Anaphylaxis associated with antiphospholipid syndrome

Background: To our knowledge, no previously published reports have describe d food-induced anaphylaxis associated with the antiphospholipid syndrome. Objective: We undertook a study of four patients with thrombosis associated with the antiphospholipid syndrome after each patient experienced anaphyla xis attributable to ingestion of vegetal foods. Methods: IgE antibody levels to various foods were determined in serum spec imens from the study patients, and skin prick tests with the same allergens were conducted to determine their in vivo responses. Hematologic, cardiopu lmonary, vascular, and rheumatologic studies were also performed. IgG antic ardiolipin antibody levels were determined by ELISA. Results: All four patients fulfilled the criteria for antiphospholipid synd rome and had high levels of specific IgE antibodies for certain food allerg ens. By immunoblot analysis, the presence of serum IgE specific for a 45-kD protein band in an almond extract was detected in these four patients who experienced food-related anaphylaxis. No specific IgE was detected in sera from normal subjects. No IgE antibodies specific for the food panallergen l ipid transfer proteins were detected. Conclusions: This is the first report of severe food-precipitated anaphylax is associated with the antiphospholipid syndrome and the first description of a patient with allergy to blackberry. The possible involvement of food p anallergens distinct from lipid transfer proteins is also discussed.