BACKGROUND: Allergic reactions after consumption of spices are well-known. In Asia, fenugreek seeds are consumed as spices and also as medicines. Literature survey carried out does not reveal reports of allergic reactions to fenugreek. In our survey carried out on patients with food allergy, we found two cases of severe allergy to fenugreek. METHODS: We report here two cases of immediate allergy following ingestion, inhalation, and external application of fenugreek seed powder. In the first case, inhalation of the fenugreek seed powder resulted in rhinorrhea, wheezing, and fainting. The second case was of a patient with chronic asthma who developed numbness of head, facial angioedema, and wheezing after application of fenugreek paste to her scalp as a treatment for dandruff. Skin scratch test was performed with fenugreek and other members of the Leguminosae family as fenugreek also belongs to Leguminosae. Objective evidence of the reaction was obtained by conducting double-blind placebo-controlled challenges (DBPCFC). For detecting IgE binding by immunoblotting method, the proteins of the fenugreek extract were resolved using sodium dodecyl sulphate polyacrylamide gel electrophoresis. RESULTS: Skin scratch tests for the patients revealed strong sensitivity to fenugreek and chickpeas. None of the controls showed such response with fenugreek extract. During DBPCFC, both patients showed > 20% drop in peak flow rate after consumption of fenugreek and chickpea. Immunoblots demonstrated binding of specific IgE from the patients' sera with the protein from extracts between 20 kD to 70 kD bands. CONCLUSION: This case report has enlarged the list of food allergens with the addition of fenugreek.
BACKGROUND:Allergic reactions after consumption of spices are well-known. In Asia, fenugreek seeds are consumed as spices and also as medicines. Literature survey carried out does not reveal reports of allergic reactions to fenugreek. In our survey carried out on patients with food allergy, we found two cases of severe allergy to fenugreek. METHODS: We report here two cases of immediate allergy following ingestion, inhalation, and external application of fenugreek seed powder. In the first case, inhalation of the fenugreek seed powder resulted in rhinorrhea, wheezing, and fainting. The second case was of a patient with chronic asthma who developed numbness of head, facial angioedema, and wheezing after application of fenugreek paste to her scalp as a treatment for dandruff. Skin scratch test was performed with fenugreek and other members of the Leguminosae family as fenugreek also belongs to Leguminosae. Objective evidence of the reaction was obtained by conducting double-blind placebo-controlled challenges (DBPCFC). For detecting IgE binding by immunoblotting method, the proteins of the fenugreek extract were resolved using sodium dodecyl sulphatepolyacrylamide gel electrophoresis. RESULTS: Skin scratch tests for the patients revealed strong sensitivity to fenugreek and chickpeas. None of the controls showed such response with fenugreek extract. During DBPCFC, both patients showed > 20% drop in peak flow rate after consumption of fenugreek and chickpea. Immunoblots demonstrated binding of specific IgE from the patients' sera with the protein from extracts between 20 kD to 70 kD bands. CONCLUSION: This case report has enlarged the list of food allergens with the addition of fenugreek.
Authors: Elham Hossny; Motohiro Ebisawa; Yehia El-Gamal; Stefania Arasi; Lamia Dahdah; Rasha El-Owaidy; Cesar A Galvan; Bee Wah Lee; Michael Levin; Santiago Martinez; Ruby Pawankar; Mimi L K Tang; Elizabeth H Tham; Alessandro Fiocchi Journal: World Allergy Organ J Date: 2019-12-02 Impact factor: 4.084