A 43-year-old woman presented with oral discomfort, sneezing, urticaria, eyelid angioedema, abdominal pain, diarrhoea, dyspnoea and wheeze soon after eating a Japanese flour pancake (okonomiyaki, containing wheat, egg, yam, pork, prawn and squid). Subsequent analysis of the flour used in the pancake revealed the presence of Dermatophagoides farinae (4500 mites/g). The patient tested positive for specific IgE to D. farinae (15.2 kU/L) and D. pteronyssinus (14.0 kU/L) with negative responses to other ingredients in the pancake. Oral ingestion of dust mite in poorly stored foods can cause anaphylactic reactions in patients with allergy.
- primary care
- emergency medicine
- occupational and environmental medicine
- allergy, asthma
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Contributors KM, KF and RH wrote the draft. KM and KY collected the data and analysed the specimen. All authors read and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Provided