Anaphylaxis from linseed

A case report of flaxseed anaphylaxis in an infant: Lessons to be learned

Flaxseed allergy is uncommon. An 11-month-old infant developed severe anaphylaxis after ingesting flaxseed.

Case report: A first case of flaxseed-induced anaphylaxis in Korea

RATIONALE

Anaphylaxis is a serious, generalized allergic reaction typically triggered by drugs, food, and bee venom, which can be life-threatening. Seeds are one of the major food allergens and can cause anaphylaxis as well as systemic hypersensitivity reactions. Flaxseed has been widely used crop for numerous purposes, such as in alternative medicine and as a dietary supplement, hypersensitivity to it has rarely been reported.

PATIENT CONCERNS

A 42-year-old female presenting with facial edema, dyspnea and urticaria after ingested half teaspoon of flaxseed flour 30 minutes previously.

DIAGNOSES

A skin prick test for heated flaxseed flour extract showed negative responses, but intradermal test showed positivity which suggested an Immunoglobulin E-mediated reaction.

INTERVENTIONS

The patient was instructed to avoid future ingestion of flaxseed.

OUTCOMES

The patient had no recurrence of symptoms at 1-year follow-up.

LESSONS

This is the first case of flaxseed-induced anaphylaxis in Korea, confirmed by an intradermal skin test.

Hypersensitivities to sesame and other common edible seeds

Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1-0.2%. In this review, we summarize the information relevant to each of the six seeds and their oils regarding the manifestations, routes of exposure, identified major allergens, and cross-reactivity with other seeds or other foods. We also addressed the important role of a thorough history taking in suspecting seed allergy, the limited reliability of routine diagnostic procedures, and the importance of verification by appropriate challenge tests. At present, management is basically dietary avoidance and the use of symptomatic medications that may include epinephrine auto-injectors. We did not encounter any well-designed studies on immunotherapy for seed allergy, but it is hoped that such a gap be filled by the development of safe effective protocols in the near future.

Nutrient- and non-nutrient-based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events

BACKGROUND

To address knowledge gaps regarding natural health product (NHP) usage in mental health populations, we examined their use in adults with mood disorders, and explored the potential for adverse events.

METHODS

Food and NHP intake was obtained from 97 adults with mood disorders. NHP data was used to compare prevalence with population norms (British Columbia Nutrition Survey; BCNS). Bivariate and regression analyses examined factors associated with NHP use. Assessment of potential adverse effects of NHP use was based on comparing nutrient intakes from food plus supplements with the Dietary Reference Intakes and by reviewing databases for reported adverse health effects.

RESULTS

Two-thirds (66%; 95% CI 56 to 75) were taking at least one NHP; 58% (95% CI 47 to 68) were taking NHPs in combination with psychiatric medications. The proportion of each type of NHP used was generally higher than the BCNS (range of p's < 0.05 to 0.0001). When intakes from food and NHP sources were combined, a small proportion exceeded any Lowest-Observed-Adverse-Effect-Levels: only for niacin (n = 17) and magnesium (n = 6), two nutrients for which the potential for adverse effects is minimal. Conversely, about 38% (95% CI 28 to 49) of the sample were taking a non-nutrient based NHP for which previous adverse events had been documented.

CONCLUSIONS

The prevalent use of NHPs in this population suggests that health care providers need to be knowledgeable about their characteristics. The efficacy and safety of NHPs in relation to mental health warrants further investigation.

Anaphylaxis to Linum

BACKGROUND

Flax (Linum usitatissimum) seeds are increasingly used in bread and as laxatives. Hypersensitivity to linseeds has been infrequently described, and we report a case of anaphylaxis induced by linseed ingestion in a 39-year-old woman.

METHODS AND RESULTS

The clinical course, as well as positive skin prick tests and histamine release tests performed with linseed extracts, suggested a type I hypersensitivity as the underlying cause for the patient's multisystemic involvement. The presence of linum-specific IgE in her serum was confirmed by immunoCAP assay.

CONCLUSION

Linum seeds might be a source of allergic sensitization that should be taken into account due to its widespread distribution at health food stores.