FOOD ALLERGY RELATED TO MUGWORT SENSITIZA TION .2. CROSS-REACTIONS INMUGWORT SENSITIZATION

Food allergy in adulthood is mainly caused by IgE elicited to air-born e allergens (specifically birch and mugwort pollen) which crossreacts with allergens in certain food. In this study we evaluated a) the symp toms caused by mugwort sensitization, which elicits specific IgE frequ ently crossreactive with certain vegetables (celery-roots, carots, pot atoes) and different spices; b) the relevance of skin tests and serolo gical determinations of mugwort or food-specific IgE and c) the freque ncy of (isolated) food allergies caused by cross-reactive IgE to mugwo rt pollen, which, however, did not elicit a saisonal rhinoconjunctivit is. In addition, we wanted to analyze, whether patients with celery al lergy also have an increased incidence of intolerance reactions to add itives or non-steroidal anti inflammatory drugs (NSAID), since the sym ptoms are very similar. About 20% (n = 460/2307) of the atopic patient s were sensitized to mugwort, but only 46% had saisonal rhinoconjuncti vitis. 11.3 % of mugwort sensitizied patients had an associated food a llergy. Interestingly, this food allergy was only associated in 6% wit h saisonal rhinoconjunctivitis, while 5% had a celery allergy without rhinoconjunctivitis. Indeed, only 28 of 53 patients with allergy to ve getables or spices (53%) had also a rhinoconjunctivitis. Mugwort sensi tivity may thus manifest itself as an isolated food allergy to crossre active antigens in certain foods. Skin symptoms were dominating the cl inical picture of food allergy. Of 74 celery-allergic patients, 43% ha d urticaria, 22% angioedema, 18% oral allergy syndrome and 15% asthma. Anaphylaxis was observed in 8 patients (11%). Spices caused very simi lar symptoms with 12% (7/57) anaphylactic reactions, while carots more frequently elicited an oral allergy syndrome but rarely caused anaphy laxis (2/61). The level of specific IgE to mugwort-correlated to the i ncidence of food allergy. The determination of specific IgE against fo od was not sensitive, as 51% of patients with negative IgE still had c elery allergy. The symptoms of celery allergy and intolerance reaction s to additivs or NSAIDs were very similar, with mainly skin symptoms. However, no association of intolerance reactions and food allergy was found.