From Patch to Plate: Evaluation of Systemic Symptoms in Patients With Positive Patch Test Reactions to Sodium Disulfite.

Background

Sodium disulfite is a well-established contact allergen. Whether individuals with this contact allergy also experience systemic symptoms after ingesting sulfites remains unclear.

Objective

To evaluate whether patients with positive patch test reactions to sodium disulfite report systemic symptoms after consuming high-sulfite-containing foods and beverages compared with patch test-negative controls.

Methods

In this retrospective cross-sectional study, 41 patients with positive and 41 patients with negative patch tests to sodium disulfite completed a standardized survey assessing symptoms (eg, headache, coughing, gastrointestinal distress) following consumption of high-sulfite foods and beverages. Symptom frequency, severity, and triggers were analyzed and compared between groups.

Results

Systemic symptoms were significantly more common among patch test-positive individuals (57.9%) compared with controls (26.8%, P = 0.005), particularly with wine (58.1% vs 25.6%, P = 0.006). Stronger patch test reactions correlated with greater symptom frequency and severity.

Conclusions

Patients with sodium disulfite contact allergy more frequently report systemic symptoms after ingesting high-sulfite foods and beverages. These findings suggest a possible overlap between contact allergy and systemic intolerance, supporting a potential role for dietary counseling in select patch test-positive patients.