Spice allergy T78.1

Spice allergies have become increasingly common in recent years. When taken orally, oropharyngeal but also enteral (flatulence, diarrhoea) symptoms are in the foreground. Monovalent sensitizations are possible. Cross-reactions seem to be not uncommon (Jäger L 2001). An example of a broader cross-reactivity is the "celery-mugwort syndrome" or also the "celery-spice-birch syndrome" (Yagami A et al. 2009). In patients with at least 1 positive prick test for spices, birch pollen sensitisation was also found in 80%, and mugwort pollen in 30%. Only about 10% of the patients had neither birch nor mugwort allergies. Mugwort pollen and birch pollen seem to play a certain role as lead allergens (Thiel 1981). Occupational exposure (spice production, trade) can lead to contact dermatitis; but also to rhinitis and bronchial asthma (van der Walt A et al. 2010).

By definition, only parts of plants are considered as "spice". These include:

• leaves (dried herbs, bay leaves, etc.)
• buds, flowers or flower parts (saffron, cloves, capers)
• Bark(cinnamon)
• Plant roots, rhizomes, onions (ginger, turmeric, horseradish, kitchen onion, garlic)
• Fruits or seeds(nutmeg, pepper, paprika, vanilla, caraway, aniseed)
• In some plants, such as caraway, cinnamon and nutmeg, several components of the plant can be used.

Thus, the term spice, like the termfruit, is a collective term for these parts of the plant. In addition to their taste benefits, spices are also traditionally used to preserve food and beverages. Spices contain essential oils as well as irritants whose fragrances drive away pests, among other things. The most important representatives of the spice group belong to the following families (Jäger L et al. 2001):

• Piperaceae (pepper)
• Labitae (marjoram, oregano, rosemary, sage, basil, peppermint, lemon balm, thyme)
• Umbelliferae (coriander, anise, fennel, parsley, dill)
• Compositae (mugwort, tarragon)
• Solanaceae (pepper, paprika)
• Zingiberaceae (Ginger, Cardamom)
• Myristicaceae (nutmeg)
• Lauraceae (cinnamon, laurel)
• Cruciferae (white mustard, black mustard)
• Liliaceae (kitchen onions; garlic)
• Iridaceae (Saffron)

The symptoms of an allergy to spices usually correspond to those of a food allergy, but also symptoms of a contact or pollen allergy.

The following clinical symptoms can occur in spice allergy sufferers:

• urticaria, angioedema and rhinoconjunctivitis
• oral allergy syndrome (itching, swelling of the mouth, tongue or lips)
• Urticarial exanthema, urticaria, pruritus, contact allergic eczema
• Allergic rhinitis, allergic rhinitis, sneezing, itching of the nose
• Gastroenteric symptoms such as diarrhoea, flatulence and bloating
• circulation problems, heavy sweating, headaches
• In severe cases anaphylactic reactions up to allergic shock may occur.

The word spice has its origins in the Middle High German "wurz" and in its original forms simply meant "root". Spices (e.g. curry, paprika, coriander, caraway) often cause irritating local reactions in prick and scratch tests. These should be interpreted very cautiously (Dietschi R et al. 1987).

Asero R et al (2018) Allergy to LTP: to eat or not to eat sensitizing foods? A follow-up study. Eur Ann Allergy Clin Immunol 50:156-162.

Dietschi R et al (1987) So-called "celery-carrot-mugwort-spice syndrome." RAST results with new spice discs. Z Hautkr 62:524-531.

Franke W (1997) Herbology: useful plants of temperate latitudes, subtropics and tropics. 6th edition, Thieme, Stuttgart

Jäger L et al (2001) Food allergens. In Jäger L et al (ed.) Food allergies and intolerances. Urban&Fischer Publisher p.148-149

Pastorello EA et al (1994) Allergenic cross-reactivity among peach, apricot, plum, and cherry in patients with oral allergy syndrome: an in vivo and in vitro study. J Allergy Clin Immunol 94:699-707.

Sánchez-Monge R et al (1999) Lipid-transfer proteins are relevant allergens in fruit allergy. J Allergy Clin Immunol 103:514-519.

van der Walt A et al (2010) Work-related allergy and asthma in spice mill workers - The impact of processing dried spices on IgE reactivity patterns. Int Arch allergy Immunol 152:271-278.

Yagami A et al (2009) Curry spice allergy associated with pollen-food allergy syndrome and latex fruit syndrome. J Dermatol 36:45-49.