Sesame allergy in adults: Investigation and outcomes of oral food challenges

Abstract

Sesame (Sesamum indicum) allergy is the most common seed allergy and has been increasingly reported worldwide. [1] Gangur V. Kelly C. Navuluri L. Sesame allergy: a growing food allergy of global proportions?. Ann Allergy Asthma Immunol. 2005; 95: 4-11 Abstract Full Text PDF PubMed Google Scholar The variation in prevalence between populations is likely due to different food habits and awareness. Similar to peanut, immunoglobulin E (IgE)-mediated sesame allergy begins early in life (usually before 2 years of age) and persists in 80% of patients. [2] Cohen A. Goldberg M. Levy B. et al. Sesame food allergy and sensitization in children: the natural history and long-term follow-up. Pediatr Allergy Immunol. 2007; 18: 217-223 Crossref PubMed Scopus (78) Google Scholar Clinical manifestations range from mucocutaneous, respiratory, and gastrointestinal manifestations to life-threatening systemic anaphylaxis. Therefore, accurate diagnosis of sesame allergy is crucial but the value of skin prick tests (SPTs) and sesame-specific IgE (sIgE) has been questioned. Previous studies, largely performed in children, have suggested that neither test sufficiently predicts true allergy as determined by oral food challenges (OFCs). 3 Kanny G. De Hauteclocque C. Moneret-Vautrin D.A. Sesame seed and sesame seed oil contain masked allergens of growing importance. Allergy. 1996; 51: 952-957 Crossref PubMed Scopus (116) Google Scholar , 4 Leduc V. Moneret-Vautrin D.A. Tzen J.T. et al. Identification of oleosins as major allergens in sesame seed allergic patients. Allergy. 2006; 61: 349-356 Crossref PubMed Scopus (144) Google Scholar , 5 Permaul P. Stutius L.M. Sheehan W.J. et al. Sesame allergy: role of specific IgE and skin-prick testing in predicting food challenge results. Allergy Asthma Proc. 2009; 30: 643-648 Crossref PubMed Scopus (30) Google Scholar This is of particular concern because anaphylaxis has been reported in adult patients with negative SPT reactions and sIgE levels. [3] Kanny G. De Hauteclocque C. Moneret-Vautrin D.A. Sesame seed and sesame seed oil contain masked allergens of growing importance. Allergy. 1996; 51: 952-957 Crossref PubMed Scopus (116) Google Scholar We performed a retrospective evaluation of the utility of SPT, sIgE, and other clinical parameters in predicting sesame allergy confirmed by OFC reactions in adults.