title: Anaphylaxis after ingestion of wheat flour contaminated with mites.
abstract: BACKGROUND
  Anaphylaxis after ingestion of flours contaminated with mites has been recently reported.
  
  
  OBJECTIVE
  The study was designed to determine whether four-induced reactions in the absence of food sensitivity may result from mite contamination.
  
  
  METHODS
  Patients with systemic reactions after ingestion of foods containing wheat flour and without food sensitivities were included in a prospective study. The flours were examined microscopically, and major Dermatophagoides allergens were quantified by monoclonal antibody techniques. Skin prick tests and IgE determinations to mites and flours were performed. Single-blind, placebo-controlled oral challenges were also performed.
  
  
  RESULTS
  Sixteen patients were included in our protocol. They showed respiratory allergies to dust mites (100%) and intolerance to acetylsalicylic acid (87%). Microscopic examination of four flours implicated in allergic reactions revealed a high degree of mite contamination: Dermatophagoides farinae in one case and Thyreophagus entomophagus in three cases. Our patients' skin test and specific IgE responses to the flours implicated in the reactions were positive. A high level of Der 2 was found in the flour infested by D. farinae. Three of six food challenges with contaminated flours resulted in systemic reactions. Good tolerance to control flours was shown in our patients.
  
  
  CONCLUSIONS
  Ingestion of foods contaminated with mites may induce systemic anaphylactic reactions in patients with respiratory allergy to mites.
authors.affiliation: Hospital Universitario Nuestra Señora del Pino, Facultad de Ciencias Médicas y de la Salud, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Blanco
authors.forename: J
authors.initials: J
authors.lastname: Quiralte
authors.forename: R
authors.initials: R
authors.lastname: Castillo
authors.forename: J
authors.initials: J
authors.lastname: Delgado
authors.forename: C
authors.initials: C
authors.lastname: Arteaga
authors.forename: D
authors.initials: D
authors.lastname: Barber
authors.forename: T
authors.initials: T
authors.lastname: Carrillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000276:immunology*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology; D039741:Antigens, Dermatophagoides; D001241:Aspirin / Q000009:adverse effects; D004342:Drug Hypersensitivity; D005260:Female; D005433:Flour / Q000009:adverse effects* / Q000032:analysis; D005506:Food Contamination; D006023:Glycoproteins / Q000032:analysis / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008924:Mite Infestations / Q000276:immunology*; D008925:Mites / Q000276:immunology*; D011446:Prospective Studies; D012130:Respiratory Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D012882:Skin Tests
chemical_list: D000485:Allergens; D000911:Antibodies, Monoclonal; D039741:Antigens, Dermatophagoides; D006023:Glycoproteins; D007073:Immunoglobulin E; D001241:Aspirin