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Anaphylaxis caused by lipid transfer proteins: an unpredictable clinical syndrome

Mota, Inês, Gaspar, Ângela, Benito-Garcia, Filipe, Correia, Magna, Arêde, Cristina, Piedade, Susana, Sampaio, Graça, Pires, Graça, Santa-Marta, Cristina, Borrego, Luís-Miguel, Morais-Almeida, Mário·2018·Allergologia et Immunopathologia

Abstract

Introduction Lipid transfer proteins (LTPs) are panallergens found in many plant foods. They are a common cause of food-induced anaphylaxis (FIA) in adults living in the Mediterranean area. LTPs have also been proposed as a main cause of food-dependent exercise-induced anaphylaxis (FDEIA). Objectives Describe clinical characteristics and allergen sensitization profiles in patients with FIA related to LTP. Materials and methods Forty-three patients were included, aged 3-52 years with a clinical history of FIA and proven sensitization to LTP. Patients were tested with a multiple plant food and pollen panel and specific IgE to LTP allergens. LTP sensitization was assessed by in vivo (Pru p 3, LTP extract) and/or by in vitro tests (specific IgE, ImmunoCAP/ISAC ® ). Results Median age of first anaphylactic episode was 24 years (range 2-51), 44% had asthma, 74% were atopic and 42% had pollinosis (olive, mugwort, plane tree, wall pellitory and cypress). Co-sensitization to profilins was found in 22%. Overall in our center, LTP-induced anaphylaxis represents 17% of all causes of FIA. Foods implicated in anaphylactic reactions were: fresh fruits 51%, tree nuts 42%, vegetables (including peanut) 40% and seeds 14%. Seven patients had FDEIA. Conclusions LTPs are important allergens of FIA in Portugal. Clinical reactivity to several taxonomically unrelated plant foods may raise suspicion toward LTP sensitization. The association of LTP-induced anaphylaxis with pollinosis is relevant in ou…

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Metadata

Authors
Mota, I., Gaspar, Â., Benito-Garcia, F., Correia, M., Arêde, C., Piedade, S., Sampaio, G., Pires, G., Santa-Marta, C., Borrego, L.-M., & Morais-Almeida, M.
Venue
Allergologia et Immunopathologia
Published
2018-11
Volume
46
Issue
6
Pages
565-570
ISSN
0301-0546
Cited by
23
References
0
Language
en

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