ANAPHYLAXIS TO CRICKETS, CROSS REACTIVITY TO HOUSE DUST MITE AND ASSOCIATED COFACTORS. CASE REPORT

Abstract

<h3>Introduction</h3> Entomophagy common in Latin America, becoming widespread for their nutritional properties and increase world population. Severe cross reaction between insects, shrimp, and mites has a 7.6% prevalence. We present a case of anaphylaxis after consumption of crickets (<i>Ornithachris turbida cavroisi</i>) and its allergenic relationship with dust mite, and cofactors. The objective of this case is to portray how panallergens such as tropomyosin and arginine kinase, common in insects are responsible for cross reactions. <h3>Case Description</h3> 35-year-old male with allergic rhinitis and asthma, completed immunotherapy to <i>Dermatophagoides spp</i> and <i>Junglans regia</i> 5 years ago. 40 minutes after consumption of crickets with alcohol on an up-hill walk, presented generalized urticaria, cough and wheezing. He self-injects 0.5 ml of epinephrine, resolving symptoms within 10 minutes. First evaluation, skin test on food and prick to prick test with crickets were negative. Adding shrimp specific IgE: 0.27 kUA/L, rPen a 1: 0.19 kUA/L, rDer p10: 0.46 kUA/L. Follow-up, negative history of symptoms, avoided eating crickets, and known allergenic cross-reactions, carrying his adrenalin self-injector. <h3>Discussion</h3> There are few reports of allergy due to the consumption of crickets and no studies in Mexico that document cross-reactivity between cricket and house dust mite. IgE-binding cross-reactivity is not the only mechanism of hypersensitivity. The study of anaphylaxis induced by crickets involves prick by prick testing, tropomyosin, molecular allergen reaction, as well as influence of cofactors (ethanol and physical activity). Reaffirming that in the future, allergies to insects will increase and molecular study must be considered for specific treatment, opening new doors for research.