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Jarisch R.,FAZ Floridsdorfer Allergiezentrum
Aktuelle Dermatologie | Year: 2014

Besides the physiologic actions (control of brain functions, release of gastric fluid and downregulation of blood pressure) increased histamine may be responsible for several diseases like: cephaleas, migraine, stuffy or running nose postprandial, bronchial asthma, tachycardia, urticaria, diarrhia, dysmenorrhea, hypotension and anaphylactic shock. In addition, motion sickness, vomiting in pregnancy, osteoporosis, paradontosis, drug dependency, hypotension, atopic dermatitis and wound healing may be clearly influenced by histamine. The diagnosis is based on a case history of intolerance of food containing high levels of histamine, like red wine, hard cheese, sauerkraut, salami and fish. Besides the case history, the radioimmunologic determination of histamine and DAO in blood is necessary, followed by a histamine free diet for two weeks and again determination of histamine and DAO in blood. Therapy is then based on a histamine free diet, antihistamines and possibly diaminooxidase containing capsules prior to food intake. © Georg Thieme Verlag KG Stuttgart. Source

Jarisch R.,FAZ Floridsdorfer Allergiezentrum | Hemmer W.,FAZ Floridsdorfer Allergiezentrum
Allergologie | Year: 2010

Apart from Hymenoptera venom allergy, allergic reactions caused by insects may also occur after bites from blood-feeding species as well as after exposure to airborne insect particles and ingestion of insect proteins. The contribution of insects to respiratory allergies is not yet well understood. Ubiquitous insect proteins cross-reactive with minor house dust mite allergens, like tropomyosins and arginine kinases, may play a role within the scope of "arthropod panallergy". On the other hand, there is good evidence from occupational settings for the occurrence of more restricted sensitization to particular insect groups. We present the case of a female farmer allergic to house fly (Musca domestica). Her IgE response was highly specific for the Muscidae family with no cross-reactivity observed with flies and midges from other families. Blood-feeding insects commonly elicit various local adverse reactions mostly representing either type I- or type IV-allergic immune responses. Several saliva allergens have been characterized in mosquitoes (Culicidae). Rarely, blood-feeding insects may also cause generalized reactions. We present a patient having experienced anaphylaxis twice after bites by horseflies (Tabanidae), which together with Triatoma bugs (Reduviidae) and mosquitoes are the blood-feeding insects most often causing systemic reactions. Food allergy to insects is primarily described from Asian countries, where moth larvae and other insects are more regularly consumed. Furthermore, allergic reactions may occur after ingestion of carmine (a natural food coloring made from female cochineal insects) and honeybee royal jelly. The presented case refers to a patient with a previous history of silk allergy who developed anaphylaxis after drinking a tea mixture contaminated with silk allergens. Presumably, some herbal material was infested with flour moths (Pyralidae) or other moth pests thereby leading to contamination with silk proteins from pupal cocoons. © 2010 Dustri-Verlag Dr. Karl Feistle. Source

Hemmer W.,FAZ Floridsdorfer Allergiezentrum | Mayer D.,FAZ Floridsdorfer Allergiezentrum | Jarisch R.,FAZ Floridsdorfer Allergiezentrum
Allergologie | Year: 2011

Meat allergy is a diverse disease with symptoms reaching from local contact reactions to severe anaphylaxis. It may start early in life or manifest only in late adulthood. Immunologically, meat allergies may represent true food allergies or may develop in patients sensitized to airborne serum albumins from cat/dog dander or bird feathers due to the presence of cross-reacting serum albumins in meat (cat-pork-syndrome, bird-egg-syndrome). Likewise, sensitization to bovine serum albumin in milk-allergic children may be associated with beef intolerance. Overall, meat allergens are still poorly characterized with only three being currently listed by the IUIS (Gal d 5: chicken serum albumin/egg yolk α-livetin, Bos d 6: bovine serum albumin, Bos d 7: bovine IgG). Immunoglobulin G represents another major allergen in red meat, especially in adults. Like serum albumins, IgG is considered heat-labile. In genuine meat allergies, several low-molecular weight proteins between 5 kDa and 25 kDa have been identified in poultry and in red meat as partly muscle-specific and heat-resistant allergens (e.g. myoglobin, α-parvalbumin, hemoglobin). Very recently, delayed anaphylactic reactions after the consumption of red meat have been reported in subjects with IgE antibodies against α-galactose, a highly immunogenic carbohydrate structure present in all mammals with the exception of old-world monkeys and humans. Diagnosis of a meat allergy by skin testing and IgE determination using commercially available non-standardized meat extracts is hampered by low sensitivity.On the other hand, positive test results with low clinical relevance may be commonly encountered in subjects sensitized to heat-labile meat allergens such as serum albumins. © 2011 Dustri-Verlag Dr. Karl Feistle. Source

Hemmer W.,FAZ Floridsdorfer Allergiezentrum | Litschauer-Poursadrollah M.,FAZ Floridsdorfer Allergiezentrum | Sesztak-Greinecker G.,FAZ Floridsdorfer Allergiezentrum | Wohrl S.,FAZ Floridsdorfer Allergiezentrum | And 2 more authors.
Allergologie | Year: 2012

Allergic reactions to exotic fruits are relatively rare, but an increasing number of cases might be expected in view of the ever increasing availability, affordability and assortment of such fruits in Central Europe. Most cases of allergic reactions to tropical fruits represent examples of secondary food allergy with many of the implicated foods showing immunologic relationships with more than one primary sensitizer. The scale of exotic fruit allergy might be exceptionally complex in Central Europe due to the high diversity of locally relevant indoor and outdoor allergens associated with food hypersensitivity. Apart from latex allergy, also sensitization to birch or mugwort pollen is commonly associated with adverse reactions to tropical fruits. PR-10 allergens cross-reactive with the major birch pollen allergen Bet v 1 have been identified in kiwi, persimmon, fig and jackfruit. Some cases of anaphylaxis from mango and lychee appear to be related to concomitant mugwort pollen allergy. Profilins have been described as relevant allergens in pineapple, banana, mango, lychee, and melons. Sensitization to Ficus benjamina is commonly associated with fig fruit allergy. The responsible allergens, cysteine proteases, show partial cross-reactivity with homologous allergens in kiwi (Act d 1), papaya, pineapple, and banana. Lipid transfer proteins (nsLTP) have been identified in kiwi, banana and pitaya and might represent relevant allergens also in other tropical fruits. Still little is known about the significance of other potentially relevant protein families, such as thaumatin-like proteins, isoflavone reductases, cyclophilins, and pectinesterases. The present paper describes 15 patients with allergic reactions to tropical fruits, including fig, jackfruit, mango, lychee, persimmon and papaya. Primary sensitization to birch pollen (Bet v 1), mugwort pollen, profilins as well as Ficus benjamina and papain was identified as the cause of the reactions. © 2012 Dustri-Verlag Dr. Karl Feistle. Source

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