[Fungal food allergy syndrome: A rare cause of anaphylaxis].

INTRODUCTION

Alternaria alternata is a mold commonly found in both indoor and outdoor environments. It can induce IgE-mediated sensitization, leading to symptoms such as rhinitis and, in some cases, severe asthma. However, allergic reactions resulting from the accidental ingestion of food contaminated with Alternaria have only rarely been reported.

OBSERVATIONS: We report two cases of patients with respiratory allergies who were sensitized to Alternariaalternata, with asthma exacerbations in humid environments and during summer thunderstorms. Following the ingestion of mold-contaminated food, both patients experienced anaphylaxis. (1) Male, 33 years old: skin prick-tests (SPT) and sIgE were positive only for Alternariaalternata (sIgE rAlt a1 at 10.5kU/L). Multiplex IgE (ISAC®) revealed strong sensitization to Alt a1 and less sensitization to Thaumatin-Like Protein (TLP) from kiwi. (2) Male, 58 years old: SPTs were are positive for pollen and Alternaria; sIgE was positive only for Alternaria alternaria (sIgE rAlt a1 at 1.59kU/L).

CONCLUSION

The ingestion of food contaminated with aeroallergens can trigger severe allergic reactions in sensitized patients, as described in "pancake syndrome" associated with dust mite contamination. In the present cases, reactions were related neither to true food allergy nor to cross-reactivity between aeroallergens and food allergens, but rather to food contamination with Alternariaalternata. These findings highlight the importance of comprehensive allergy evaluation in asthmatic patients, including systematic assessment for food-related allergic reactions.