title: Nasal response to carrot and lettuce challenge in allergic patients.
abstract: 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.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH 44106.
authors.forename: H J
authors.initials: HJ
authors.lastname: Schwartz
authors.forename: J L
authors.initials: JL
authors.lastname: Arnold
authors.forename: K P
authors.initials: KP
authors.lastname: Strohl
mesh_terms: 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
chemical_list: D007073:Immunoglobulin E