Anaphylaxis to Japanese butterbur scapes

摘要

Patient no. 1 had ingested Japanese butterbur scape tempura. Thirty minutes later, she developed urticaria with intense itching over the entire body and dyspnea. Patient no. 2 had urticaria over her whole body and dyspnea following ingestion of Japanese butterbur scape tempura. The symptoms of both patients disappeared after emergency treatment. Both patients had never experienced an allergic reaction to butterbur scapes before these episodes. We suspected anaphylaxis caused by Japanese butterbur scapes. Skin prick test was performed with Japanese butterbur scapes and other Asteraceae plants (as is) with positive (histamine chloride; 10 mg/ml) and negative (saline) control. A positive response was recorded when mean diameter of wheal was more than a half of positive control. Prick test results were found to be positive for Japanese butterbur scapes and other Asteraceae plants, including chrysanthemum and dandelion (Table 1). Prick tests of Japanese butterbur scapes did not produce any reactions in three normal subjects. These findings led to a diagnosis of anaphylaxis due to Japanese butterbur scapes. Subsequent avoidance of ingestion of butterbur and other Asteraceae plants has resulted in no recurrence of symptoms.