Cumin anaphylaxis and allergy to spices in pediatrics: a case report and literature review.

While spice allergies are rarely documented in children, spices are becoming an increasingly common allergen in pre-packaged foods. Current literature reports contradictory findings regarding the risk of severe reactions in pediatric patients, with some evidence suggesting that small amounts of spices usually used in home-cooked meals may be safe for children. However, allergens, such as spices, are increasingly used in the food industry, coupled with diverse culinary habits and customs, necessitates a re-evaluation of this risk. To the best of our knowledge, this is the first report of cumin anaphylaxis via inhalation in a pediatric patient. Spice allergies should be suspected in patients with allergic manifestations occurring briefly after the consumption or inhalation of multiple different and unrelated foods. Our experience indicates that prick-by-prick tests with spice powders are helpful and should be recommended as part of the diagnostic workup to investigate this peculiar type of food allergy and prevent misdiagnosis of idiopathic anaphylaxis. Limited data concerning the reliability of skin tests with native spices and extracts are available in the literature. Native spices could contain irritant agents leading to false-positive results, but standardized case-control studies are currently lacking. New techniques can be used in the diagnostic process; however, they still need to be validated and integrated into clinical practice. Further investigation is required to quantify the impact of spice allergies on the pediatric population, especially in today's multiethnic societies.