D2.92 - LTP-Mediated Corn-Induced Anaphylaxis

Introduction: IgE-mediated food allergies are on the rise globally. Lipid transfer proteins (LTPs) are notable for their thermal and digestive stability and are a common cause of severe allergic reactions. Corn, which has low allergenic potential, has been recognized as a source of LTPs (Zea m14) involved in severe systemic reactions. We aim to present a clinical case of severe corn anaphylaxis mediated by LTP, highlighting the importance of correct diagnosis and adequate management of this rare type of allergy.

Case study: A 47-year-old patient admitted to the Allergy Department describestwo episodes of systemic reaction with urticaria, facial angioedema, dyspnea, and hypotension 80/40 mmHg, occurring 20 minutes after consuming polenta. The event was repeated twice, at two different exposures, the common food in both cases being corn. No other potential cofactors (physical exertion, NSAIDs, alcohol) were identified. Treatment with epinephrine, volume replacement, and antihistamines induced remission of symptoms. Serological testing revealed evated levels of IgE specific to molecular allergens for several LTP allergens: corn Zea m 14 (3.9 kU/L), as well as apple Mal d 3 (8.5 kU/L), peach Pru p 3 (10.9 kU/L),grape Vit v 1 (7.8 kU/L), celery Api g 2 (6 kU/L), and hazelnut Cor a 8 (9.6 kU/L). The recommendation of an epinephrine autoinjector and avoidance of corn consumption are essential in preventing further events.

Corn is a rare food allergen with low allergenic potential, but in some sensitized patients it can induce severe systemic reactions, including anaphylaxis. Multiple sensitization to LTP from other allergenic sources may underlie food allergies to multiple allergenic sources. Molecular IgE testing is an essential tool in accurate diagnosis and making the best treatment decisions. Keywords: anaphylaxis, corn,lipid transfer proteins.