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Original Article


Bread eating induced oral angioedema due to α-amylase allergy


Á. Moreno-Ancillo1, C. Domínguez-Noche1, A. C. Gil-Adrados2, P. M. Cosmes 1

(1) Allergy Unit. Hospital Virgen del Puerto, Plasencia, Cáceres, Spain.
(2) Centro de Salud “La Estación”, Talavera de la Reina, Toledo, Spain.

J Invest Allergol Clin Immunol 2004; Vol. 14(4): 346-347



Inhalation of dust from different enzymes can be the cause of occupational asthma in exposed workers. Enzymes from different sources are being increasingly used in food. Few cases of food allergy to α-amylase induced by eating bread have been reported. Those cases were reported in bakery-related patients and in a pharmaceutical-industry worker. A 25-year-old farmer suffered sneezing, rhinorrhea, oropharyngeal itching,
hoarseness, cough, and non-wheezy dyspnea after eating white bread. Skin prick tests (SPT) with common aeroallergens and food allergens revealed only sensitization to Olea europaea pollen. SPT response was positive to Aspergillus oryzae α-amylase. Specific IgE against α−amylase was positive. A double-blind placebo-controlled challenge with 5 mg of uncooked -amylase induced sneezing, cough, oral angioedema within 10 minutes. The provocation test with 50 g of white bread gave similar findings. This case indicates that α-amylase contained in bread may provoke IgE-mediated food allergy. It is worth noting that in this case, the only source of α-amylase sensitization was bread.

Key words: α-amylase, food allergy, bread, asthma, angioedema,