چکیده (انگلیسی):

Background: Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized.
Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral
mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mitecontaminated
okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital.
Methods: In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched
for patients with oral mite anaphylaxis in Japan.
Results: Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of
36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix
which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit
mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der
f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3
cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific
IgE to Der p and Der f were more than class 2 in all cases.
Conclusions: Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.