ALEX³ FOOD Case #1

Mala, 22 years from India

Clinical history

None

Family history

No known allergies

Present situation

After nut consumption: oral tingling, mouth itching; antihistamines prescribed, symptoms improve, nuts largely avoided. Weeks later: Indian curry (no nuts, but soy milk and tofu); during eating dizziness, nausea, vomiting, suspected nut traces; breathing difficulty and skin rash, hospital admission.

Mala's ALEX FOOD test results

Allergen source Allergen

Peanut

Ara h 1

Peanut

Ara h 2

Peanut

Ara h 3

Peanut

Ara h 6

Soy

Gly m 5

Soy

Gly m 6

Allergen source Biochemical designation

Peanut

7/8S Globulin

Peanut

2S Albumin

Peanut

11S Globulin

Peanut

2S Albumin

Soy

7/8S Globulin

Soy

11S Globulin

Allergen source IgE Level [kUA/L]

Peanut

54.95

Peanut

51.02

Peanut

30.54

Peanut

45.52

Soy

42.80

Soy

48.86

Analysis

Peanut

  • Positive peanut storage proteins
  • Marker for severe clinical reactions: severe peanut allergy

Soy

  • Positive soy storage proteins
  • Risk marker for severe reactions up to anaphylaxis

Interpretation & summary

  • Peanut risk components (Ara h 1, Ara h 2, Ara h 3, Ara h 6) were positive: peanut allergy
  • Surprisingly, soy allergens Gly m 5 and Gly m 6 were also positive
  • Gly m 5/6 are also risk markers that can cross-react with Ara h 1/3
  • Mala regularly consumed soy products like soy milk and tofu over a long period of time (vegan diet)
  • Remained as a silent sensitisation until a peanut allergy also affected the soy allergy: co-sensitisation
  • Avoidance of nut and soy products is strongly advised to prevent anaphylactic shock
  • Emergency kit with an adrenaline autoinjector, a corticosteroid, and an antihistamine is prescribed

Novel findings revealed by ALEX FOOD:

  • Peanut allergy
  • Soy allergy
Macroimage of half a peanut with peanuts in shells unterneath
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