Oral Mite Anaphylaxis Caused by Mite-Contaminated Okonomiyaki/Pancake-Mix in Japan: 8 Case Reports and a Review of 28 Reported Cases

Background: Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which we...

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Bibliographic Details
Main Authors: Kentaro Takahashi, Masami Taniguchi, Yuma Fukutomi, Kiyoshi Sekiya, Kentaro Watai, Chihiro Mitsui, Hidenori Tanimoto, Chiyako Oshikata, Takahiro Tsuburai, Naomi Tsurikisawa, Kenji Minoguchi, Hiroshi Nakajima, Kazuo Akiyama
Format: Article
Language:English
Published: Elsevier 2014-01-01
Series:Allergology International
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Online Access:http://www.sciencedirect.com/science/article/pii/S1323893015300083
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Summary:Background: Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mitecontaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital. Methods: In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan. Results: Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3 cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to Der p and Der f were more than class 2 in all cases. Conclusions: Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.
ISSN:1323-8930