Buckwheat allergy

Buckwheat, a gluten-free pseudocereal, is a traditional staple in parts of East Asia-particularly Japan, Korea, and northern China-as well as in Russia, but is rarely consumed in Southeast Asia where rice dominates the diet. Its growing use in gluten-free products worldwide has increased exposure, raising concerns about buckwheat allergy, which can manifest as urticaria, rhinoconjunctivitis, asthma, or life-threatening anaphylaxis. Both dietary ingestion and occupational inhalation pose risks. Despite relatively high sensitization rates in endemic regions, many individuals remain asymptomatic, complicating clinical interpretation. Conventional diagnostic methods using aqueous extracts often miss lipid-soluble allergens such as oleosins (e.g., Fag t 6), potentially leading to false-negative results. Component-resolved diagnostics targeting Fag e 2-a pepsin-resistant 2S albumin recognized by IgE in up to 90% of symptomatic patients-significantly enhances diagnostic specificity. Cross-reactivity with latex, peanut, and wheat has been reported, though its clinical relevance requires individual assessment. Strict avoidance remains the cornerstone of management, as no approved immunotherapy exists. Given buckwheat's frequent inclusion in unlabeled "gluten-free" foods, accurate diagnosis and patient education are critical. Future efforts should focus on standardized detection protocols that include non-aqueous extraction and the development of precision diagnostic tools.