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  Substance Info: (and synonyms)
Lentils / Daal / Pulse / Masoor

Background Info:

Lentils are annuals with flattened edible seeds just a few millimetres in diameter. Lentils were cultivated by the Persians and Egyptians from 2500 BC. Lentils are now cultivated in most warm and subtropical regions of the world. Popular in parts of Europe and a staple throughout much of the Middle East and India, this tiny, lens-shaped, high-protein pulse, said to be the most nutritious of the pulses, has long been used as a meat substitute.

Lentils are usually dried for storage, transport and sale. They may be used in soups, salads and casseroles, and as dahl, and ground into cereal flour for enriching other flours or infant food. Lentils need to be boiled for first 15 minutes to destroy harmful toxins found in the skin.

The young seedpods can be eaten raw or cooked like Green beans. Lentils are more digestible than many legumes. They are high in protein (but low in fat) and have a fair amount of minerals and vitamins.

The seeds are mucilaginous and laxative. They are considered helpful in the treatment of a variety of intestinal afflictions. Made into a paste, they are used as a cleansing application for indolent ulcers.

If Lentils are to be eaten whole, they must be boiled an extra 15 minutes to destroy harmful toxins found in the skins.

See also Legumes.

 

Adverse Reactions:

IMMUNE REACTIONS


[ 1 / 24 ]

An 8 1/2-year-old boy developed anaphylaxis with the inhalation of steam from boiling lentils. He suddenly developed conjunctival hyperemia, flushing, face and body erythema, face and eyelids swelling, cough, wheezing, dyspnea and confusion immediately following exposure to steam from boiling lentils. He had a history of anaphylactic reactions with similar clinical findings within 30 minutes following the intake of lentil soup when he was 3 years old and after eating chickpea when he was 4 years old. Lentil and chickpea had been removed from his diet since then. When he was 7 years old, just after ingestion of a little amount of pea, he suffered from conjunctival hyperemia, nasal congestion and discharge and had avoided eating pea thereafter. Total serum IgE was 846 IU/ml. Epidermal prick tests were positive with lentil, chickpea and pea. Specific IgE antibodies to lentil and chickpea were 16.7 kUA/L and 10.3 kUA/L respectively. Oral challenge tests were not performed with lentil and chickpea. (Aysenur 2012 ref.28060 7)

Reference:
Aysenur K, Akan A, Mustafa E, Muge T, Kocabas CN. Anaphylaxis induced by lentil inhalation. Asian Pac J Allergy Immunol 2012 Jun;30(2):167-169



[ 2 / 24 ]

A patient with pollen allergy multi-sensitized to different pollens, who also reports symptoms of food allergy: oral syndrome, urticaria and exercise induced anaphylaxis. Results of IgE determinations using microarray technique (ISAC) showed that the aeroallergens involved were typical from a Mediterranean environment; exercised-induced anaphylaxis was certainly related to tomato LTP whereas for episodes of oral syndrome and urticaria from peach LTP, storage proteins from lentils and soya were likely also involved. (Pauli 2010 ref.26975 5)

Reference:
Pauli G, Chivato T. Molecular study of allergies in practice: About a polysensitized patient presenting several severe food allergies. Rev Fr Allergol 2010;50(6):513-515



[ 3 / 24 ]

A report of a patient with pollen allergy to different pollens, and who also reported food allergy: oral syndrome, urticaria and exercise induced anaphylaxis. The etiology of the symptoms are discussed in context with the results of IgE determination by the microarray technique (ISAC). The aeroallergens involved were typical that of a Mediterranean environment; exercised-induced anaphylaxis was certainly related to tomato LTP whereas oral allergy syndrome and urticaria were in addition to peach LTP, probably also involved the storage proteins from lentil and soya. (G. 2010 ref.25409 9)

Reference:
Pauli G, Chivato T. Allergologie moléculaire en pratique : à propos d’un patient polysensibilisé présentant plusieurs allergies alimentaires sévères / Molecular allergology in practice: about an polysensitized patients with multiple severe food allergies Revue Française d'Allergologie 2010;50(6):513-515
Pages



