Hidden allergens and oral mite anaphylaxis: the pancake syndrome revisited

To present currently available information on oral mite anaphylaxis.

Oral mite anaphylaxis (pancake syndrome) is a new syndrome characterized by severe symptoms triggered by the intake of foods containing mites and their allergens. Breathlessness, face and/or laryngeal angioedema, wheezing, rhinorrhea, cough, dysphagia, and wheals are the most frequent clinical manifestations.

Pancake syndrome can occur in individuals at any age and in any geographical location. Foods made with wheat and corn flour, especially pancakes, are the most common inducers of the clinical picture. Both, domestic and storage mites have been incriminated. Increased physician awareness is required for early diagnosis and treatment, and for the prevention of future episodes in predisposed individuals.