MITE-CONTAMINATED FOODS AS A CAUSE OF ANAPHYLAXIS

Background: Although insect and arthropod contamination of certain foo ds has been recognized for many Sears, allergic manifestations caused by ingestion of mite allergens have only rarely been reported. Objecti ve: The purpose of this study is to present clinical observations in p atients who experienced acute anaphylaxis after eating mite-contaminat ed foods,Methods: Thirty atopic subjects who were first seen with syst emic anaphylaxis precipitated by the ingestion of wheat-containing foo ds underwent skin prick tests with inhalant and food extracts, as well as with uncontaminated and mite-contaminated wheat flour, Flour sampl es were examined michoscopically for identification and counting of mi tes, Der p 1 and Der f 1 levels were quantitated by using immunochemic al methods. Results: The most common symptoms were breathlessness, ang ioedema, wheezing, and rhinorrhea, which started between 10 and 240 mi nutes after eating. Abundant mites sere present in the flour obtained from 25 patients; Suidasia spp. mites were found in grated bread from the other two patients. Positive pride test responses to Dermatophagoi des farinae- and mite-contaminated flour and negative skin test respon ses to wheat extract, other food extracts, and uncontaminated wheat fl our were found in all patients. Skin test responses were positive in v olunteers with mite allergy even after heating Lire mite-contaminated flour at 100 degrees C. Screening of 35 unselected flour samples demon strated the presence of mites in 13 of them (37.1%). Conclusions: Syst emic anaphylaxis can occur after the ingestion of heated or unheated m ite-contaminated foods. This problem may be mure prevalent in tropical and subtropical countries than previously recognized.