Severe contact urticaria to guar gum included as gelling agent in a local anaesthetic

Anaphylaxis After Consumption of Guar Gum-Containing Food: A Report of Two Cases

Guar gum is a food additive that acts as a thickening agent. Although the relationship between guar gum and occupational rhinitis/asthma has already been established, only very few cases of anaphylaxis were associated with guar gum ingestion. We present two examples of anaphylaxis induced by guar gum. Both cases were successfully treated with adrenaline. Moreover, serum-specific immunoglobulin E (IgE) with the culprit agent was detected in blood samples. To the best of our knowledge, here we present the first case of class 6 guar gum-specific IgE-positive anaphylaxis. This report aims to raise awareness of rare food additive allergies such as guar gum.

Safety Assessment of Galactomannans as Used in Cosmetics

The Cosmetic Ingredient Review Expert Panel (Panel) reviewed the safety of 16 galactomannans as used in cosmetics. These ingredients are legume polysaccharides that function mostly as hair/skin-conditioning agents and viscosity-increasing agents in cosmetic products. Their substantial molecular sizes suggest that skin penetration of these ingredients would be unlikely. The Panel concluded that these galactomannans are safe in the present practices of use and concentration described in this safety assessment.

Allergic and immunologic reactions to food additives

For centuries, food additives have been used for flavouring, colouring and extension of the useful shelf life of food, as well as the promotion of food safety. During the last 20 years, the studies implicating the additives contained in foods and medicine as a causative factor of allergic reactions have been proliferated considerably. In this review, we aimed to overview all of the food additives which were approved to consume in EU and find out how common and serious allergic reactions come into existence following the consuming of food additives.

Less travelled roads in clinical immunology and allergy: drug reactions and the environmental influence

Allergy and clinical immunology are examples of areas of knowledge in which working hypotheses are dominant over mechanistic understanding. As such, sometimes scientific efforts follow major streams and overlook some epidemiologically prevalent conditions that thus become underestimated by the research community. For this reason, we welcome the present issue of Clinical Reviews in Allergy and Immunology that is dedicated to uncommon themes in clinical immunology and allergy. First, comprehensive discussions are provided for allergy phenomena of large potential impact in clinical practice such as reactions to cephalosporins or aspirin-induced asthma and in everyday life such as allergies to food additives or legumes. Further, the issue addresses other uncommon themes such as urticaria and angioedema, cercarial dermatitis, or late-onset inflammation to soft tissue fillers. Last, there will be discussion on transversal issues such as olfactory defects in autoimmunity, interleukin 1 beta pathway, and the search for new serological markers in chronic inflammation. As a result, we are convinced that this issue will be of help to clinicians involved in internal medicine as well as to allergists and clinical immunologists. More importantly, we are convinced that these discussions will be of interest also to basic scientists for the numerous translational implications.

Aspirin sensitivity: acetylsalicylate or excipients

We present three patients who developed urticaria while taking an enteric formulation of aspirin, confirmed on a second exposure. Although hypersensitivity reactions to aspirin, especially in asthmatic patients or those with nasal polyps, are well reported, our patients did not exhibit any underlying history of atopy. Furthermore, two of the patients were able to tolerate a soluble formulation. We review the literature and discuss whether these symptoms might be caused by pharmaceutical excipients, present in very small amounts in the enteric coating, rather than the active ingredient acetylsalicylate. Adverse reactions to excipients are fortunately rare but are occasionally reported.