title: Anaphylaxis following the ingestion of flour contaminated by house dust mites--a report of two cases from Singapore.
abstract: This study presents two patients who developed anaphylaxis after eating mite-contaminated food, and also contains a survey of dust-mites contamination in flour samples from Singapore households. The clinical records of each patient was studied. Patient A developed anaphylaxis twenty minutes following the ingestion of home-made fried fish coated with Japanese flour, while Patient B developed similar life-threatening symptoms one hour after the ingestion of home baked scones. Both patients were NSAID-intolerant and had a history of allergic rhinitis. Skin prick tests showed a strong positive result for dust-mites and for extracts prepared from the ingested flour. Flour samples were also examined microscopically which revealed large numbers of live Dermatophagoides farinae dust-mites. A survey of 57 flour samples showed that 4 samples (7%) were contaminated with dust mites. The findings in the present study confirm that mite-contamination of flour exists in Singaporean households, and it may trigger anaphylaxis in susceptible individuals.
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: S Y
authors.initials: SY
authors.lastname: Tay
authors.forename: Tay Sok
authors.initials: TS
authors.lastname: Yan
authors.forename: E
authors.initials: E
authors.lastname: Tham
authors.forename: Tham
authors.initials: T
authors.lastname: Elizabeth
authors.forename: C T
authors.initials: CT
authors.lastname: Yeo
authors.forename: Yeo Chor
authors.initials: YC
authors.lastname: Tzien
authors.forename: F C
authors.initials: FC
authors.lastname: Yi
authors.forename: Yi Fong
authors.initials: YF
authors.lastname: Cheng
authors.forename: J Y
authors.initials: JY
authors.lastname: Chen
authors.forename: Chen
authors.initials: C
authors.lastname: Jiayi
authors.forename: N
authors.initials: N
authors.lastname: Cheong
authors.forename: Cheong
authors.initials: C
authors.lastname: Nge
authors.forename: K Y
authors.initials: KY
authors.lastname: Chua
authors.forename: Chua Kaw
authors.initials: CK
authors.lastname: Yan
authors.forename: B W
authors.initials: BW
authors.lastname: Lee
authors.forename: Lee Bee
authors.initials: LB
authors.lastname: Wah
mesh_terms: D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D000799:Angioedema; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D005260:Female; D005433:Flour; D005506:Food Contamination; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology; D039981:Pyroglyphidae / Q000276:immunology*; D012135:Respiratory Sounds; D012846:Singapore; D012882:Skin Tests; D014581:Urticaria
chemical_list: D039741:Antigens, Dermatophagoides