Are Organic Foods Safer or Healthier Than Conventional Alternatives?: A Systematic Review, 4 September 2012 Annals of Internal Medicine Volume 157 • Number 5
ANAPHYLAXIS TO AN ORGANiC HEALTH FOOD CEREAL: AMARANTH ALLERGY
Susan Mozzicato, MD and Robert M Bedard, MD university of Connecticut, Department of Internal medicine, Farmington, Connecticut Asthma and Allergy Center, West Hartford
A38-year-old male developed chest and throat tightness, facial swelling, generalized itching and hives within one hour after eating an amaranth-containing organic cereal for the first time. The patient took Benadryl and went to the emergency room where he was given epinephrine and steroids with recovery.
The cereal eaten contained whole grain oats, amaranth flour, brown rice, yellow corn, rye flour, juice concentrates of apple, pear, or grape, ascorbic acid, and vitamin e; per labeling, it did not contain peanuts or tree nuts. The patient did not have a history of asthma, hay fever, aspirin sensitivity or occupational exposure to grain flour.
People around the world value amaranths as leaf vegetables, cereals, and ornamentals. Amaranth grain is a traditional food in Africa and has been used as a grain crop on that continent as well as in Asia and South America. Amaranth grain is gluten-free and contains higher protein content than other conventional cereals. It can be a useful substitute for patients who are wheat allergic or gluten sensitive.
Prick skin testing was done using the amaranth cereal flakes, cooked and uncooked whole grain amaranth, whole wheat flour, lamb’s quarters, dust mites, soy, and other organic cereals containing kamut, spelt, and buckwheat. Tests were positive to the amaranth cereal flakes (wheal 6 mm, flare 20 mm), raw whole grain amaranth (wheal 6 mm, flare 20 mm), and cooked whole grain amaranth (wheal 5 mm, flare 25 mm). Histamine control developed a 5 mm wheal and a 20 mm flare. Tests to lamb’s quarters (pigweed surrogate), dust mite (grain dust mite surrogate), soy commercial extracts, whole wheat flour, and the other cereals were negative.
To ensure the positive reactions represented true allergy and not irritants, three staff members were tested with amaranth flakes, raw whole grain amaranth, and cooked whole grain amaranth, and all were negative.
The patient was advised to avoid amaranth in all preparations. A food allergy treatment plan and epipen instruction were provided.
With the increasing popularity of organic health foods, this first reported case of anaphylaxis to amaranth or- ganic cereal is of interest.
218 Connectticut Medicine, APRIL2010