Inmediate Reaction After Ingestion Of Cooked Mushrooms

RATIONALE: Fungal spores are established as important causes of respiratory allergy, but very few cases of allergic reactions after ingestion of mushroom have been previously described. METHODS: 3 patients came to our department refering inmediate reaction after ingestion of cooked mushrooms (Agaricus campestris and Pleorotus). Patient 1: 15 years old, male, half an hour after eating cooked Pleorotus, had an anaphylaxis. Patient 2: 20 years old, male, several times after ingestion of Agaricus campestris began with digestive simptoms (vomits, abdominal pain an diarrhoea). Patient 3: 29 years old, female, several times rinoconjuntivitis while cooking Agaricus campestris and Pleorotus. All of them were diagnosed of extrinsic asthma sensitized to molds years before. Skin prick test (SPT) to perennial (including molds) and seasonal inhalants, prick-prick to fresh and boild Agaricus campestris and Pleorotus, total and specific IgE (CAP system-Pharmacia) to same alergens and CAP-inhibition were performed. RESULTS: Prick-prick with fresh and cooked mushroom were possitive in all of patients as well as SPT to Alternaria, Cladosporium, Penicillium and Aspergillus. Rest of inhalants were negative. Specific IgE to Alternaria, Cladosporium, Penicillium, Aspergillus and Agaricus campestris were found. A 30% of inhibition was found in CAP when Alternaria was preincubated with Pleorotus. CONCLUSIONS: We present 3 cases of inmediate reaction after ingestion of cooked mushrooms. A cross-reaction between molds (Alternaria alternata) and mushrooms was found.