This study suggests that, in view of their pollen.

After 6 years of specific

good tolerability and low cost, LRA Allergy to linden pollen (Tilia immunotherapy, she experienced clinical
should be tried in all patients with cordata) improvement.
unremitting, steroid-dependent chronic However, every A specific linden-pollen
urticaria before more challenging June, during the allergen of ,50 kDa
P. Mur*, F. Feo Brito, M. Lombardero, D. Barber,
therapies, such as IVIG or cyclosporin, are last 4 years, she has been detected.
P. A. Galindo, E. Gómez, J. Borja
considered. reported nasal,

Key words: linden allergens; linden pollen allergy; ocular, palatine, ear, and pharynx pruritus;
Acknowledgments We thank Mr Enos conjunctival hyperemia; sneezing; and
rhinoconjunctivitis; Tilia cordata.
Venturini and Ms Sonia Minisini for tech- night cough. She related it to the flowering
nical assistance. . ALLERGY to linden pollen (the most of a linden tree near her house. She was
common species is Tilia cordata) has asymptomatic in June when she was away
not been previously documented. from home.
*Ambulatorio di Allergologia
Ospedale Caduti Bollatesi We present the case of a pollinic Her white cell count and differential
Via Piave 20 patient sensitized to linden blood count were normal. The total IgE
20021 Bollate (MI) pollen. (Pharmacia CAP) was 334 kUA/l. The
Italy
A 21-year-old woman was diagnosed 10 skin prick test (SPT) to extract of T.
years ago as having rhinoconjunctivitis cordata pollen (5% w/v) was positive
Accepted for publication 23 January 2001
Allergy 2001: 56:456–457 and asthma caused by olive and grass (11317 mm). SPT was also positive to
Copyright # Munksgaard 2001
ISSN 0105-4538

References
1. SPECTOR S. Antileukotrienes in chronic
urticaria [Letter]. J Allergy Clin Immunol
1998;101:572.
2. ELLIS MH. Successful treatment of chronic
urticaria with leukotriene antagonists.
J Allergy Clin Immunol 1998;102:
876–877.
3. ASERO R. Leukotriene receptor antagonists
may prevent NSAID-induced exacerbations
in patients with chronic urticaria. Ann
Allergy Asthma Immunol 2000;85:
156–157.
4. TEDESCHI A, SULI C, LORINI M, AIRAGHI L.
Successful treatment of chronic urticaria.
Allergy 2000;55:1097–1098.
5. SOTER NA, LEWIS RA, COVEY EJ, AUSTEN
KF. Local effects of synthetic leucotrienes
(LTC4 , LTD4 , LTE4 ) in human skin. J
Invest Dermatol 1983;80:115–119.
6. WEDI B, NOVACOVICH V, KOERNER M, KAPP
A. Chronic urticaria serum induces
histamine release, leukotriene production,
and basophil CD63 surface expression.
Inhibitory effects of anti-inflammatory
drugs. J Allergy Clin Immunol
2000;105:552–560.
7. BRAY MA. Leukotriene B4 : a mediator of
vascular permeability. Br J Pharmacol Figure 1. IgE immunodetection experiment: lane 1) Tilia extract; 2) Platanus extract; 3) negative control;
1981;72:483–486. 4) inhibition of Tilia-IgE immunodetection with Platanus extract.

