Biphasic buckwheat anaphylaxis:Case report and systematic review

Area of Science:

• Allergy and Immunology
• Clinical Medicine
• Food Science

Background:

• Buckwheat anaphylaxis is a known but infrequently reported condition globally.
• Biphasic anaphylaxis, characterized by a recurrence of symptoms, is a rare presentation of allergic reactions.

Observation:

• A 57-year-old male experienced two distinct episodes of anaphylaxis on the same day after consuming buckwheat noodles.
• The patient presented with loss of consciousness in both episodes.
• Serum analysis revealed significantly elevated levels of immunoglobulin E (IgE) specific to Dermatophagoides pteronyssinus (Dp) and buckwheat.

Findings:

• The case demonstrates a rare instance of biphasic anaphylaxis specifically triggered by buckwheat ingestion.
• High levels of both buckwheat-specific IgE and cross-reactive IgE to Dermatophagoides pteronyssinus were observed.
• The biphasic nature of the reaction, with recurrence within 24 hours, underscores the potential severity.

Implications:

• Clinicians should maintain a high index of suspicion for biphasic anaphylaxis in buckwheat allergy cases.
• Awareness of the potential for a second, severe reaction is crucial for patient management and monitoring.
• This case contributes to understanding the clinical spectrum and potential severity of buckwheat-induced anaphylaxis.