title: Coriander anaphylaxis in a spice grinder with undetected occupational allergy.
abstract: BACKGROUND
  Anaphylaxis after ingestion of spices as a result from occupational sensitization remains anecdotal. We describe a patient, working in a spice factory, with anaphylaxis from coriander in a meal. He also demonstrated urticaria, angio-edema, rhinoconjunctivitis and bronchospasm during handling coriander and fenugreek.
  
  
  OBJECTIVE
  To determine the mechanism of the anaphylactic reaction and to evaluate cross-reactivity between both botanically unrelated spices.
  
  
  METHODS
  Investigations comprised quantification of total and specific IgE by Immuno-CAP FEIA, skin testing, basophil activation experiments by flow-assisted determination of CD63 expression in the patient and 3 healthy controls. Immuno-CAP inhibition experiments were applied to investigate cross-reactivity.
  
  
  RESULTS
  Specific IgE, skin tests and basophil activation tests were clearly positive in the patient, whereas they remained negative in controls. No cross-reactivity between fenugreek and coriander was demonstrable by inhibition experiments.
  
  
  CONCLUSIONS
  The clinical manifestations in temporal relationship to ingestion of coriander and handling of coriander and/or fenugreek, the positive specific IgE results, skin tests and basophil activation assays support the diagnosis of allergy to both spices. History suggests sensitization by occupational exposure.
authors.affiliation: Dept. Immunology-Allergology-Rheumatology, University Antwerpen.
authors.forename: D G
authors.initials: DG
authors.lastname: Ebo
authors.forename: C H
authors.initials: CH
authors.lastname: Bridts
authors.forename: M H
authors.initials: MH
authors.lastname: Mertens
authors.forename: W J
authors.initials: WJ
authors.lastname: Stevens
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D028526:Coriandrum / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009784:Occupational Diseases / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D016273:Occupational Exposure / Q000009:adverse effects*; D012720:Severity of Illness Index; D012882:Skin Tests; D017365:Spices / Q000009:adverse effects*
chemical_list: D007073:Immunoglobulin E