Food Allergy

Inulin is a plant fructans used as storage carbohydrate in >36000 plants including globe artichoke and salsify. Natural Inulin has been used as food ingredient for many years but it is only recently that their used has considerably expended for their postulated beneficial effects. Inulin and oligofructose (hydrolyzed inulin) are now added to an increasing number of foods such as sweets, beverages, yogurts, butter ... We report a case of 39 year-old butcher who was suffered of 4 episodes of anaphylaxis (generalized weal and flare reaction of the skin, laryngeal edema, nasal itching, cough and breathing difficulties) within the previous 2 years occuring a few minutes after ingestion of salsify, leaves of globe artichoke, a margarine (Brunch, Migros, Switzerland) containing inulin (Raftiline HP, Orafti, Tienen, Belgium) and a sweet (Actilife Toffeeorange/carotte, Migros) containing inulin (Raftline HP) and oligofructose (Raftilose P95). He also developped local wheal and flare reactions after touching globe artichoke. Prick-to-prick testing (PPT) were positive with Raftiline HP, salsify, globe artichoke, Brunch, Actilife Toffee, Raftilose P95. Immediately reactions to intradermally injected undiluted Inutest (iunlin for clearance) and Raftilose P95 were also strongly positive. PPT with Raftiline HP in 10 control individuals and intradermal tests with Inutest 25% and Raftilose P95 in 3 controls remained negative. A double blind, placebo controlled food challenge (DDBPCFC) after ingestion of log of inulin (Raftiline HP) induced generalized urticaria, rhinoconjonctivitis and a drop in expiratory peak flow rate by 20%. An open oral challenge with 40g of oligofructose (Raftilose P95) was negative in the patient. We postule then an anaphylaxis to inulin in this case. Allergic reactions to this dietary ingredient may be/ become more frequent than currently recognized. 77s Sensitization to Anisakis simplex in Malaga. Clinical and parasitologic study