Allergy to lentils in Mediterranean pediatric patients

Peanuts and soybeans are the major legumes involved in human food allergy; however, scarce data exist on adverse reactions to other temperate legumes, such as lentils.

The purpose of this study was to identify patients who are allergic to lentils, to assess clinical features and other associated food allergies, and to characterize allergens in lentil extract.

Twenty-two children each with a history of adverse reactions to lentils were enrolled in the study. The diagnosis of lentil allergy was based on food challenges or a convincing history of anaphylaxis, with positive skin tests and/or specific serum IgE to lentils. Lentil components were characterized by SDS-PAGE immunoblotting.

Twenty of 22 subjects had symptomatic allergy to lentils at the diagnostic time. The most frequent symptoms were oropharyngeal symptoms (40%) and acute urticaria (30%); 3 patients also reported symptoms when they were exposed to steam from cooked lentils. In 18 patients, symptoms after lentil ingestion started under 4 years of age (median, 2.7 years). Nine patients had allergic reactions to other legumes: chick peas (6 patients), peas (2 patients), and green beans (1 patient). Immunoblotting patterns obtained with patients' sera showed IgE-binding bands ranging from 14 to 84 kd. Five sera recognized 9 or more IgE-binding bands, and more than 50% of patients who were tested have specific IgE antibodies to 7 components in lentil extract.

Allergic reactions to lentils started early in life, usually below 4 years of age; oropharyngeal symptoms and acute urticaria were the most common symptoms through ingestion, and symptomatic reactivity to chick peas is frequently associated.