Objective: To review systemic reactions due to the oral ingestion of mites.
Data sources: We performed a MEDLINE search of peer-reviewed research articles published between 1993 and 2004 relevant to the subject of anaphylactic reactions to mite-contaminated foods.
Study selection: Recent studies that emphasized the potentially life-threatening nature of anaphylactic reactions, responsible foodstuffs and mites, populations at risk, and pathogenesis were selected for inclusion in this review.
Results: Although relatively few new cases of oral mite anaphylaxis are reported in the literature, we speculate that this clinical condition is occurring more frequently than realized in many geographic locations, and only the suspicion of an informed physician can contribute to its diagnosis and prevention. Oral anaphylaxis from mite-contaminated foods may be lethal if not promptly recognized and treated, and some preventive measures may be helpful for individuals at risk. Frequent cross-reactions among domestic, storage, and phytophagous mites explain the increased risk of oral mite anaphylaxis in sensitive patients living in both urban and rural areas. The enzymatic activity of some mite allergens contributes to the pathogenesis of this syndrome by means of mucosal damage and enhanced allergen absorption through the oral route.
Conclusions: Oral mite anaphylaxis is a severe, potentially lethal allergic condition that occurs in many countries and is frequently undiagnosed. Early recognition may lead to the implementation of simple prophylactic measures in at-risk populations of allergic patients.