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Lolium sp., Olea sp., Plantago sp., *C/San José, 11, 48A been regularly treated with hydrocortison
Artemisia sp., Platanus sp., Chenopodium 13500 Puertollano rectal foam and mesalazine. She observed
Spain
sp., and Parietaria sp. a very strict
E-mail: [email protected]
The conjunctival provocation test (1) diet, poor in
Healed by diet,
was positive in our patient at 0.5 mg/ml. fiber, without
antihistamines, and
The nonspecific bronchial reactivity test Accepted for publication 29 January 2001 roughage
Allergy 2001: 56:457–458
cromoglycate.
with methacholine (2) was negative. A or green
Copyright # Munksgaard 2001
specific bronchial provocation test (3) was ISSN 0105-4538 vegetables. Nonetheless, the
performed with extract of linden pollen abdominal pain appeared several
and found to be negative. Specific IgE References times per week, and she presented
(Pharmacia CAP System) to T. cordata 1. JIMENEZ A, MORENO C, MARTı́NEZ J, et al. regularly one soft stool per day. Several
pollen was positive (27.7 kUA/l) and also Sensitization to sunflower pollen: only an
episodes of glairy and bloody stools were
occupational allergy? Int Arch Allergy
to pollens of Lolium perenne (13.8 kUA/l), also noted.
Immunol 1994;105:297–307.
Artemisia vulgaris (10.8 kUA/l), Plantago 2. CHATHMAN M, BLEECKER ER, NORMAN P, As food allergy to egg was diagnosed in
ovata (9.6 kUA/l), and Platanus acerifolia SMITH PL, MASON P. A screening test for her two children by skin tests, specific IgE
(15.5 kUA/l). airways reactivity. An abbreviated determination, and standardized oral
By means of RAST inhibition with methacholine inhalation challenge. Chest provocation tests, she underwent tests in
1982;83:15–18.
paper disks sensitized to T. cordata and January 2000 to detect masked food
3. CHAI H, FARR RS, FROEHLICH LA, et al.
the patient’s serum (4), no inhibition of allergy.
Standardization of bronchial inhalation
RAST was detected with Lolium, Olea, challenge procedures. J Allergy Clin Prick tests were negative to the usual
and Plantago extracts, but a partial Immunol 1975;56:323–327. aeroallergens and to 25 foods, particularly
inhibition (,30–40%) was detected with 4. CESKA M, ERIKSSON R, VARGA JM. wheat flour and egg, which she usually
Radioimmunosorbent assay of allergens.
Artemisia and Platanus pollen extracts. IgE consumed. Total IgE was within the
J Allergy Clin Immunol 1972;49:1–9.
immunodetection of T. cordata extract normal range (138 kU/l), and egg- and
5. FEO F, MARTINEZ A, PALACIOS R, et al.
after SDS–PAGE indicated that the Rhinoconjunctivitis and asthma caused by wheat flour-specific IgEs were negative
patient’s serum had IgE against several vine pollen: a case report. J Allergy Clin (Pharmacia CAP). The lymphocyte
bands, mainly at ,50 kDa and also at Immunol 1999;103:262–266. activation test (TAL) by flow cytometry (1
,23 and ,10 kDa (Fig. 1). Similar bands 2) showed 8% spontaneous activation
were detected in the Platanus extract, (normal ,2%), normal nonspecific
but the ,50 kDa band was much activation in the presence of
weaker. Inhibition of Tilia-IgE phytohemagglutinin A (44%), and
immunodetection with Platanus extract nonsignificant activation (,2%) in the
showed the existence of cross-reactivity of presence of wheat flour, egg, and gliadin
the smaller bands, but not of the 50-kDa Ulcerative colitis possibly due extracts (Allerbio Laboratory, France).
band (Fig. 1). to hypersensitivity to wheat The basophil activation test (TAB) by flow
In conclusion, exposure to linden and egg cytometry (2, 3) showed normal anti-IgE
pollen can induce IgE-mediated induced activation (44%) and
rhinoconjunctivitis and cough, as nonsignificant activation (,2%) in the
D. A. Moneret Vautrin*, J. Sainte-Laudy, G. Kanny
demonstrated by SPT, conjunctival presence of wheat flour and egg. On the
provocation, and IgE in vitro tests. contrary, the LTC4 release test was
Key words: food allergy; positive CAST; recovery;
A specific 50-kDa linden allergen has ulcerative colitis. positive for the two food extracts,
been detected. Linden pollen must be respectively, wheat flour and egg, and fo
taken into account when the patient’s . A 44-YEAR-OLD woman was treated for the three concentrations tested (1/25, 1/
symptoms correlate with linden ulcerative colitis. Abdominal pain and 125, and 1/625): 210, 168, and 45 pg/ml,
pollination, as other relevant pollens diarrhea had appeared in 1980. The and 316, 237, and 36 pg/ml, respectively
in the area (olive and grass) could diagnosis was confirmed by coloscopy and (LTC4 release is positive over
hide it (5). histology of biopsies. Since 1987, she had 100 pg/ml) (3).

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