2019 Volume 33 Issue 1 Pages 117-122
Background : Mugwort and birch pollen allergies are frequently associated with immunoglobulin E (IgE) -mediated hypersensitivity to celery and spices. The phenomenon is known as the celery-birch-mugwort-spice syndrome and is well documented in Europe, but rare in Japan.
Patient : A 14-year-old girl with a history of seasonal rhinoconjunctivitis and runny nose in the spring experienced pruritus of the tongue and mouth when she consumed spaghetti bolognese with celery. She also developed coughs, wheezing, and a squeaky voice after consuming a curry and rice. We performed detailed questioning, measurement of specific IgE antibodies, a skin prick test, and an oral challenge test.
Result : Serum-specific IgE antibodies to Japanese cedar, cypress, birch, alder pollen, celery, and birch PR-10 (Bet v 1) were detected. On the other hand, serum-specific IgE antibodies to mugwort pollen and birch profilin (Bet v 2) were not detected. She showed positive reactions to several Apiaceous spices in the skin prick test. She also showed positive reactions to coriander and celery in the oral challenge test.
Conclusion : According to these results, we suspected an apiaceous spice allergy caused by cross-reactions with a Betulaceae pollen allergy in this case. Although it is well known that celery and mugwort profilin can generate cross-reactions with birch profilin (Bet v 2), Bet v 2 was not detected in this case. Thus, we suspect that there are unknown cross-reactive proteins between celery, Betulaceae pollen, and apiaceous spices. Since more children have Betulaceae pollen allergies, we should pay attention to spice allergies.