[ 4 / 24 ]

6 lentil-allergic adults are described.
A 20-year-old woman allergic to lentil and peanut reported itchy mouth, difficulty swallowing, tongue swelling, disseminated urticaria, asthma, and abdominal pain on lupine seed ingestion. Skin prick-prick testing with lupine seeds was positive. Specific IgE to lupine was 7.61 kUA/L. No oral challenge was conducted. This prompted the authors to evaluate a possible cross-reactivity between lupine and lentil. Five consecutive lentil-allergic adults (aged 18-54 years) were seen over 5-year period: hone had ingested lupine previously. Results of SPT to lentil were positive in all patients. Specific IgE to lentil was 0-30.7 kUA/L. Patient 2, a 49-year-old man, and patient 3, a 27-year-old woman, both non-allergic to peanut, had positive SPT and specific IgE to lupine (11and 7.5-mm wheals and 100 and 1.42 kUA/L, respectively). DBPCFC with lupine flour resulted in intense oropharyngeal pruritus, difficulty swallowing, and dyspnea with a 0.6-g cumulative dose in patient 2. Patient 3 showed oropharyngeal pruritus, nausea, and intense abdominal pain with a 10-g cumulative dose. Patient 4 was SPT positive with specific IgE of 2.87 kUA/L to lupine. SPT and specific IgE to lupine were negative in patients 5 and 6. Open oral challenges with lupine seeds (25-g cumulative dose) elicited a negative result in these 3 patients. IgE immunoblot with sera from the 3 lentil and lupine-allergic patients were performed. All sera reacted to 49-, 36-, 18-, and 16-kDa proteins in lentil. IgE immunoblot to lupine showed IgE binding to a 72to 73-kDa protein in all sera. Two of 3 sera recognized a 36-kDa protein. Serum from patient 2 showed dose-dependent, almost complete inhibition by lupine of all bands in the lentil immunoblot. Serum from patient 3 showed complete inhibition of lupine by lentil in all concentrations used. These findings show lupine sensitization in 4 of 6 lentil-allergic adults and clinical reactivity to lupine in 3 of 6. To the authors knowledge, only an isolated case of lupine-induced anaphylaxis in a patient reporting symptoms with lentil had been described. In the 2 DBPCFC-positive patients opposite results was shown: lupine seemed to be the primary sensitizer in patient 2, with onset of lentil allergy at 47 years of age. In contrast, lentil seemed to be the primary sensitizer in patient 3, with onset of lentil allergy at 5 years of age and a recent anaphylactic reaction. (Cabanillas 2010 ref.25153 7)

Reference:
Cabanillas B, Crespo JF, Cuadrado C, Burbano C, Rodriguez J. Uncovered reactivity to lupine in lentil-allergic patients. Ann Allergy Asthma Immunol 2010 Jul;105(1):94-96



[ 5 / 24 ]

A 17-year-old male reported suffering from pruritus, diffuse warmth, and facial erythema followed by generalized urticaria, edema of the eyelids, lips and tongue, wheezing, dyspnea, and short-term unconsciousness 30 to 60 minutes after beginning any kind of physical exertion immediately after ingestion of lentil soup. He had experienced 4 separate episodes, the latest episode occurring after a football game. He experienced no reaction to lentil soup (approx 250 mL) if consumed without subsequent physical exertion. He also described 2 episodes of pruritus and tingling of the lips and tongue followed by generalized urticaria, edema of the eyelids, lips and tongue, mild stridor, wheezing, and shortness of breath that began immediately after ingestion of chickpea. He reported no reactions following consumption of other legumes. Total serum IgE was 117u.g/L. Wheal and flare reactions in SPTs and prick-prick tests with lentil were 9/11 mm and 8/11 mm, and with chickpea they were 7/9 mm and 7/10 mm, respectively. SPTs and prick-prick tests with bean, soy, peanut, and pea were negative. Specific IgE antibodies to lentil and chickpea were 13.9 kU/L and 11.3 kU/L, respectively. Specific IgE antibodies to bean, soy, peanut, and pea were all below 0.35 kU/L. An open oral challenge test with lentil soup in progressively increasing doses (1,5, 10, 30, 75, and 125 mL) every 15 minutes was negative. Oral challenge with chickpea was not performed due to patient refusal. Specific food and exercise challenge 1 hour after lentil soup intake resulted in pruritus of the hands, forearms, shoulders, and back, urticarial lesions on the face and shoulders, mild angioedema of the lips, and mild hoarseness and cough. The authors considert this is the first case of food-dependent exercise-induced anaphylaxis due to lentil. (Orhan 2008 ref.22799 7)

