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Sesame allergy

Sesame allergy
Raw sesame seeds with sesame plants in background
Pronunciation
  • sesəmi ælə(r)dʒi
SpecialtyEmergency medicine
Allergy & immunology
Symptomsitchiness, rash, swelling of lips, tongue or the whole face, eczema, wheezing and shortness of breath, nausea, vomiting, abdominal pain, diarrhea, anaphylaxis[1][2]
CausesType I hypersensitivity[3]
Risk factorsChildhood in Middle East, where sesame is a traditional food, and increasingly in developed countries[4]
Diagnostic methodMedical history and standard allergy tests[5]
Differential diagnosisPeanut allergy, Tree nut allergy[6]
PreventionIntroduction to allergenic foods during infancy[7]
TreatmentEpinephrine[8]
Antihistamines (mild)[9][10]
Prognosis70% to 80% persist into adulthood[4]
Frequency0.1–0.2% (higher in Middle East countries)[11][12]

A food allergy to sesame (Sesamum indicum) seeds has prevalence estimates in the range of 0.1–0.2% of the general population,[11][12][13][4] and are higher in the Middle East and other countries where sesame seeds are used in traditional foods.[4] Reporting of sesame seed allergy has increased in the 21st century, either due to a true increase from exposure to more sesame foods or due to an increase in awareness.[11][12][3] Increasing sesame allergy rates have induced more countries to regulate food labels to identify sesame ingredients in products and the potential for allergy.[14][15][16] In the United States, sesame became the ninth food allergen with mandatory labeling, effective 1 January 2023.[14]

The allergic reaction is an immune hypersensitivity to proteins and lipophilic proteins in sesame seeds and foods made with sesame seeds, including food-grade sesame oil. Symptoms can be either rapid or gradual in onset, occurring over minutes to days. Rapid allergic reaction may include anaphylaxis, a potentially life-threatening condition requiring treatment with epinephrine.[17] Other, slower presentations may include atopic dermatitis or inflammation of the esophagus.[18] For food labeling requirements established in many countries, sesame labeling is required in addition to the eight most common food allergens, responsible for 90% of allergic reactions to foods: cow's milk, eggs, wheat, shellfish, peanuts, tree nuts, fish, and soy beans.[19][20]

In addition to water-soluble allergenic proteins, sesame seeds share with peanuts and hazelnuts a class of allergenic proteins known as oleosins. Commercially prepared sesame extracts lack these lipophilic proteins, and so can be the reason for false negative skin prick test results even though the oleosins can be responsible for a range of allergic reactions, including anaphylactic shock.[21] Unlike early childhood allergic reactions to milk and eggs, which often lessen as children age,[22] sesame allergy persists into older childhood and adulthood; an estimated 20–30% of affected people develop tolerance.[4] Strong predictors for adult-persistence are anaphylaxis, high sesame-specific serum immunoglobulin E (IgE) and robust response to the skin prick test. Sesame allergy can be cross-reactive with allergy to peanuts, hazelnuts, and almonds.[6]

  1. ^ Cite error: The named reference medlineplus was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference MedicalNews was invoked but never defined (see the help page).
  3. ^ a b Gangur V, Kelly C, Navuluri L (July 2005). "Sesame allergy: a growing food allergy of global proportions?". Ann Allergy Asthma Immunol. 95 (1): 4–11. doi:10.1016/S1081-1206(10)61181-7. PMID 16095135.
  4. ^ a b c d e Adatia A, Clarke AE, Yanishevsky Y, Ben-Shoshan M (April 2017). "Sesame allergy: current perspectives". J Asthma Allergy. 10: 141–51. doi:10.2147/JAA.S113612. PMC 5414576. PMID 28490893.
  5. ^ Cite error: The named reference Overview was invoked but never defined (see the help page).
  6. ^ a b Cite error: The named reference Dreskin2021 was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference Ferraro2019 was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference EAACI2014 was invoked but never defined (see the help page).
  9. ^ "Choosing Wisely: Don't rely on antihistamines as firstline treatment in severe allergic reactions". American Academy of Family Physicians. Retrieved 28 August 2022.
  10. ^ Fineman SM (July 2014). "Optimal Treatment of Anaphylaxis: Antihistamines Versus Epinephrine". Postgraduate Medicine. 126 (4): 73–81. doi:10.3810/pgm.2014.07.2785. PMID 25141245. S2CID 25203272.
  11. ^ a b c Patel A, Bahna SL (October 2016). "Hypersensitivities to sesame and other common edible seeds". Allergy. 71 (10): 1405–13. doi:10.1111/all.12962. PMID 27332789. S2CID 13026863.
  12. ^ a b c Dalal I, Goldberg M, Katz Y (August 2012). "Sesame seed food allergy". Curr Allergy Asthma Rep. 12 (4): 339–45. doi:10.1007/s11882-012-0267-2. PMID 22610362. S2CID 11111725.
  13. ^ Warren CM, Chadha AS, Sicherer SH, Jiang J, Gupta RS (August 2019). "Prevalence and Severity of Sesame Allergy in the United States". JAMA Netw Open. 2 (8): e199144. doi:10.1001/jamanetworkopen.2019.9144. PMC 6681546. PMID 31373655.
  14. ^ a b Cite error: The named reference SesameLaw2021 was invoked but never defined (see the help page).
  15. ^ Cite error: The named reference EU2015 was invoked but never defined (see the help page).
  16. ^ Taylor SL, Baumert JL (2015). "Worldwide food allergy labeling and detection of allergens in processed foods". Chem Immunol Allergy. Chemical Immunology and Allergy. 101: 227–34. doi:10.1159/000373910. ISBN 978-3-318-02340-4. PMID 26022883.
  17. ^ Cite error: The named reference Muraro2014 was invoked but never defined (see the help page).
  18. ^ National Report of the Expert Panel on Food Allergy Research, NIH-NIAID 2003 "National Report of the Expert Panel on Food Allergy Research" (PDF). 30 June 2003. Archived from the original (PDF) on 4 October 2006. Retrieved 7 August 2006.
  19. ^ "Food Allergies" Archived 6 October 2012 at the Wayback Machine Asthma and Allergy Foundation of America
  20. ^ Cite error: The named reference NHS was invoked but never defined (see the help page).
  21. ^ Cite error: The named reference Jappe2017 was invoked but never defined (see the help page).
  22. ^ Urisu A, Ebisawa M, Ito K, Aihara Y, Ito S, Mayumi M, Kohno Y, Kondo N (September 2014). "Japanese Guideline for Food Allergy 2014". Allergol Int. 63 (3): 399–419. doi:10.2332/allergolint.14-RAI-0770. PMID 25178179.

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