カレースパイスおよびライチによる口腔アレルギー症候群からアナフィラキシーショックに至った1例

摘要

A 30 year-old woman with mugwort pollinosis repeatedly developed oral allergy syndrome with generalized urticaria, dyspnea, diarrhea and bloody stool after eating lychee or curry rice. Prick tests were positive for lychee and various kinds of Apiaceae spices in curry rues ; that is, cumin seed, parsley, celery seed, coriander, fennel, ajowan and dill seed etc. Histamine releasing tests using the patient's basophils showed positive reaction to the extracts of several kinds of Apiaceae spices. Immunoblot studies using patient's serum showed common bands of 20 and 22 kds among mugwort leaves, raw parsley, celery and lychee, which seems to be as thaumatin-like protein. Immunoblot studies using patient's serum showed common bands of 20, 22 kds and 60 kD high-molecular weight allergens among Apiaceae spices and mustard. Because immunoblot studies showed reactive bands at various MW of Apiaceae spices and horseradish peroxidase, we consider the cross-reactive carbohydrate determinants as a candidate for the common epitope of the IgE reactivity in the patient's serum. Based on these findings, we diagnosed the patient as mugwort-celery-spice syndrome, showing a various crossreactivty among antigens in spices and lychee.