Reference:
Orhan F, Karakas T. Food-dependent exercise-induced anaphylaxis to lentil and anaphylaxis to chickpea in a 17-year-old boy. J Investig Allergol Clin Immunol 2008;18(6):465-8.



[ 6 / 24 ]

The objective of this study was to describe the clinical features of a Spanish pediatric population allergic to legumes (lentils, chickpeas, peas, white beans, and peanuts), to evaluate the clinical allergy to several legumes, and to determine which legume extract is most appropriate to use in the diagnosis of legume allergy by skin tests. Fifty-four children with allergic reactions after exposure to legumes were studied. The onset of allergic reactions was at approximately the age of 2 years (median, 22 months). Skin prick test results were positive for at least 3 legumes in 38 children (70%). Positive results were more frequent to boiled extracts than to raw extracts in children with a positive oral challenge. Allergy to lentil was the most frequently diagnosed legume allergy (43 children [80%]), followed by allergy to chickpea (32 children [59%]), pea (27 children [50%]), peanut (18 children [33%]) and white bean (6 children [11%]). Oral challenges with more than 1 legume (median, 3 legumes) were positive in 37 children (69%). The most frequent induced symptoms on challenge were respiratory (rhinitis and/or asthma) and cutaneous.
Clinical Manifestations During Oral Challenges
Symptom Total Lentil Chickpea Pea White bean Peanut
(n=105) (n=37) (n=29) (n = 24) (n=6) (n=9)
Cutaneous 45 (43) 14 (38) 15 (52) 13 (54) 2(33) 3 (33)
GITl 20 (19) 4 (11) 3 (10) 3 (13) 2(33) 2 (22)
Resp 60 (57) 12 (32) 17 (59) 11 (46) 0 4 (44)
OAS 28 (27) 16 (43) 5 (17) 3 (13) 2 (33) 2 (22)
Severe react 11(10) 3 (8) 4(14) 2 (8) 0 2 (22)
(Martínez 2008 ref.22238 3)

Reference:
Martínez San Ireneo M, Ibáñez MD, Sánchez JJ, Carnés J, Fernández-Caldas E. Clinical features of legume allergy in children from a Mediterranean area. Ann Allergy Asthma Immunol 2008 Aug;101(2):179-84



[ 7 / 24 ]

Legume allergy, mainly to lentils and chickpeas, is the fifth most common cause of food allergy in Spanish children. Serological cross-reactivity among legumes is frequent, but its clinical relevance is controversial. The aim of this study was to investigate the cross-reactivity among lentils, chickpeas, peas, white beans and peanuts and its clinical relevance in pediatric patients. Fifty-four children with clinical allergy to legumes were included. Inhibition experiments demonstrated more than 80% inhibition with lentil, chickpea and pea extracts. Immunoblots performed with raw legume extracts (lentil, chickpea and pea) and individual sera revealed that more than 50% of the sera identified an allergen with approximately 50 kDa in all three legume extracts. In all three boiled extracts an intense band at approximately 50 kDa was visualized using a serum pool. The oral legume challenges demonstrated that 37 children (69%) were allergic to 2 or more legumes (median 3 legumes). The most frequent associations were allergy to lentils and chickpeas (57%), allergy to lentils and peas (54%) and allergy to lentils, chickpeas and peas (43%). Food challenges confirmed that clinical allergy to all three legumes is frequent in this cohort of Spanish children. (Martínez 2008 ref.21964 7)

