Corn-induced anaphylaxys mediated by lipid transfer proteins (LTP)

Abstract

Background. IgE-mediated food allergies are increasing globally. Lipid transfer proteins (LTP), being thermally and digestively stable, frequently cause severe allergic reactions. Corn, with low allergenic potential, has been recognized as a source of LTP (Zea m14) involved in severe systemic reactions. Objective(s). Presentation of a clinical case of severe corn-induced anaphylaxis mediated by LTP, highlighting the importance of correct diagnosis and appropriate management of this rare type of allergy. Materials and methods. 47-year-old patient, admitted to the General Therapy and Allergology Department of Timofei Moșneaga Republican Clinical Hospital. Evaluation included a detailed allergological history. IgE-mediated food allergy diagnosis was supported by multiplex ALEX serology. Anaphylaxis was diagnosed according to EAACI/WAO criteria. Results. Two episodes of systemic reaction with urticaria, facial angioedema, dyspnea, and hypotension 80/40 mmHg were noted, occurring 20 min after polenta consumption. The event recurred twince on separate exposures, with corn as the common food. No potential cofactors were identified (physical effort, NSAID, alcohol). Treatment with epinephrine, fluid resuscitation, and antihistamines led to symptom remission. Serological testing revealed increased specific IgE levels to several LTP allergens: Corn Zea m14 (3.9 kU/L), apple Mal d3 (8.5 kU/L), peach Pru p3 (10.9 kU/L), grape Vit v1 (7.8 kU/L), celery Api g2 (6 kU/L), hazelnut Cor a8 (9.6 kU/L). Conclusion(s). Corn is a rare food allergen with low allergenic potential, but it can cause severe systemic reactions in sensitized patients. Multiple LTP sensitization explains food allergies to several allergenic sources. Molecular IgE testing is essential for diagnosis and treatment.