title: Anaphylaxis to Cyphomandra betacea Sendth (tamarillo) in an obeche wood (Triplochiton scleroxylon)--allergic patient.
abstract: BACKGROUND
  Anaphylaxis after the first exposure to a food allergen is uncommon unless a cross-reaction is present.
  
  
  OBJECTIVE
  To investigate a possible relationship between the fruit Cyphomandra betacea Sendth (commonly known as tamarillo) and the wood of Triplochiton scleroxylon (obeche) in a patient with allergic occupational bronchial asthma due to obeche wood who began to experience anaphylaxis episodes after eating tamarillo.
  
  
  METHODS
  A 33-year-old carpenter exposed to obeche wood in his occupation was initially seen with rhinitis and bronchial asthma. The causal relationship of these symptoms to obeche wood exposure was investigated by means of peak flow monitoring and bronchial inhalation testing. Furthermore, the patient had 2 acute episodes of anaphylaxis a few minutes after eating salad containing tamarillo. He had never tasted tamarillo before. The allergologic study included skin prick tests, serum specific IgE determinations, bronchial challenges, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting.
  
  
  RESULTS
  Results of skin prick tests with common aeroallergens were negative. Strong skin prick test responses were obtained with obeche and tamarillo. Results of bronchial challenge testing with obeche extract were positive. In tamarillo extract, a 28-kDa band appeared as the most relevant IgE-binding antigen. A similar band of 28 kDa happens to be frequently detected in obeche-allergic patients.
  
  
  CONCLUSIONS
  To our knowledge, this is the first reported case of anaphylaxis to tamarillo presented in a patient allergic to obeche, which raises the question of a new cross-reactivity antigen.
authors.affiliation: Department of Allergy, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. carmen.vidal.pan@sergas.es
authors.forename: Carmen
authors.initials: C
authors.lastname: Vidal
authors.forename: Arturo
authors.initials: A
authors.lastname: González-Quintela
authors.forename: Virginia
authors.initials: V
authors.lastname: Rodriguez
authors.forename: Margarita
authors.initials: M
authors.lastname: Armisén
authors.forename: Tania
authors.initials: T
authors.lastname: Liñares
authors.forename: Enrique
authors.initials: E
authors.lastname: Fernández-Caldas
mesh_terms: D000328:Adult; D000707:Anaphylaxis; D052179:Antigens, Plant / Q000276:immunology; D001249:Asthma / Q000097:blood / Q000276:immunology; D001985:Bronchial Provocation Tests; D003429:Cross Reactions; D005512:Food Hypersensitivity / Q000097:blood / Q000276:immunology*; D005638:Fruit / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D019660:Malvaceae / Q000276:immunology*; D009784:Occupational Diseases / Q000097:blood / Q000276:immunology*; D010936:Plant Extracts / Q000494:pharmacology; D010940:Plant Proteins / Q000276:immunology; D012220:Rhinitis / Q000097:blood / Q000276:immunology; D012882:Skin Tests; D032322:Solanum / Q000009:adverse effects* / Q000276:immunology*; D014934:Wood
chemical_list: D052179:Antigens, Plant; D010936:Plant Extracts; D010940:Plant Proteins; D007073:Immunoglobulin E