Reference:
Martínez San Ireneo M, Ibáñez MD, Fernández-Caldas E, Carnés J. In vitro and in vivo cross-reactivity studies of legume allergy in a Mediterranean population. Int Arch Allergy Immunol 2008 Jul 2;147(3):222-230



[ 8 / 24 ]

In an overview of the role of hidden allergens in allergic reactions in a geographical area of Spain, legumes caused 5.8% of food allergic reactions in our patients. All the reactions caused by hidden allergens of legumes occurred in soy-allergic patients but one lentil-allergic patient suffered urticaria after contact with a contaminated napkin. Thirty-nine percent of the soy-allergic patients had some reaction caused by soy as a hidden allergen. The most frequent sources of hidden soy allergens were boiled ham, sausages, cheese puffs, precooked dishes, desserts and gravy. (Anibarro 2007 ref.20813 2)

Reference:
Añíbarro B, Seoane FJ, Múgica MV. Involvement of hidden allergens in food allergic reactions. J Investig Allergol Clin Immunol 2007;17(3):168-172



[ 9 / 24 ]

In 2002, 107 cases were reported to the French Allergy Vigilance Network of which 59.8 % were cases of anaphylactic shock (one being fatal), 18.7% systemic reaction, 15.9% laryngeal angio-edema, 5.6% serious acute asthma (one fatal). Adults represented 69% of cases (74 cases). The most frequent causal allergens were peanut (14), nuts (16), shellfish (9) latex group fruit (9 patients), and most often in-patients allergic to latex: avocado (4), kiwi (2), fig (2), and banana (1). Next came lupine flour (7), wheat flour (7), celery (5) and snails (5), sesame (4), milk (3), buckwheat (3), fish (3), peach (2), chicken (2). Single observations included sulfites, quinine (an additive in a tonic drink), mustard, lentils, kidneys, pork, melon, grapes, pears, chicory, artichokes, oranges and Anisakis simplex. Four patients had an immediate post-prandial shock and were reported as idiopathic shock. The allergen was present in a masked form in 13% of cases: peanut (6 - with one fatal), lupine (4), sesame (3), and hazelnut (1).
In 4 cases of which one lethal a severe anaphylactic reaction occurred after consumption of macaroon in which the almonds have been replaced by peanuts paste without an adequate labeling. Two cases of anaphylactic shocks in hospitalized children were due to chocolate drink containing lupine flour. Both children were allergic to peanuts and AS occurred by cross allergy. A case of food allergy to hazelnuts is due to a mislabeling on chocolate packaging at Halloween. Two cases of severe anaphylaxis by proxy are reported: the incriminated allergenic peanuts. The patient presented the allergic reaction by contact with another person eating peanuts. (Moneret-Vautrin 2004 ref.10176 0)

Reference:
Moneret-Vautrin DA, Kanny G, Morisset M, Rance F, Fardeau MF, Beaudouin E. Severe food anaphylaxis: 107 cases registered in 2002 by the Allergy Vigilance Network. Allerg Immunol (Paris) 2004;36(2):46-51



[ 10 / 24 ]

Lentils are among the main plant foods causing allergic reactions in pediatric patients in the Mediterranean area and in many Asian communities. A high proportion (approximately 20%) of the subjects allergic to these legumes present with severe and systemic symptoms, although isolated cutaneous reactions are most common. (Lopez-Torrejon 2003 ref.8841 1)

Reference:
Lopez-Torrejon G, Salcedo G, Martin-Esteban M, Diaz-Perales A, Pascual CY, Sanchez-Monge R. Len c 1, a major allergen and vicilin from lentil seeds: protein isolation and cDNA cloning. J Allergy Clin Immunol 2003;112(6):1208-15



[ 11 / 24 ]

