PMID- 34091191
OWN - NLM
STAT- MEDLINE
DCOM- 20210903
LR  - 20210903
IS  - 1873-1244 (Electronic)
IS  - 0899-9007 (Linking)
VI  - 89
DP  - 2021 Sep
TI  - Anaphylaxis after consumption of pumpkin seeds in a 2-y-old child tolerant to its 
      pulp: A case study.
PG  - 111272
LID - S0899-9007(21)00134-9 [pii]
LID - 10.1016/j.nut.2021.111272 [doi]
AB  - OBJECTIVES: Pumpkin and its seeds are increasingly consumed by children for their 
      potential health benefits. Each day, approximately 30% of teenagers consume nuts 
      and seeds, including pumpkin seeds. However, there is some evidence that pumpkin 
      seeds may exert allergenic effects and induce severe life-threatening 
      anaphylaxis. Allergy to melon, cucumber, and zucchini, which belong to the same 
      Cucurbitaceae family as pumpkin, are well known, opposite to pumpkin allergy. Few 
      descriptions of allergic reactions associated with pumpkin have been published, 
      especially in children. To date, three cases of pumpkin pulp and two seed cases 
      have been reported among children. Our case report describes a case of pumpkin 
      seed anaphylaxis in a child with good tolerance of pulp. METHODS: In the present 
      study, a 2-y-old child experienced anaphylaxis, presenting with generalized 
      urticaria, swollen lips, and increasing dyspnea after consuming pumpkin seeds. 
      RESULTS: The patient's history showed that, although the child had been receiving 
      an elimination diet because of an immunoglobulin E (IgE)-mediated food allergy to 
      cow's milk and eggs, the basic dietary element was pumpkin pulp. The skin-prick 
      test was positive for pumpkin seed (5 mm) but negative for pumpkin pulp (1 mm), 
      and allergen-specific IgE was 1.34 kUA/L for seed and 0.37 kUA/L for pulp. The 
      component-resolved diagnostics (CRD) found IgE to sesame seed, buckwheat, and 
      walnut (storage proteins). Based on these findings, severe anaphylactic reaction 
      to pumpkin seeds was identified. CONCLUSIONS: Pumpkin seed anaphylaxis can 
      develop in a child with a tolerance to pumpkin pulp. Pumpkin seed allergens have 
      not been well characterized. Homology between amino-acid sequences in storage 
      proteins may indicate cross reactivity between different edible seeds and nuts.
CI  - Copyright (c) 2021 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Gawryjolek, Julia
AU  - Gawryjolek J
AD  - Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier 
      Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland. 
      Electronic address: gawryjolek.j@gmail.com.
FAU - Ludwig, Hanna
AU  - Ludwig H
AD  - Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier 
      Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
FAU - Zbikowska-Gotz, Magdalena
AU  - Zbikowska-Gotz M
AD  - Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik 
      Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 
      Poland.
FAU - Bartuzi, Zbigniew
AU  - Bartuzi Z
AD  - Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik 
      Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 
      Poland.
FAU - Krogulska, Aneta
AU  - Krogulska A
AD  - Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier 
      Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
LA  - eng
PT  - Case Reports
DEP - 20210420
PL  - United States
TA  - Nutrition
JT  - Nutrition (Burbank, Los Angeles County, Calif.)
JID - 8802712
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - *Anaphylaxis/etiology
MH  - Animals
MH  - Cattle
MH  - Child
MH  - *Cucurbita
MH  - *Food Hypersensitivity/diagnosis/etiology
MH  - Humans
MH  - Immunoglobulin E
MH  - Seeds
OTO - NOTNLM
OT  - Anaphylaxis
OT  - Case report
OT  - Child
OT  - Cross reactivity
OT  - Food allergy
OT  - Pulp
OT  - Pumpkin seeds
EDAT- 2021/06/07 06:00
MHDA- 2021/09/04 06:00
CRDT- 2021/06/06 20:55
PHST- 2021/01/16 00:00 [received]
PHST- 2021/02/25 00:00 [revised]
PHST- 2021/04/01 00:00 [accepted]
PHST- 2021/06/07 06:00 [pubmed]
PHST- 2021/09/04 06:00 [medline]
PHST- 2021/06/06 20:55 [entrez]
AID - S0899-9007(21)00134-9 [pii]
AID - 10.1016/j.nut.2021.111272 [doi]
PST - ppublish
SO  - Nutrition. 2021 Sep;89:111272. doi: 10.1016/j.nut.2021.111272. Epub 2021 Apr 20.