Anaphylaxis induced by lentils

Background: The legume food family is large and includes peanut and soybean, two of the most frequent causes of food allergy. Literature on type I hypersensitivity to lentils, also a legume, is scarce. Objective: To describe a child with repeated anaphylactic reactions related to lentils. Methods: Skin prick tests with both commercial and cooked extracts and serum-specific IgE measured by CAP-RIA were used to identify specific IgE antibodies to various legumes. Results: An 8-year-old girl suffered four episodes of anaphylaxis related to lentils from ages 3 to 7 years. The first three involved ingestion of cooked lentils and each time smaller amounts induced symptoms. The fourth episode occurred with inhalation exposure to cooking lentil soup. Subsequently, she presented with contact urticaria from raw chickpeas and an anaphylactic reaction after ingestion of cooked chickpeas. Prick tests showed strongly positive reactions to lentil and chickpea and weaker positive reactions to peanut, pea, soybean, and white bean. CAP-RIA was class 6 to lentil; class 5 to peanut, pea, and soybean; class 4 to white bean, and class 0 to green bean. Conclusion: Severe type I hypersensitivity to lentils occurred in this patient and was associated with clinically relevant hypersensitivity to chickpeas. Prick tests and CAP-RIA demonstrated multiple positive reactions to other legumes.