Allergy to lentils in Mediterranean pediatric patients

Background: Peanuts and soybeans are the major legumes involved in human fo od allergy; however, scarce data exist on adverse reactions to other temper ate legumes, such as lentils. Objective: The purpose of this study was to identify patients who are aller gic to lentils, to assess clinical features and other associated food aller gies, and to characterize allergens in lentil extract. Methods: Twenty-two children each with a history of adverse reactions to le ntils were enrolled in the study. The diagnosis of lentil allergy was based on food challenges or a concerning history of anaphylaxis, with positive s kin tests and/or specific serum IgE to lentils, Lentil components were char acterized by SDS-PAGE immunoblotting. Results: Twenty of 22 subjects had symptomatic allergy to lentils at the di agnostic time. The most frequent symptoms a ere oropharyngeal symptoms (40% ) and acute urticaria (30%); 3 patients also reported symptoms when they we re exposed to steam from cooked lentils, In 18 patients, symptoms after len til ingestion started under 3 years of age (median, 2.7 years). Nine patien ts had allergic reactions to other legumes: chick peas (6 patients), peas ( 2 patients), and green beans (1 patient). Immunoblotting patterns obtained with patients' sera showed IgE-binding bands ranging from 14 to 84 kd. Five sera recognized 9 or more IgE-binding bands, and more than 50% of patients who were tested have specific IgE antibodies to 7 components in lentil ext ract. Conclusion: Allergic reactions to lentils started early in life, usua lly below 4 Sears of age; oropharyngeal symptoms and acute urticaria were t he most common symptoms through ingestion, and symptomatic reactivity to ch ick peas is frequently associated.