Anaphylaxie alimentaire aux produits de la ruche : à propos de 32 cas déclarés au Réseau d’Allergo-Vigilance®

Abstract

Food supplements based on products of the hive are very popular and considered beneficial to health. However, they are not without risk for atopic patients as pointed out by the notice issued by the ANSES in 2018.We present a retrospective descriptive study of cases of food anaphylaxis to bee-gathered pollen and hive products reported to the French Allergy-Vigilance® Network from 2002 to June 2021. ResultsIn all, 32 anaphylaxis cases were reported, i.e., 1.26% of all food anaphylaxis reports, 16 to bee-gathered pollen (50%), 14 to honey (40.6%), 2 to royal jelly (6.3%) and 1 to propolis (3.1%). Most of the patients were adults (81.3%), half of them suffering from grade 2 anaphylactic reactions and one third of them from grade 3. The 2 anaphylaxis to royal jelly were grade 3 with asthma. Among these patients, 37.5% were hospitalized, only 21.9% received adrenaline. Pollen sensitization was present in 87.5% of cases with seasonal rhinitis in 53.2%. In bee-gathered pollen anaphylaxis, all patients (100%) were sensitized to pollens with 75% for composites. Concerning honey anaphylaxis, 3 patients were not sensitized to pollens. ConclusionsThis is the largest reported series of anaphylaxis to bee-gathered pollen and hive products. Food allergy to pollen is most often linked to the presence of composite pollen (entomophilic pollens but also to anemophilic pollens), with the possibility of a link with bee secretion proteins such as MRJP1, which is the allergen incriminated in anaphylaxis to royal jelly.