Nurgul SEVIMLI, Makbule Seda BAYRAK DURMAZ
Asthma Allergy Immunology - 2026;24(1):127-129
Food-induced hypersensitivity reactions are a significant clinical concern, ranging from mild oral symptoms to life-threatening anaphylaxis. While classical allergens such as nuts, shellfish, and milk are well-recognized triggers, reactions to less commonly consumed or culturally specific foods have also been described. However, these atypical allergens may go unrecognized in routine clinical practice, particularly when standard allergy panels yield negative results. Purslane species, lettuce, and thyme are widely consumed plant-based foods in certain regions but are not typically included in standard allergen panels. Hypersensitivity reactions to these foods are rarely reported and may therefore be underdiagnosed due to their unexpected nature. Moreover, when reactions do occur, they may be mistakenly attributed to other co-ingested foods or overlooked altogether. Here, we present three adult patients who developed immediate-type hypersensitivity reactions, including urticaria and anaphylaxis, triggered by ingestion of these uncommon food items. The suspected triggers were evaluated using prick-to-prick testing with fresh, raw food samples, with histamine and saline used as positive and negative controls, respectively; a wheal diameter >=3 mm above the negative control at 15-20 minutes was considered positive. Oral food challenge was not performed because of patient refusal and the potential risk of severe systemic reactions. This retrospective evaluation was approved by the Local Ethics Committee (Approval No: 591, Date: 25/7/2025) and was conducted in accordance with the principles of the Declaration of Helsinki. Clinical data were analyzed anonymously. This letter aims to emphasize the importance of obtaining a detailed dietary history and performing targeted testing in patients with otherwise unexplained allergic reactions.
