FENUGREEK: A HIDDEN ALLERGEN TO CONSIDER IN PEANUT ALLERGIC PATIENTS
Angela Claver, Manuel Morales, Carolina Elduque, Begoña Navarro, Elena Botey, Miriam Castillo Fernandez, Fernando Pineda, Anna Cistero-Bahima.
Alergia Dexeus. Hospital Universitario Quiron Dexeus. UAB, Barcelona, Spain
Laboratorios Diater, Madrid, Spain.
Journal of Allergy and Clinical Immunology, Vol. 143, Issue 2, AB241
Published in issue: February 2019
RATIONALE: Fenugreek (Trigonella foenum-graecum ) is a legume plant traditionally used as spice in Indian-style foods. Although it has been used since ancient times, its allergenicity has only been reported in the last two decades, often as hidden allergen, in peanut allergic patients.
METHODS: A 10-year-old girl, with known peanut allergy was refered to our unit with a history of severe anaphilaxys after eating curried chicken. Skin prick testing (SPT) and sIgE measurements (ImmunoCAP Thermofisher ) were performed with the implicated curry and its components and peanut. IgE –binding-protein molecular mass study (SDS-PAGE- Immunobloting) was also performed with the curry powder and its ingredients, fenugreek (grains and powder) and a whole extract of roasted peanut. Immunoblotting inhibition studies were also carried out. RESULTS: SPT were positive to peanut (13 mm), curry powder (18.5 mm), fenugreek (23 mm). The diameter of the wheal on SPT with the remaining spices contained in curry was less than the histamine control. Specific IgE: peanut >100 KU/L, curry 35.20 KU/L, fenugreek 45 KU/L, Ara h 2 >100 KU/L. SDS- PAGE-Immunoblotting: The peanut protein band pattern was in accordance with previous studies. Curry and Fenugreek extract showed similar pattern: IgE-binding bands 50, 28 and 22 kDa (same molecular mass bands are observed in peanut pattern). Cross-reactivity study with curry and fenugreek extract as solid phase: peanut extract inhibited completely IgE binding to fenugreek and curry extract.
CONCLUSIONS: Cross reactivity between peanut and fenugreek is demonstrated. Physicians might be aware about possible curry allergy in peanut-allergic patients.