What is in your pantry? Entomologic anaphylaxis.

Area of Science:

• Food allergy
• Immunology
• Environmental health

Background:

• Liposcelis bostrychophila, a common booklouse, is a known allergen linked to respiratory issues.
• Anaphylaxis from ingesting this insect, despite its presence in stored grains, is not well-documented.
• This report details a case of anaphylaxis in a patient who consumed oats and rice contaminated with L. bostrychophila.

Observation:

• The patient experienced anaphylaxis after eating contaminated grains.
• Skin-prick tests showed positive reactions to dust mite, flour, and oats contaminated with L. bostrychophila.
• Western blot analysis revealed a specific IgE binding band at 24 kD in contaminated grain extracts and L. bostrychophila extract.

Findings:

• A 24 kD protein from L. bostrychophila was identified as the likely allergen responsible for the patient's reaction.
• This 24 kD allergen was distinct from the 14 kD allergen found in dust mite extracts.
• Fresh oats and rice did not elicit allergic responses, indicating contamination was the key factor.

Implications:

• L. bostrychophila should be considered a potential cause of unexplained anaphylaxis related to grain consumption.
• The widespread presence of booklice suggests this allergy may be underdiagnosed.
• Further research is needed to understand the prevalence and clinical significance of L. bostrychophila-induced food allergies.