Lupine inhalation induced asthma in a child

Area of Science:

• Allergology
• Pediatric Allergy
• Clinical Immunology

Background:

• Lupine seed flour is a known allergen.
• Asthma exacerbations can be triggered by environmental and food allergens.
• Cross-reactivity among legumes is a common phenomenon in allergic individuals.

Observation:

• An 8-year-old asthmatic child with a peanut allergy experienced an asthma attack while exposed to lupine seeds.
• The asthma attack worsened with salbutamol administration.
• Skin tests and serum IgE antibodies indicated sensitization to Lupinus albus, peanut, soy, lentil, and garbanzo bean.

Findings:

• Prick-by-prick tests with lupine seeds were strongly positive.
• The patient experienced asthma symptoms upon manipulation of lupine seeds, despite tolerating salbutamol.
• While cross-reactivity to other legumes was observed, only peanut allergy was clinically significant as boiled legumes were tolerated.

Implications:

• Lupine seeds should be considered a potential trigger for asthma exacerbations, particularly in sensitized individuals.
• Accurate diagnosis of asthma triggers requires thorough patient history and appropriate allergy testing.
• This case underscores the importance of identifying specific food allergens in managing pediatric asthma.