Nasal response to carrot and lettuce challenge in allergic patients. 1995

H J Schwartz, and J L Arnold, and K P Strohl
Case Western Reserve University School of Medicine, Cleveland, OH 44106.

BACKGROUND Food allergies are usually recognized by historical triggers; yet, on occasion, objective testing may be needed to demonstrate allergic causes more convincingly. OBJECTIVE Two atopic adult patients presented with respiratory and/or ocular symptoms with an unusual association to handling or eating of vegetables. A third atopic patient presented without attribution of symptoms to vegetable exposure. In all, work-up had revealed positive skin tests and in vitro assays for specific IgE to carrot and/or lettuce; none had gastrointestinal complaints. METHODS To assess further these unusual histories and/or IgE antibody findings, laboratory challenge was performed with nasal resistance being used as a monitor of rhinitic reaction. RESULTS The first two patients had prolonged nasal objective responses to challenge; the third had a transient response to one of two challenges. CONCLUSIONS We conclude that lettuce and carrot can account for clinically significant IgE-mediated allergic reactions, manifested by nasal obstruction. This laboratory reaction to foodstuffs appears to correlate with patient-reported upper airway and ocular symptoms.

UI MeSH Term Description Entries
D007073 Immunoglobulin E An immunoglobulin associated with MAST CELLS. Overexpression has been associated with allergic hypersensitivity (HYPERSENSITIVITY, IMMEDIATE). IgE
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009299 Nasal Provocation Tests Application of allergens to the nasal mucosa. Interpretation includes observation of nasal symptoms, rhinoscopy, and rhinomanometry. Nasal provocation tests are used in the diagnosis of nasal hypersensitivity, including RHINITIS, ALLERGIC, SEASONAL. Provocation Tests, Nasal,Nasal Provocation Test,Provocation Test, Nasal,Test, Nasal Provocation,Tests, Nasal Provocation
D005260 Female Females
D005512 Food Hypersensitivity Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens in food. Allergy, Food,Food Allergy,Hypersensitivity, Food,Allergies, Food,Food Allergies,Food Hypersensitivities,Hypersensitivities, Food
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D018545 Lactuca Any of the various plants of the genus Lactuca, especially L. sativa, cultivated for its edible leaves. (From American Heritage Dictionary, 2d ed) Iceberg Lettuce,Lactuca sativa,Lettuce,Iceberg Lettuces,Lettuce, Iceberg,Lettuces,Lettuces, Iceberg
D018552 Daucus carota A plant species of the family APIACEAE that is widely cultivated for the edible yellow-orange root. The plant has finely divided leaves and flat clusters of small white flowers. Carrots,Daucus,Carrot

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