D3.208 - Alpha-L-Fucosidase and Other Allergens in Cardamom-Induced Allergy: A Case Study

Cardamom (Elettaria cardamomum), a widely used spice, is rarely reported as an allergenic source, with few cases described in the literature. This study investigates a case of allergic reactions triggered by cardamom ingestion, aiming to characterize its allergenic proteins.

A 32-year-old male experienced two episodes of allergic reactions after ingesting cardamom. In 2022, he developed generalized urticaria within minutes of ingesting a cardamom seed from tea. In 2023, he presented with generalized pruritus, abdominal pain, and presyncope after eating butter chicken prepared with cardamom. He had tolerated cardamom tea prior to the described episodes. The patient also tolerated ginger, curry and other seeds such as sesame and sunflower. Skin prick tests were negative for cardamom, and IgE-specific assays revealed low sensitization (0.28 kUA/L). An oral provocation test with cardamom tea was negative. A provocation with ground cardamom elicited generalized urticaria and abdominal discomfort. The patient was treated with antihistamines (oral and intravenous), corticosteroids (oral and intravenous), and a proton pump inhibitor, with complete recovery.

Protein extracts were prepared from cardamom seeds and ground cardamom. SDS-PAGE and IgE-Western blot analyses were performed to identify allergenic proteins, using patient serum under reducing and non-reducing conditions.

An written informed consent for publication was obtained from the patient.

SDS-PAGE showed distinct protein profiles between cardamom seeds and ground cardamom, with a prominent 11 kDa band in both extracts under reducing conditions. IgE-Western blot revealed reactivity to multiple bands (10–75 kDa), including strong recognition of the 11 kDa band. Additional bands at 19, 25, and 35 kDa were identified in seed extracts, while a 60 kDa band was unique to ground cardamom. The 11 kDa protein aligns with alpha-L-fucosidase, a recognized allergen in cardamom.

Alpha-L-fucosidase and other proteins are implicated in cardamom-induced allergic reactions. This case emphasizes the need for detailed allergenic profiling to guide diagnosis and management, particularly for rare allergens like cardamom.