A-52-year-old woman ate dinner after preening roses in her garden. Immediately, she developed oralaryngeal malaise and pruritic rash. Nasal obstruction and increase of cutaneous lesions were seen although she took betamethasone, 2 mg, orally. Physical examination revealed geographic wheal on trunk and extremities, and no overt mucosal lesions. History demonstrated that she had developed such reactions four times before: three of the four were seen shortly after eating soybean. Tofu was examined by prick-by-prick testing, and prick testing was performed with a petal, a piece of stem and rose leaf, positive and negative control. Positive reactions to tofu (wheal, 5 × 7 mm) and positive control (wheal 5 × 5 mm) and negative ones to others were noted. Although sensitization to soybean seemed to antedate pollen allergy on the basis of interview, oral allergy syndrome could be complicated because of various pollens-specific IgE. Since soy-bean specific IgE was class 2, such titer was not an effective predictor of clinical severity. This case should be classified into stage 3 of contact urticaria syndrome (CUS). Since CUS can be fatal, we must be careful in management for such patients.
Honda, T., Michigami, M., Miyachi, Y. and Kabashima, K. (2014) A Case of Late-Onset Anaphylaxis to Fermented Soybeans (Natto). The Journal of Dermatology, 41, 940-941. http://dx.doi.org/10.1111/1346-8138.12616
Lachapelle, J. and Maibach, H.I. (2012) Methodology of Open (Non-Prick) Testing, Prick Testing, and Its Variants. In: Lachapelle, J. and Maibach, H.I., Eds., Patch Testing and Prick Testing, 3rd Edition, Springer, Berlin, 159-170. http://dx.doi.org/10.1007/978-3-642-25492-5_11
Yagami, T. (2002) Allergies to Cross-Reactive Plant Proteins. Latex-Fruit Syndrome Is Comparable with Pollen-Food Allergy Syndrome. International Archives of Allergy and Immunology, 128, 271-279. http://dx.doi.org/10.1159/000063859
Sato, M., Shukuya, A., Sato, S., Komata, T., Utsunomiya, T., Imai, T., Tomikawa, M. and Ebisawa, M. (2016) Oral Challenge Tests for Soybean Allergies in Japan: A Summary of 142 Cases. Allergology International, 65, 68-73. http://dx.doi.org/10.1016/j.alit.2015.07.010
Lachapelle, J. and Maibach, H.I. (2012) Methodology of Open (Non-Prick) Testing, Prick Testing, and Its Variants. In: Lachapelle, J. and Maibach, H.I., Eds., Patch Testing and Prick Testing, 3rd Edition, Springer, Berlin, 147-157. http://dx.doi.org/10.1007/978-3-642-25492-5_10