In the Mediterranean area and Middle East, the most commonly consumed legumes are lentils and chickpea. In the United States, United Kingdom and south-east Asia, the major legumes involved in food allergy are considered to be peanut and soy bean, respectively. The clinical manifestations of the allergy to legumes are similar for all legumes and range from oral allergy syndrome, urticaria, angioedema, rhinitis and asthmatic crises to anaphylaxis and even death. Legumes have a high degree of immunological cross-reactivity. The allergenicity of legumes is mainly is mainly related to allergens from the storage proteins of seeds. Vicilins from this group of proteins could be an important common allergen in clinical allergy to legumes. Other panallergens of increasing importance are lipid transfer proteins. (Pereira 2002 ref.7746 2)

Reference:
Pereira MJ, Belver MT, Pascual CY, Martin Esteban M. The allergenic significance of legumes. [Spanish] Allergol Immunopathol (Madr) 2002;30(6):346-53



[ 12 / 24 ]

Serum samples were obtained from 22 patients with histories of adverse reactions to lentils, 14 had also immediate allergic reactions with chickpeas and 10 with peanuts; no one referred symptoms with soy or soy- derived products. All of them had positive specific IgE antibodies to the four legumes. (Belver 2002 ref.13778 5)

Reference:
Belver MT, Pascual CY, Pereira MJ, Valls A, Garcia Ara MC, Boyano T, Martin Esteban M. Cross-reactivity between lentils and chickpeas towards peanuts and soy, in a Spanish children population. [Poster: XXI Congress of EAACI] Allergy 2002;57 Suppl 73:79-84.



[ 13 / 24 ]

Allergic reactions. Asthma. Cough. Rhinitis. Dyspnoea. Vomiting. Crude and boiled extracts were compared using 36 patients with a history of allergic reactions after the ingestion of lentil. Of these, 13 patients had a negative oral challenge, but the heated extract identified best the clinically sensitive individuals. (Marinez 2001 ref.4229 6)

Reference:
Martinez San Ireneo M, Ibanez Sandin MD, Fernandez-Caldas E, Maranon F, Munoz Martinez MC, Laso Borrego MT. The diagnostic value of crude or boiled extracts to identify tolerant versus nontolerant lentil-sensitive children. Ann Allergy Asthma Immunol 2001;86(6):686-90



[ 14 / 24 ]

This study investigated the cross-reactivity to non-Rosaceae LTPs. IgE antibodies to Rosaceae LTPs reacted to a broad range of vegetable foods were evaluated in 498 subjects (age > 12 years) with Rosaccae allergy as judged by skin prick test with fresh fruits and (in most cases) clinical history. The majority had OAS (>97%), and only a minority (approximately 10%) showed urticaria/angioedema, gastrointestinal symptoms, food-induced rhinitis, asthma, or anaphylaxis. Sera from 37 patients were available for follow-up studies. Peach was identified most frequently as an offending Rosaceae food (in 30/37 patients), followed by apple (16/37), apricot (11/37), cherry (9/37), plum (8/37), almond (7/37) and pear (6/37). Four patients did not have any clinical symptoms related to Rosaccae fruits, despite a positive SPT with commercial plum extract and peach peel extract. All 37 patients were interviewed for allergies to other foods. Walnut and hazelnut were most frequently reported as offending foods (19/37 and 15/37, respectively), closely followed by peanut (9/37). For the other 33 different foods, the number of patients reporting symptoms ranged from 1 to 5. These foods were found among all major groups of vegetable foods, including cereals (corn, wheat), legumes (soybean, string bean, white bean, chick pea, lentils, lupine), Solanaceae (potato, tomato, eggplant) Brassicaceae (cabbage, mustard), Umbelliferae (celery, fennel), Rutaceae (lemon, orange), and several other plant families. This article contains a table of the 37 patients and the effecting foods and symptoms of each patient.
(Asero 2000 ref.3711 7)

Reference:
Asero R, Mistrello G, Roncarolo D, de Vries SC, Gautier MF, Ciurana CL, Verbeek E, Mohammadi T, Knul-Brettlova V, Akkerdaas JH, Bulder I, Aalberse RC, van Ree R. Lipid transfer protein: a pan-allergen in plant-derived foods that is highly resistant to pepsin digestion. Int Arch Allergy Immunol 2000;122(1):20-32



