NASAL RESPONSE TO CARROT AND LETTUCE CHALLENGE IN ALLERGIC PATIENTS

Background: Food allergies are usually recognized by historical trigge rs; yet, on occasion, objective testing may be needed to demonstrate a llergic causes more convincingly. Objective: Two atopic adult patients presented with respiratory and/or ocular symptoms with an unusual ass ociation to handling or eating of vegetables. A third atopic patient p resented without attribution of symptoms to vegetable exposure. In all , work-up had revealed positive skin tests and in vitro assays for spe cific IgE to carrot and/or lettuce; none had gastrointestinal complain ts. Methods: To assess further these unusual histories and/or IgE anti body findings, laboratory challenge was performed with nasal resistanc e being used as a monitor of rhinitic reaction. Results: The first two patients had prolonged nasal objective responses to challenge; the th ird had a transient response to one of two challenges. Conclusion: We conclude that lettuce and carrot can account for clinically significan t IgE-mediated allergic reactions, manifested by nasal obstruction. Th is laboratory reaction to foodstuffs appears to correlate with patient -reported upper airway and ocular symptoms.