Allergy to curry: case report.

In recent years, the increasing use of spices has resulted in a rise of allergic reactions to them, especially in atopic patients. Curry is a mixture of several seeds such as coriander, onion, curcuma, caraway, cumin or mustard. Most of them belong to the Umbelliferae family. Contact dermatitis, the oral allergy syndrome and some cases of anaphylaxis are the most reported allergic reactions to these allergenic sources. Various pollen-food syndromes (PFS) have been described in pollinic patients, many of them produced by panallergens, but curry has never been included in them. However, some of the spices present in curry powder (parsley, caraway or coriander) have been reported as hidden allergens and cross-reactivity with mugwort pollens have been described (The celery--mugwort--spice syndrome). We describe a 45-year-old woman with rhinoconjunctivitis through May, June and September. She referred several episodes of papular lesions and pruritus in mouth mucosa, itching and erythema in face, palms and neckline immediately after eating several meals containing curry spices. No apparent relationship with other ingredients of the culprit meals as chicken, cous-cous or rice was suspected. The symptoms did not return when the patient ate the same meals cooking without curry. Skin prick test was positive to extracts from curry and coriander (Bial-Arístegui, Bilbao, Spain) (Fig. 1) as well as to pollens from Platanus acerifolia, Artemisa vulgaris and Chenopodium album (ALK-Abelló, Madrid, Spain). It was negative to other curry components: curcuma, mustard, cinnamon, onion, garlic, fennel, ginger, black pepper, laurel, nutmeg, cardamom and clove (BialArístegui, Bilbao, Spain) and pollens from Olea europaea, Cupressus arizonica, Plantago lanceolata and Dactylis glomerata (ALK-Abelló, Madrid, Spain). Serum specific IgE was determined by EAST technique (enzyme allergo sorbernt test). Solid-phase was obtained by coupling the extract solution (10 mg/mL) to the 6-mm diameter CNBr-activated paper discs, as described by Ceska and Lunqvist. EAST was performed following the manufacturer’s instructions (Specific IgE EIA kit HYTEC HYCOR Biomedical Ltd. UK), and values equal to or higher than 0.35 kU/L were considered positive. Serum specific IgE against extract from three different types of curry powder were 1.3, 1.9 and 2.2 kU/L, respectively. Serum specific IgE measurements to three different types of curry powder were 1.3, 1.9 and 2.2 kU/L, respectively. Among the species of the Umbelliferae family, it resulted