[ 15 / 24 ]

Ranked 4th as a cause of hypersensitivity reactions in Spanish children, and 5th in India. Antigens are heat-stable. Lentils seem to be the most common legume implicated in pediatric allergic patients in the Mediterranean area. In this study, lentil allergic children had urticaria and OAS as the most frequent symptoms. (Sanchez-Monge 2000 ref.3996 6)

Reference:
Sanchez-Monge R, Pascual CY, Diaz-Perales A, Fernandez-Crespo J, Martin-Esteban M, Salcedo G. Isolation and characterization of relevant allergens from boiled lentils. J Allergy Clin Immunol 2000;106(5 Pt 1):955-961



[ 16 / 24 ]

Elicitation of asthma by the steam of cooking vegetables such as chick peas and lentils (Martin 1992 ref.543 95) (Pascual 1999 ref.7341 8), and fish, is also possible. (Crespo 1995 ref.15426 0)

Reference:
Pascual CY, Fernandez-Crespo J, Sanchez-Pastor S, Padial MA, Diaz-Pena JM, Martin-Munoz F, Martin-Esteban M. Allergy to lentils in Mediterranean pediatric patients. J Allergy Clin Immunol 1999;103(1 Pt 1):154-8



[ 17 / 24 ]

In a Spanish study, in 20 of 22 subjects who experienced allergy symptoms following exposure to lentils, the most frequent symptoms were oropharyngeal symptoms (40%) and acute urticaria (30%); 3 patients also reported symptoms when they were exposed to steam from cooked lentils. Onset of sensitisation occurred less than 4 years of age and 9 patients had allergic reactions to other legumes: chick peas (6 patients), peas (2 patients), and green beans (1 patient). The heating process caused a significant decrease in specific-IgE-binding.
CLINICAL FEATURES
Age-onset Symptoms Lentil-slgE Other food allergies
(kUA/L)
2.5* U 6.64 Chick peas
3 U 4.75 Chick peas
4 OAS 18.2
5 NS 44.9 Fish
12 U,C,W 13.1
3* OAS/R 17.5 Green beans
3 U,V,LE 5.61 Chick peas, peaches, fish
3 V,AP,D 8.7 Fish, milk
2 AD 54.6
2 U/A 7.16 Peas
3 U/A 16.7 Peas, fish
3* OAS/R 4.72 Chick peas
3 OAS 4.86
12 U/A,C,W 20.3 Peaches
6 NS 8.9 Chestnut
1.5 U,C,W >100
1.5 OAS 25.9 Fish
1.5 OAS 13.4 Chick peas
1.7 U/A 5.43
2.1 OAS 43.6
1.8 OAS 5.87 Chick peas
1.2 U/A 44.4
U, generalized urticaria; OAS, oral allergy syndrome; NS, no symptoms; C. cough; W, wheezing; R, rhinitis; V, vomiting; LE, laryngeal edema; AP, abdominal pain; D, diarrhea; AD, atopic dermatitis; A, facial angioedema.
*Also, symptoms after exposure to steam from cooked lentils.
(Pascual 1999 ref.7341 3)

Reference:
Pascual CY, Fernandez-Crespo J, Sanchez-Pastor S, Padial MA, Diaz-Pena JM, Martin-Munoz F, Martin-Esteban M. Allergy to lentils in Mediterranean pediatric patients. J Allergy Clin Immunol 1999;103(1 Pt 1):154-8



[ 18 / 24 ]

Fixed food eruption. (Yanguas 1998 ref.2348 4)

Reference:
Yanguas I, Oleaga JM, et al. Fixed food eruption caused by lentils. J Am Acad Dermatol 1998;38(4):640-1



[ 19 / 24 ]

