Anaphylactic reaction to lupine flour

J Dtsch Dermatol Ges. 2007 Sep;5(9):774-6. doi: 10.1111/j.1610-0387.2007.06457.x.
[Article in English, German]

Abstract

Roasted lupine seeds have been used as snack food in Mediterranean countries for years. Since the 1990s, lupine flour has been used as a substitute for or additive to other flours in countries of the European Union; usually the amount is so low that no declaration is required. Since 1994, a number of cases of immediate-type allergy to lupine flour-containing products have been published. A 52-year-old woman developed facial and mucosal edema, followed by dizziness and shortness of breath a few minutes after ingestion of a nut croissant containing lupine flour; she required emergency care. Allergy diagnostic tests revealed a total IgE of 116 kU/l, a highly elevated concentration of IgE specific for lupine seed (42.9 kU/l) and birch pollen IgE of 2.57 kU/l. Skin prick test with native lupine flour was strongly positive. Allergy against lupine seeds may develop de novo or via cross-reactivity to legumes, particularly peanuts, the latter being detectable in up to 88% of cases, founded on a strong sequence similarity between lupine and peanut allergens. In our patient, no cross-reactivity could be detected via immunoblotting, indicating a rare monovalent sensitization to lupine flour. Treatment consists of avoidance of lupine flour-containing products. Patients with proven peanut allergy should also avoid lupine flour because of the major risk of cross-reaction.

Publication types

  • Case Reports

MeSH terms

  • Anaphylaxis / chemically induced*
  • Anaphylaxis / diagnosis*
  • Dermatitis, Atopic / chemically induced*
  • Dermatitis, Atopic / diagnosis*
  • Female
  • Flour / adverse effects*
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / etiology*
  • Humans
  • Lupinus / adverse effects*
  • Middle Aged