title: Urticaria and anaphylaxis in a child after inhalation of lentil vapours: a case report and literature review.
abstract: BACKGROUND
  Among legumes, lentils seem to be the most common legume implicated in pediatric allergic reactions in the Mediterranean area and India, and usually they start early in life, below 4 years of age.
  
  
  METHODS
  A 22 -month-old child was admitted to our Pediatric Department for anaphylaxis and urticaria. At the age of 9 months she presented a first episode of angioedema and laryngeal obstruction, due to a second assumption of lentils in her diet. At admission we performed routine analyses that were all in the normal range, except for the dosage of specific IgE, that revealed a positive result for lentils. Prick tests too were positive for lentils, while they were all negative for other main food allergens. The child also performed a prick by prick that gave the same positive result (with a wheal of 8 mm of diameter). The child had not previously eaten lentils and other legumes, but her pathological anamnesis highlighted that the allergic reaction appeared soon after the inhalation of cooking lentil vapours when the child entered the kitchen Therefore a diagnosis of lentils vapours allergy was made.
  
  
  CONCLUSIONS
  Our case shows the peculiarity of a very early onset. In literature there are no data on episodes of anaphylaxis in so young children, considering that our child was already on lentils exclusion diet. Therefore a diet of exclusion does not absolutely preserve patients from allergic reactions, that can develop also after their cooking steams inhalation.
authors.affiliation: O.U. Bronchopneumology and Cystic Fibrosis, Department of Pediatrics, University of Catania, Catania, Italy. giovitaliti@yahoo.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Vitaliti
authors.forename: Ignazio
authors.initials: I
authors.lastname: Morselli
authors.forename: Valeria
authors.initials: V
authors.lastname: Di Stefano
authors.forename: Angela
authors.initials: A
authors.lastname: Lanzafame
authors.forename: Mario
authors.initials: M
authors.lastname: La Rosa
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leonardi
mesh_terms: D000707:Anaphylaxis / Q000175:diagnosis* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D003296:Cooking; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D019570:Inhalation Exposure; D007428:Intradermal Tests; D027806:Lens Plant / Q000009:adverse effects* / Q000276:immunology; D010328:Patch Tests; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors; D014581:Urticaria / Q000175:diagnosis* / Q000276:immunology
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E