An 8-year-old girl suffered with contact urticaria from raw chickpeas and an anaphylactic reaction after ingestion of cooked chickpeas. She experienced four episodes of anaphylaxis related to lentils between the ages of 3 and 7 years. The first three involved ingestion of cooked lentils, and each time smaller amounts induced symptoms. The fourth episode occurred with inhalation exposure to cooking lentil soup. Prick tests showed strongly positive reactions to lentil and chickpea and weaker positive reactions to peanut, pea, soybean, and white bean. CAP-RIA was class 6 to lentil; class 5 to peanut, pea, and soybean; class 4 to white bean, and class 0 to green bean. Severe type I hypersensitivity to lentils occurred in this patient and was associated with clinically relevant hypersensitivity to chickpeas. (Kalogeromitros 1996 ref.824 42)

Reference:
Kalogeromitros D, Armenaka M, Galatas I, Capellou O, Katsarou A. Anaphylaxis induced by lentils. Ann Allergy Asthma Immunol 1996;77(6):480-2



[ 20 / 24 ]

A 54-year-old female, who developed episodes of asthma, sometimes requiring hospital care, when exposed to vapours from cooking certain legumes (peas, chick peas, beans, lentils). The same symptoms appeared after ingestion of these legumes, as well as mouth itch and lip angioedema immediately after eating peanuts. The SPT for the 5 legumes: peas, peanuts, beans, lentils and chickpeas, including the heated extracts, were clearly positive. CAP values were: pea (> 100 KU/L), peanut (55.3 KU/L), bean (9 KU/L), lentil (> 100 KU/L) and chickpea(> 100 KU/L). Inhibition tests showed cross-reactivity among legumes. (Garcia 1995 ref.735 8)

Reference:
Garcia Ortiz JC, Lopez Asunsolo A, Cosmes P, Duran AM. Bronchial asthma induced by hypersensitivity to legumes. Allergol Immunopathol (Madr) 1995;23(1):38-40



[ 21 / 24 ]

This study reports the case of a 20-year-old man who experienced asthmatic attacks when exposed to the steam from cooking either chick pea or lentil. Type I hypersensitivity to the antigens in these legumes was demonstrated by means of immediate skin reactivity, histamine release tests, RAST and RAST inhibition. Specific bronchial challenges with the heated (75 degrees for 30 min) extracts of chick pea and lentil elicited isolated immediate responses. (Martin 1992 ref.543 43)

Reference:
Martin JA, Compaired JA, de la Hoz B, Quirce S, Alonso MD, Igea JM, Losada E. Bronchial asthma induced by chick pea and lentil. Allergy 1992;47:185-187



[ 22 / 24 ]

A 54-year-old female patient, diagnosed of nasal polyposis and intrinsic corticodependent bronchial asthma, who since a year has developed episodes of asthma when exposed to vapours from cooking some kinds of legumes (peas, chick-peas, beans, lentils) and an oral allergy syndrome with peanuts.The skin tests were clearly positive for legumes. Specific IgE by CAP was strongly positive for legumes. (Martin 1991 ref.32 112)

Reference:
Martin MA, Compaired JA, de la Hoz B, et.al. Bronchial asthma induced by legumes (abstract). CH Schweiz med Wschr 1991;121:2297.S40



[ 23 / 24 ]

In this study, 102 patients with the initial diagnosis of idiopathic anaphylaxis were evaluated with a battery of 79 food-antigen skin prick tests selected to include foods reported or suspected of provoking anaphylaxis. Thirty-two patients (31%) had positive tests to one or more food antigens. In five of these patients, subsequently eating a food that elicited a positive test provoked an anaphylactic reaction. Two patients eliminated the foods completely, stopped having reactions, and refused challenge. In these seven patients, 10 different antigens provoked anaphylaxis: aniseed, cashew nut, celery, flaxseed, hops, mustard, mushroom, shrimp, sunflower, and walnut. We conclude that a battery of selected food-antigen skin prick tests provided a useful method for identifying an offending antigen in these patients and that some (7% in our series) cases of "idiopathic" anaphylaxis by history are not truly idiopathic.
The 10 antigens with positive clinical correlation
Antigens A B C
Aniseed 1 5 20
Cashew nut 1 2 50
Celery 2 4 50
Flaxseed 1 1 100
Hops 1 2 50
Mushroom 1 3 33
Mustard 2 3 66
Shrimp 1 3 33
Sunflower seed 1 3 33
Walnut 1 1 100
A = Total No. of positive skin tests with positive correlation
B = Total No. of positive skin tests
C = Percent of positive skin tests with positive correlation

