Oral Mite Anaphylaxis Caused by Mite-Contaminated Okonomiyaki/ Pancake-Mix in Japan: 8 Case Reports and a Review of 28 Reported Cases

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Author(s)

    • Takahashi Kentaro
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital|Department of Allergy and Clinical Immunology, Chiba University Hospital
    • Tsurikisawa Naomi
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Minoguchi Kenji
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Nakajima Hiroshi
    • Department of Allergy and Clinical Immunology, Chiba University Hospital
    • Akiyama Kazuo
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Taniguchi Masami
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Fukutomi Yuma
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Sekiya Kiyoshi
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Watai Kentaro
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Mitsui Chihiro
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Tanimoto Hidenori
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Oshikata Chiyako
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital
    • Tsuburai Takahiro
    • Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital

Abstract

<b>Background:</b> Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mite-contaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital.<br> <b>Methods:</b> In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan.<br> <b>Results:</b> Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as <i>Dermatophagoides farina (Der f) (5 cases)</i>, <i>Tyrophagus putrescentiae (Tyr p) (4 cases)</i>, and<i> Dermatophagoides pteronyssinus (Der p) (3 cases)</i>. The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to <i>Der p</i> and <i>Der f </i>were more than class 2 in all cases.<br> <b>Conclusions:</b> Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.<br>

Journal

  • Allergology International

    Allergology International 63(1), 51-56, 2014

    Japanese Society of Allergology

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