Sunflower seed allergy

Area of Science:

• Allergy and Immunology
• Food Science
• Clinical Medicine

Background:

• Sunflower seed allergy is uncommon, with limited systematic descriptions of its allergens.
• Occupational allergies to sunflowers have been documented, but food allergies require further characterization.

Observation:

• A 40-year-old male experienced shortness of breath and urticaria after ingesting sunflower seeds.
• Physical examination revealed pharyngeal and lingual swelling.
• Skin prick tests showed positive reactions to mugwort pollen, oranges, egg protein, and hazelnuts, with a strong positive reaction to sunflower seeds.

Findings:

• Elevated IgE levels were found against weed mix, Artemisia vulgaris, and Artemisia absinthium.
• ImmunoCap ISAC test indicated mugwort pollen allergy (Art v 1) and sensitivity to lipid transfer proteins (LTPs).
• ISAC inhibition tests confirmed cross-reactivity between sunflower seed allergens and IgE specific to mugwort pollen components (Art v 1, Art v 3) and Jug r 3.

Implications:

• The patient's anaphylactic reaction to sunflower seeds was confirmed, likely due to hypersensitivity to sunflower LTP and defensin-like proteins.
• These sunflower proteins exhibit cross-reactivity with mugwort pollen allergens, explaining the observed allergic response.
• This case underscores the need to consider cross-reactive allergens in diagnosing sunflower seed-induced anaphylaxis.