer from 
      rhino-conjunctival symptoms during workdays. Skin prick tests with agents from 
      the patient's workplace revealed allergies not only to wheat and rye flours but 
      also to psyllium, with a remarkable 10 mm wheal. Subsequently, nasal provocation 
      tests confirmed occupational allergic rhinitis to psyllium. We also found 
      work-related sensitization to buckwheat, which she used in gluten-free baking. 
      Due to the increased prevalence of celiac disease and the popularity of 
      gluten-free and vegan food, psyllium has recently become a common ingredient in 
      baking, used as a substitute for gluten or eggs. Bakers handle allergens such as 
      these in high concentrations and this may lie behind the emergence of respiratory 
      and dermal symptoms. It is essential to consider new or recenlty introduced 
      materials as possible allergens if it is suspected that a baker has work-related 
      respiratory or allergic symptoms.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Jungewelter, Soile
AU  - Jungewelter S
AUID- ORCID: 0000-0003-3592-1072
AD  - Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
FAU - Suomela, Sari
AU  - Suomela S
AD  - Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
FAU - Airaksinen, Liisa
AU  - Airaksinen L
AD  - Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
LA  - eng
PT  - Case Reports
DEP - 20210302
PL  - United States
TA  - Am J Ind Med
JT  - American journal of industrial medicine
JID - 8101110
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 8063-16-9 (Psyllium)
SB  - IM
MH  - Allergens/*immunology
MH  - *Cooking/methods
MH  - Diet, Gluten-Free
MH  - Diet, Vegan
MH  - Female
MH  - Humans
MH  - Immunoglobulin E
MH  - Occupational Diseases/*immunology
MH  - Occupational Exposure/*adverse effects
MH  - Psyllium/*immunology
MH  - Rhinitis, Allergic/*immunology
MH  - Young Adult
OTO - NOTNLM
OT  - allergy
OT  - baker
OT  - ispaghula
OT  - nasal provocation test
OT  - occupational rhinitis
EDAT- 2021/03/03 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/03/02 12:17
PHST- 2021/01/11 00:00 [revised]
PHST- 2020/10/26 00:00 [received]
PHST- 2021/02/13 00:00 [accepted]
PHST- 2021/03/03 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/03/02 12:17 [entrez]
AID - 10.1002/ajim.23238 [doi]
PST - ppublish
SO  - Am J Ind Med. 2021 May;64(5):431-434. doi: 10.1002/ajim.23238. Epub 2021 Mar 2.