Oral Allergy Syndrome Precipitation and Sprouted-Grain Bread

Abstract

Oral allergy syndrome (OAS), a class 2 food allergy, occurs when individuals sensitized to plant pollens ingest foods containing allergens homologous to the plant pollen. Common trigger foods include fruits, vegetables, and nuts, and when consumed, they result in oropharyngeal pruritis, tingling, and edema. Here, we report the case of a 28-year-old female with a history of allergy and exercise-induced asthma who presented with oral urticaria, lower lip edema, and tingling of the lips, mouth, and tongue after switching her daily consumption of whole-wheat bread to sprouted-grain bread. The patient discussed the symptoms with her pharmacist, who suggested OAS as a possible diagnosis and an elimination diet as an initial treatment. She removed fruits and vegetables from her diet, but coincidentally noticed that the ingestion of sprouted-grain bread consumed only during her work week triggered the reaction. The diagnosis of OAS and the implementation of an elimination diet that excluded the spouted-grain bread provided a successful treatment strategy for the OAS in this patient, and such therapy can be easily carried out by a wide variety of practitioners who are well positioned to offer such assistance.