Nasal response to carrot and lettuce challenge in allergic patients.
BACKGROUND
Food allergies are usually recognized by historical triggers; yet, on occasion, objective testing may be needed to demonstrate allergic causes more convincingly.


OBJECTIVE
Two atopic adult patients presented with respiratory and/or ocular symptoms with an unusual association to handling or eating of vegetables. A third atopic patient presented without attribution of symptoms to vegetable exposure. In all, work-up had revealed positive skin tests and in vitro assays for specific IgE to carrot and/or lettuce; none had gastrointestinal complaints.


METHODS
To assess further these unusual histories and/or IgE antibody findings, laboratory challenge was performed with nasal resistance being used as a monitor of rhinitic reaction.


RESULTS
The first two patients had prolonged nasal objective responses to challenge; the third had a transient response to one of two challenges.


CONCLUSIONS
We conclude that lettuce and carrot can account for clinically significant IgE-mediated allergic reactions, manifested by nasal obstruction. This laboratory reaction to foodstuffs appears to correlate with patient-reported upper airway and ocular symptoms.
Schwartz
H J
HJ
Case Western Reserve University School of Medicine, Cleveland, OH 44106.
Arnold
J L
JL
Strohl
K P
KP
D000328:Adult; D018552:Daucus carota / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D018545:Lactuca / Q000276:immunology; D008875:Middle Aged; D009299:Nasal Provocation Tests
D007073:Immunoglobulin E