Allergy Asthma Respir Dis.  2022 Apr;10(2):110-117. 10.4168/aard.2022.10.2.110.

Perilla seed allergy in children: Cosensitization and cross-reactivity with sesame seed

• Kim H
• Gantulga P
• Lee E
• Lee J
• Lee S
• Jeong K

• KMID: 2529479
• DOI: http://doi.org/10.4168/aard.2022.10.2.110

Abstract

Purpose
Perilla seed (PS) is the most common cause of seed-induced anaphylaxis in Korean children, but the reports on PS allergy, including phenotype and cross-reactivity, are rare. The aim of this study is to assess the clinical characteristics of PS allergy and investigate cross-reactivity with sesame seed (SS).
Methods
Through a retrospective medical record review, patients with clinical PS allergy were identified in a single tertiary hospital. Clinical characteristics of allergic reaction upon exposure to PS and SS, results of skin prick test (SPT) to PS and SS, and the levels of serum SS-specific immunoglobulin E (SS-sIgE) were investigated. Cross-reactivity between PS and SS was studied using IgE enzymelinked immunosorbent assay (ELISA) inhibition.
Results
The median age of 34 PS-allergic children was 41.5 months (range, 10 months to 12 years), and the proportion of anaphylaxis upon exposure to PS was 29.4% (n = 10). The PS SPT was positive in 94.1% (n = 32) with the median wheal size of 6.25 mm. Among PS-allergic children, the percentages of patients with positive symptoms, negative symptoms, and indeterminate symptoms upon exposure to SS were 8.8%, 41.2%, and 50%, respectively. Out of 14 PS-allergic children who were tolerant to SS, positive sensitization to SS was noticed in 78.6% by serum SS-sIgE, and 57.1% by SS SPT. Partial cross-reactivity between PS and SS was identified in IgE ELISA inhibition.
Conclusion
This study reported the clinical profiles and SPT results in a relatively large number of PS-allergic children and identified the partial cross-reactivity between PS and SS for the first time.

Keyword

Cross reactions; Food hypersensitivity; Perilla frutescens; Seeds; Sesamum