Clinical Manifestations and Risk Factors of Anaphylaxis in Pollen-Food Allergy Syndrome

PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25–10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79–15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70–51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03–9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15–1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.

Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

PURPOSE: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. METHODS: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. RESULTS: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. CONCLUSIONS: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

Vestibular Evoked Myogenic Potentials Produced by Stimulation with 500 Hz-tone Burst / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Vestibular evoked myogenic potential (VEMP) is muscle reflex caused by surface electrodes following repeated high-intensity auditory stimulation. The current study attempted to determine whether VEMP can be consistently evoked from the sternocleidomastoid muscle (SCM) by the 100 dB air-conducted and 50 dB bone-conducted 500 Hz-tone burst. SUBJECTS AND METHOD: Air-conducted and bone-conducted VEMPs in response to 500 Hz-tone burst were recorded from the SCM of 13 normal volunteers. Subjects were seated on their chairs and made to hold their heads turned up as far as possible towards the side, contralateral to the stimulated ear voluntarily. Two different sound durations (rise/fall time=2 msec, plateau time=2 msec[2/2] and rise/fall time=5 msec, plateau time=5 msec[5/5]) were presented through a insertphone or bone vibrators. Latencies and amplitudes of p13 and n23 responses were measured. RESULTS: All normal volunteers showed p13-n23 responses to 50 dB bone-conducted tone burst as well as to 100 dB air-conducted tone burst. The values of latency of p13 and n23 were the most reliable at 5/5 air-conducted in evaluation by coefficiency of variance. Mean p13 and N23 latencies by airconducted tone burst were significantly longer than those of bone-conducted. Mean p13-n23 amplitudes by air-conducted tone burst were significantly larger than those by bone-conducted at 2/2 sound duration. CONCLUSION: VEMP could be consis-tently evoked by the 100 dB air-conducted and 50 dB bone-conducted 500 Hz-tone burst, especially at 5/5 air-conducted.