Poppy seed anaphylaxis: clinical and allergic features

Poppy seeds are increasingly used for flavoring, for example, in cakes, bread, and fruit salads, and it is gaining popularity globally. Most case reports of poppy seed allergy are in children. Ingestion of cake, in which ground poppy seed is used, is mostly associated with anaphylactic reactions. Reactions may occur even with minimal amounts or traces. In sera of patients allergic to poppy seeds, four IgE-reactive poppy seed proteins were identified. Cross allergy with sesame and buckwheat are reported. Cross-reaction is described with nuts (cashew and walnut), wheat, rye flour, buckwheat, rice, and kiwi. Although rare, allergy to poppy seed is often rapid, generalized, and potentially life-threatening and, therefore, should be considered in allergic work-up. Therapy of poppy seed allergy/anaphylaxis is based on an elimination diet. However, oral desensitization could be hypothesized in some high-risk allergic patients, according to other reports of oral desensitization in seed anaphylaxis.