Three cases of childhood nocturnal asthma due to buckwheat allergy

Background: Buckwheat flour (BF) is known as a potent food allergen. Sensit ization to it usually occurs by ingestion but also by inhalation in occupat ional or domestic exposure. Buckwheat chaff-stuffed pillows (BCP) can be co ntaminated with BF during the process of pilling, and many Korean children and adults use BCP for health reasons. Methods and Results: We here present three cases of BF allergy in children using BCP, who had been treated as nonatopic asthmatics after undergoing th e routine allergy skin tests and serologic tests. We took careful clinical histories, and performed skin prick tests (SPT), the radioimmunoassay (RIA) for specific IgE, the BCP-elimination test, the BF bronchial provocation t est, and IgE Western blot. All three children showed positive skin reaction s to BF, but none of them had positive reactions to house-dust mites. Noctu rnal asthmatic symptoms were improved during 7 days of BCP elimination, and asthmatic responses were observed by bronchial provocation tests with home made BF extract. Serum BF-specific IgE antibodies and several IgE-binding p roteins were detected by RIA and Western blot analysis, respectively. Conclusions: Thus, a small amount of BF attached to BCP can induce BF sensi tization, and BCP should be considered a main cause of childhood nocturnal asthma in those asthmatics exposed to these pillows.