Total number of positive skin prick tests.
2 - Almond
5 - Aniseed
1 - Artichoke
1 - Baker's yeast
1 - Beet
1 - Brazil nut
2 - Brewer's yeast
1 - Caraway seed
2 - Cashew nut
5 - Castor bean
4 - Celery
8 - Chamomile
2 - Chestnut
1 - Chicory
1 - Clam
2 - Coconut
1 - Cottonseed
2 - Crab
1 - Fennel
4 - Filbert (hazelnut)
I - Flaxseed
1 - Garbanzo bean
2 - Ginger
1 - Halibut
1 - Honey
2 - Hops
3 - Horseradish
1 - Lentil
1 - Lima beans
2 - Lobster
2 - Mango
1 - Milk
5 - Millet
3 - Mushroom
3 - Mustard
1 - Nutmeg
2 - Pea
1 - Pistachio
3 - Poppy seed
2 - Sesame seed
3 - Shrimp
3 - Sunflower
1 - Thyme
1 - Tumeric
1 - Walnut
None for Allspice, Apple, Banana, Bay leaf, Black pepper, Buckwheat, Cantaloupe, Chicken, Chili pepper, Chocolate, Cinnamon, Clove, Cod, Corn, Cumin seed, Dill seed, Egg, Garlic, Juniper berry, Orange, Oyster, Peach, Peanut, Potato, Psyllium seed, Raspberry, Sage, Salmon, Soybean, Strawberry, Sweet potato, Tangerine, Tapioca, Vanilla.
7 patients with positive clinical correlation to a SPT
1 : Aniseed
2 : Shrimp
3 : Mustard, flaxseed
4 : Celery, hops
5 : Celery, mustard, sunflower
6 : Walnut, cashew nut
7 : Mushroom
(Stricker 1986 ref.9 3606)

Reference:
Stricker WE, Anorve Lopez E, Reed CE. Food skin testing in patients with "idiopathic anaphylaxis". J Allergy Clin Immunol 1986;77:516-519



[ 24 / 24 ]

Urticaria, angioedema, abdominal symptoms, rhinoconjunctivitis and/or asthma following ingestion or inhalation of vapours from cooked legumes (lentil, bean or chick-pea). Lentil was found to induce the most severe reactions. (Carrillo 1986 ref.2349 5)

Reference:
Carrillo Diaz T, Cuevas Agustin M, et al. In vitro immunologic diagnosis of hypersensitivity to vegetables. [Spanish] Allergol Immunopathol (Madr) 1986;14(2):139-46




Non-Immune reactions


[ 1 ]

Six patients (four males, two females aged 3-12 months) were diagnosed with food protein-induced enterocolitis syndrome (FPIES) triggered by foods other than cow's milk and soy: chicken in four, turkey in two, peas in one, and lentils in one (five patients reacted to more than one food type). All reactions developed within 2 h of ingestion of the allergenic food. (Levy 2003 ref.8320 1)

Reference:
Levy Y, Danon YL. Food protein-induced enterocolitis syndrome--not only due to cow's milk and soy. Pediatr Allergy Immunol 2003;14(4):325-9.



[ 2 ]

Aspiration of leguminous vegetables can cause a granulomatous pneumonitis know as lentil aspiration pneumonia that manifest on radiologic studies with small, poorly defined nodular opacities. (Marom 1998 ref.7342 1)

Reference:
Marom EM, McAdams HP, Sporn TA, Goodman PC. Lentil aspiration pneumonia: radiographic and CT findings. J Comput Assist Tomogr 1998;22(4):598-600



[ 3 ]

Lentil pulmonary granulomatosis. (Gill 1974 ref.2530 6)

Reference:
Gill DG, Ritchie GJ Lentil pulmonary granulomatosis. Med J Aust 1974;1(21):836-8




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