Lupine-induced anaphylaxis.
BACKGROUND
Legumes are one of the most common foods causing allergic reactions in children and adults. Cross-reacting antibodies are frequently demonstrated in this family but the real clinical cross-reactivity is uncommon.


OBJECTIVE
To report a case of lupine-induced anaphylaxis and to elucidate in vivo and in vitro cross-reactivity with some legumes.


METHODS
Skin prick test (SPT) with some legumes were performed. Cap-IgE, ELISA-IgE, and immunoblotting were carried out. Open oral challenges with some legumes were performed. Cross-reactivity was studied by ELISA and immunoblotting inhibition.


RESULTS
The results demonstrated type-I hypersensitivity reactions with lupine and some other legumes. Cap-IgE with peanut was positive but the SPT and ELISA-IgE were negative and the patient tolerated a peanut challenge. ELISA inhibition revealed a partial inhibition (62%) using lupine as the solid phase. Partial inhibition was demonstrated by immunoblotting inhibition. Open oral challenge with peanut and green bean were negative but positive with pea.


CONCLUSIONS
We present a lupine sensitized patient with positive SPT and in vitro cross-reactivity with other legumes. Clinical cross-reactivity progressively developed over a 5-year period. Discrepancies were found between the clinical aspect and in vitro study of peanut allergy. Factors determining the wide variability in cross-reactivity among individuals are still obscure.
Matheu
V
V
Allergy Section, Gregorio Marañón University General Hospital, Madrid, Spain. vmatheud@meditex.es
de Barrio
M
M
Sierra
Z
Z
Gracia-Bara
M T
MT
Tornero
P
P
Baeza
M L
ML
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D007887:Fabaceae / Q000009:adverse effects*; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology* / Q000276:immunology; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D010946:Plants, Medicinal; D012882:Skin Tests
D007073:Immunoglobulin E