ANAPHYLAXIS AFTER INGESTION OF WHEAT-FLOUR CONTAMINATED WITH MITES

Background: Anaphylaxis after ingestion of flours contaminated with mi tes has been recently reported. Objective: The study was designed to d etermine whether flour-induced reactions in the absence of food sensit ivity may result from mite contamination. Methods: Patients with syste mic reactions after ingestion of foods containing wheat flour and with out food sensitivities were included in a prospective study. The flour s were examined microscopically, and major Dermatophagoides allergens were quantified by monoclonal antibody techniques. Skin prick tests an d IgE determinations to mites and hours were performed. Single-blind, placebo-controlled oral challenges were also performed. Results: Sixte en patients were included in our protocol. They showed respiratory all ergies to dust mites (100%) and intolerance to acetylsalicylic acid (8 7%). Microscopic examination of four flours implicated in allergic rea ctions revealed a high degree of mite contamination: Dermatophagoides farinae in one case and Thyreophagus entomophagus in three cases. Our patients' skin test and specific IgE responses to the flours implicate d in the reactions were positive. ri high level of Der 2 was found in the flour infested by D. farinae. Three of six food challenges with co ntaminated flours resulted in systemic reactions. Good tolerance to co ntrol flours was shown in our patients. Conclusion: Ingestion of foods contaminated with mites may induce systemic anaphylactic reactions in patients with respiratory allergy to mites.