A Case of Korean Ginseng-Induced Anaphylaxis Confirmed by Open Oral Challenge and Basophil Activation Test.
10.4168/aair.2012.4.2.110
- Author:
Jae Young LEE
1
;
Hyun Jung JIN
;
Jung Won PARK
;
Soon Kwang JUNG
;
Jeng Yun JANG
;
Hae Sim PARK
Author Information
1. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University, School of Medicine, Chuncheon, Korea.
- Publication Type:Case Report
- Keywords:
Anaphylaxis;
basophil;
flow cytometry;
Panax
- MeSH:
Abdominal Pain;
Adult;
Alnus;
Anaphylaxis;
Antibodies;
Basophils;
Betula;
Bronchial Provocation Tests;
Cough;
Enzyme-Linked Immunosorbent Assay;
Flow Cytometry;
Flushing;
Humans;
Hypersensitivity;
Immunoglobulin E;
Immunoglobulin G;
Methacholine Chloride;
Panax;
Physical Examination;
Pollen;
Rhinitis;
Rhinitis, Allergic, Perennial;
Seasons;
Skin;
Thorax
- From:Allergy, Asthma & Immunology Research
2012;4(2):110-111
- CountryRepublic of Korea
- Language:English
-
Abstract:
Two case reports discussing Korean ginseng-induced allergic reactions have been published; both were inhalation-induced respiratory allergies in occupational settings. In this report we discuss the first case of anaphylaxis that developed after an oral intake of ginseng, confirmed by an open oral challenge, a skin prick test (SPT), and a basophil activation test (BAT). A 44-year-old man experienced rhinorrhea and nasal stiffness, followed by respiratory difficulty with wheeze and abdominal pain 10 minutes after oral intake of fresh ginseng. He had suffered from episodes of allergic rhinitis during the spring season for several years. Upon presentation, a physical examination, chest radiograph, and routine laboratory tests were unremarkable. Total serum IgE level was 41 IU/mL. The SPT results showed strong positive responses to alder, birch pollens, and ginseng extracts (1:500 w/v). The methacholine bronchial challenge test revealed a positive result at PC20 of 5.83 mg/mL. The open oral challenge was performed using 50 g of fresh ginseng and showed immediate onset of facial flushing, cough, respiratory difficulty with wheeze, and abdominal pain combined with a significant decrease in FEV1 levels (54% from the baseline). Serum-specific IgE and IgG4 antibodies were not detectable by enzyme-linked immunosorbent assay. BAT showed a remarkable increase in the expression of CD203c and CD63 with the addition of ginseng extract in a dose-dependent manner, while no changes were noted in the controls. In conclusion, oral intake of Korean ginseng could induce anaphylaxis, which is mediated by non-IgE-dependent direct activation of basophil/mast cells.
