Sesame (Sesamun Indicum) is common ingredient in cuisine around the world. In that sense, like other nuts, it can trigger allergic reactions in some people but is not a common inhalant occupational allergen.
We studied the clinic case of a 28 years-old woman working as a kitchen assistant; after preparing a chicken dish and incorporating the use of several species, she reported a cough, dyspnea, sneezing and rhinorrhea. A deeper look into the ingredients used, it was determined she had used sesame, black pepper, garlic, thyme, nutmeg, and parsley. The aforementioned symptoms manifested themselves immediately after using the subject species.
After obtaining the medical history and patient consent, skin prick testing is utilized to the most commonly commercially used spices (sesame, black pepper, garlic, nutmeg, thyme, oregano). In addition. Skin prick testing is also applied to determine the allergens effect of nuts (walnuts, almonds, pistachios and peanuts). We measure specific IgE levels (ImmunoCAP, Phadia) to each different spices.
Skin prick test results were POSITIVE to sesame and thyme. The weal diameter for the sesame was 13mm and for the thyme 8mm.
The sesame specific IgE levels (ImmunoCAP, PHADIA) were above 2.71 KU/L.
No specific IgE was detected with thyme.
A methacoline inhalation challenge was positive with a 24% decrease in FEV1.
Our case confirms that sesame can be a sensitizing agent through inhalation in an exposed individual and might explain to a large extend the increase levels to IgE mediated as an occupational disease.