ABSTRACT
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Ingestion and inhalation of cereal grains and flours, including rice, sometimes provoke allergic disorders such as asthma, eczema and dermatitis, and gluten-sensitive enteropathy in a certain population (1,2). Clinical cases of allergic disorders caused by rice, which are less frequent than those of other cereals such as wheat have been reported in Japan and some European countries. In 1979, Shibasaki et al. (3) first reported in detail on rice allergy in Japanese patients, in which six patients showed immediate skin reaction and positive radioallergosorbent test (RAST) to soluble rice-seed extract, and five patients showed indurated skin reaction of delayed onset
and lymphocyte proliferation reaction against the extract. Later, Ikezawa’s group of Japanese dermatologists reported on the clinical effect of a replacement therapy for 43 patients with severe atopic dermatitis, who were suspected of having rice allergy (4). In this study, rice and wheat were replaced with hypoallergenic rice in their daily diet, and such a strict replacement therapy was shown to be useful or very useful in about 70% of the patients. In Europe, several clinical cases of rice allergy have been reported in Spain and Italy. A case study on hypersensitive reaction to rice (5) and another case of asthma and contact urticaria caused by handling rice and other cereals (6) were reported in Spain in 1992 and 1994, respectively. In Italy, clinical manifestations, including shock, vomiting, and diarrhea, in four infants with rice intolerance but without hypersensitivity to other foods were reported (7). In this case, double-blind oral challenges with rice were made and resulted in the induction of severe shock in three of four infants. Recently, there was report of a rare case of food allergy in the Netherlands in a 6-month-old girl, who had an anaphylactic reaction to rice flour, including a sudden onset of respiratory and gastrointestinal symptoms (8). There were also reports of clinical cases of allergic disorders induced by rice not only in infants but also in adults. A 43-year-old patient had a severe attack of bronchial asthma, and his serum immunoglobulin E (IgE) was RAST positive to rice (9). He had been eating hypoallergenic rice without experiencing any bronchialasthma-induced attack. Although the incidences of rice-induced food allergy are not very frequent even in Asian countries, including Japan, where rice is consumed daily in large quantities, rice ingestion has sometimes caused severe allergic disorders such as sudden onset of skin, respiratory, and gastrointestinal symptoms and, in rarer cases, systemic anaphylaxis.
