Characterization and Incidence of Sunflower Seed Allergy in a Pediatric Allergy Clinic

Overview

Journal J Allergy Clin Immunol Pract

Specialty Allergy & Immunology

Date 2024 Aug 8

PMID 39117271

Authors

Elsa R Treffeisen

Claire Mepyans

Ellen R Conroy

Heather J Baer

David N Williams

Kathryn A Williams

Lynda C Schneider

Affiliations

Soon will be listed here.

Abstract

Background: Sunflower seeds are a popular allergen-free peanut alternative.

Objective: To describe sunflower seed allergy incidence and characteristics.

Methods: We conducted a retrospective cohort study of patients with sunflower seed allergy from 1995 to 2021 in a pediatric allergy clinic. We described demographic characteristics, testing results, atopic comorbidities, and reaction histories of patients with sunflower seed allergy and calculated the annual cumulative incidence of the allergy. Logistic regression was used to estimate the increase in odds of sunflower seed allergy diagnosis for each year from 1995 to 2021.

Results: From 1995 to 2021, we identified 235 patients with sunflower seed allergy. Among patients with sunflower seed allergy, the median age at diagnosis was 3.9 years. More than three-quarters of patients had another atopic condition. Half of the reactions consisted of mild urticaria or rash, and a quarter met criteria for anaphylaxis. The cumulative incidence ranged from 0% (1995-1999, 2001-2004, and 2006) to 0.38% (2021). From 1995 to 2021, the odds of sunflower seed allergy diagnosis increased annually by 21% (odds ratio, 1.21; 95% CI, 1.17-1.25).

Conclusions: In our single-center cohort of children with sunflower seed allergy, most children were diagnosed in early childhood, had high rates of comorbid atopic conditions, and had high rates of cutaneous reactions to sunflower seed products. Moreover, in our cohort, incidence of sunflower seed allergy increased.

References

Palma-Carlos A, Palma-Carlos M, Tengarrinha F . Allergy to sunflower seeds. Eur Ann Allergy Clin Immunol. 2005; 37(5):183-6. View

Dyer A, Negris O, Gupta R, Bilaver L . Food allergy: how expensive are they?. Curr Opin Allergy Clin Immunol. 2020; 20(2):188-193. DOI: 10.1097/ACI.0000000000000622. View

Dribin T, Schnadower D, Spergel J, Campbell R, Shaker M, Neuman M . Severity grading system for acute allergic reactions: A multidisciplinary Delphi study. J Allergy Clin Immunol. 2021; 148(1):173-181. PMC: 8273088. DOI: 10.1016/j.jaci.2021.01.003. View

Hill D, Grundmeier R, Ram G, Spergel J . The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study. BMC Pediatr. 2016; 16:133. PMC: 4992234. DOI: 10.1186/s12887-016-0673-z. View

Crespo J, Pascual C, Burks A, Helm R, Esteban M . Frequency of food allergy in a pediatric population from Spain. Pediatr Allergy Immunol. 1995; 6(1):39-43. DOI: 10.1111/j.1399-3038.1995.tb00256.x. View

Hsu D, Katelaris C . Is "nut-free" sunflower seed butter safe for children with peanut allergy?. Med J Aust. 2007; 187(9):542-3. DOI: 10.5694/j.1326-5377.2007.tb01403.x. View

Galleani C, Dieguez M, Cabanillas B, Martin-Arriscado Arroba C, Enriquez-Matas A, Crespo J . Sunflower (Helianthus annuus) Seed Allergy. J Investig Allergol Clin Immunol. 2023; 35(1):32-39. DOI: 10.18176/jiaci.0965. View

Abrams E, Greenhawt M . The role of peanut-free school policies in the protection of children with peanut allergy. J Public Health Policy. 2020; 41(2):206-213. DOI: 10.1057/s41271-019-00216-y. View

An J . Anaphylaxis to Sunflower Seed with Tolerance to Sunflower Oil: A Case Report. Medicina (Kaunas). 2021; 57(7). PMC: 8305662. DOI: 10.3390/medicina57070661. View

10.

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

11.

Caubet J, Hofer M, Eigenmann P, Wassenberg J . Snack seeds allergy in children. Allergy. 2009; 65(1):136-7. DOI: 10.1111/j.1398-9995.2009.02155.x. View

12.

Lyons S, Burney P, Ballmer-Weber B, Fernandez-Rivas M, Barreales L, Clausen M . Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe. J Allergy Clin Immunol Pract. 2019; 7(6):1920-1928.e11. DOI: 10.1016/j.jaip.2019.02.044. View

13.

Lavine E, Ben-Shoshan M . Allergy to sunflower seed and sunflower butter as proposed vehicle for sensitization. Allergy Asthma Clin Immunol. 2015; 11(1):2. PMC: 4311509. DOI: 10.1186/s13223-014-0065-6. View

14.

Labella Alvarez M, Mera T, Baynova K, Zavala B, Castano M . Anaphylaxis due to roasted sunflower seeds with tolerance to raw sunflower seeds. Ann Allergy Asthma Immunol. 2018; 120(3):330-331. DOI: 10.1016/j.anai.2017.12.008. View

15.

Garcia Ortiz J, Cosmes P . Allergy to foods in patients monosensitized to Artemisia pollen. Allergy. 1996; 51(12):927-31. DOI: 10.1111/j.1398-9995.1996.tb02136.x. View

16.

Jackson K, Howie L, Akinbami L . Trends in allergic conditions among children: United States, 1997-2011. NCHS Data Brief. 2013; (121):1-8. View

17.

Patel A, Bahna S . Hypersensitivities to sesame and other common edible seeds. Allergy. 2016; 71(10):1405-13. DOI: 10.1111/all.12962. View

18.

Vandenplas O, Vander Borght T, Delwiche J . Occupational asthma caused by sunflower-seed dust. Allergy. 1998; 53(9):907-8. DOI: 10.1111/j.1398-9995.1998.tb04003.x. View

19.

Warren C, Chadha A, Sicherer S, Jiang J, Gupta R . Prevalence and Severity of Sesame Allergy in the United States. JAMA Netw Open. 2019; 2(8):e199144. PMC: 6681546. DOI: 10.1001/jamanetworkopen.2019.9144. View

20.

Halsey A, Martin M, Ruff M, Jacobs F, Jacobs R . Sunflower oil is not allergenic to sunflower seed-sensitive patients. J Allergy Clin Immunol. 1986; 78(3 Pt 1):408-10. DOI: 10.1016/0091-6749(86)90025-4. View