Abstract
We have followed 12 patients with acute symptoms on exposure to psyllium over a three-year period. All were hospital personnel with evidence of atopy. Exposure was by inhalation on dispensing psyllium powder. Symptoms which occurred within minutes of exposure included rhinitis (12/12), conjunctivitis (10/12), shortness of breath and wheezing (9/12). All patients had psyllium-specific IgE antibodies demonstrated by either positive prick-skin tests (1:100) or serum antibodies (rast). Controls had no reactivity to psyllium. Sensitivity persisted over the entire three-year period. We conclude that sensitivity to psyllium is an IgE-mediated occupational allergy in hospital personnel; that it produces significant symptoms and it is often unrecognized; and that persistance of sensitivity necessitates strict avoidance of psyllium by all routes of exposure.
Keywords: psyllium, substance sensitivity, rhino-conjunctivitis, asthma
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bernton H. S. The allergenicity of psyllium seed. Report of a case. Med Ann Dist Columbia. 1970 Jun;39(6):313–passim. [PubMed] [Google Scholar]
- Busse W. W., Schoenwetter W. F. Asthma from psyllium in laxative manufacture. Ann Intern Med. 1975 Sep;83(3):361–362. doi: 10.7326/0003-4819-83-3-361. [DOI] [PubMed] [Google Scholar]
- Chan-Yeung M., Lam S. Occupational asthma. Am Rev Respir Dis. 1986 Apr;133(4):686–703. doi: 10.1164/arrd.1986.133.4.686. [DOI] [PubMed] [Google Scholar]
- Gauss W. F., Alarie J. P., Karol M. H. Workplace allergenicity of a psyllium-containing bulk laxative. Allergy. 1985 Jan;40(1):73–76. doi: 10.1111/j.1398-9995.1985.tb04158.x. [DOI] [PubMed] [Google Scholar]
- Gross R. Acute bronchospasm associated with inhalation of psyllium hydrophilic mucilloid. JAMA. 1979 Apr 13;241(15):1573–1574. doi: 10.1001/jama.1979.03290410013005. [DOI] [PubMed] [Google Scholar]
- Hagy G. W., Settipane G. A. Prognosis of positive allergy skin tests in an asymptomatic population. A three year follow-up of college students. J Allergy Clin Immunol. 1971 Oct;48(4):200–211. doi: 10.1016/0091-6749(71)90066-2. [DOI] [PubMed] [Google Scholar]
- King T. P., Norman P. S., Lichtenstein L. M. Isolation and characterization of allergens from ragweed pollen. IV. Biochemistry. 1967 Jul;6(7):1992–2000. doi: 10.1021/bi00859a017. [DOI] [PubMed] [Google Scholar]
- Machado L., Stålenheim G. Respiratory symptoms in ispaghula-allergic nurses after oral challenge with ispaghula suspension. Allergy. 1984 Jan;39(1):65–68. doi: 10.1111/j.1398-9995.1984.tb01934.x. [DOI] [PubMed] [Google Scholar]
- Machado L., Zetterström O., Fagerberg E. Occupational allergy in nurses to a bulk laxative. Allergy. 1979 Feb;34(1):51–55. doi: 10.1111/j.1398-9995.1979.tb02000.x. [DOI] [PubMed] [Google Scholar]
- Mihalas L. S., Loren M. L. Oral challenges in inhalant antigens in asthmatics. Ann Allergy. 1979 Mar;42(3):145–147. [PubMed] [Google Scholar]
- Rosenberg S., Landay R., Klotz S. D., Fireman P. Serum IgE antibodies to psyllium in individuals allergic to psyllium and English plantain. Ann Allergy. 1982 May;48(5):294–298. [PubMed] [Google Scholar]
- Suhonen R., Kantola I., Björksten F. Anaphylactic shock due to ingestion of psyllium laxative. Allergy. 1983 Jul;38(5):363–365. doi: 10.1111/j.1398-9995.1983.tb04132.x. [DOI] [PubMed] [Google Scholar]
- Zaloga G. P., Hierlwimmer U. R., Engler R. J. Anaphylaxis following psyllium ingestion. J Allergy Clin Immunol. 1984 Jul;74(1):79–80. doi: 10.1016/0091-6749(84)90091-5. [DOI] [PubMed] [Google Scholar]
- Zetterström O., Wide L. IgE--antibodies and skin test reactions to a detergent--enzyme in Swedish consumers. Clin Allergy. 1974 Sep;4(3):273–280. doi: 10.1111/j.1365-2222.1974.tb01385.x. [DOI] [PubMed] [Google Scholar]