Mite Oral Allergy Syndrome / Mite-Aspirin Allergy Connection

Details

Today's video covers a case study of a man who had an anaphylaxis reaction to eating flour contaminated with a wheat mite (close relative of dust mites). We'll first start off with my story of being diagnosed with this (although it was probably a salicylate reaction), talk about the aspirin/mite allergy correlation, and look over why this case study was an amazing piece of research.

Agenda

  • Welcome to low-sal-life – What are sals? 00:00
  • My anaphylaxis story 2:00
  • Aspirin/Mite Correlations 10:51
  • Case study 15:02
  • Dealing with allergies /food can be contaminated 21:56

Research Articles Referenced

  • Erben A, Rodriguez J, Mccullough J, Ownby D. 1993. Anaphylaxis after ingestion of beignets contaminated with Dermatophagoides farinae. J Allergy Clin Immunol. 92(6):846–849. doi:10.1016/0091-6749(93)90062-k. http://dx.doi.org/10.1016/0091-6749(93)90062-k.
    Case study of a man who ingested mites in his flour mix and ended up with anaphylaxis. This is the first reported case study of oral allergy syndrome from mite ingestion.

  • Kupczyk M, Kupryś I, Górski P, Kuna P. 2004. Aspirin intolerance and allergy to house dust mites: important factors associated with development of severe asthma. Ann Allergy Asthma Immunol. 92(4):453–458. Read abstract from: https://www.annallergy.org/article/S1081-1206(10)61782-6/fulltext.
    The data from this study show that aspirin intolerance, House dust mite allergy, and asthma duration exceeding 10 years are major factors associated with severe asthma in outpatients.

  • Popescu F-D. 2015. Cross-reactivity between aeroallergens and food allergens. World J Methodol. 5(2):31–50. doi:10.5662/wjm.v5.i2.31. Read full article at: http://dx.doi.org/10.5662/wjm.v5.i2.31.
    Many different syndromes and associations due to cross-reactivity between aeroallergens and food allergens of plant, fungal and animal origin have been described. Significant examples are pollen-food syndromes or associations, along with mite-shrimp, cat-pork, and bird-egg syndromes, but rare or more complex clinical entities must also be discussed.

  • As I come across more research on this - I will post to the https://low-sal-life.com/research page, under Dust Mite/Mite Oral Allergy Syndrome tab.

 

Transcript

Provided for visual learners, improved accessibility, and for translating the page

Welcome to low-sal-life – What are sals? 00:00

Okay guys, today's video is going to give it's one of my favorite, favorite, favorite articles ever. And I guarantee you that you will have the creepy crawlies by the time you're done. And you will probably experience a short term paranoia for a little while because dust mites are just kind of creepy. Okay. We're talking … Welcome. I should probably introduce myself. I'm Sarah. This is Low-Sal-Life. We talk about anything that is salicylate sensitive related. And so, the question is, how are dust mites related? Well, that's a great question. If you're new to my channel, because you have no idea what salicylates are, but you're curious about dust mite oral allergy syndrome, you've come to a good place. We're happy you’re here. We hope that you learned something. Salicylates are basically aspirins, natural aspirins that occur naturally in plants, and a lot of cosmetics cleaners, perfumes, fragrances. So, it can be a natural or a synthetically produced compound. And generally, people, we know people have aspirin sensitivity, aspirin allergies, it’s not true allergy. But there's some of us that are extremely sensitive to very small parts. And so that's the reason why this channel exists. Because it's not very well known. There's not a lot of information. And so, I've been trying to compile a huge resource called low-sal-life.com, where I put all the research articles and information on it. So, it's easily available and free for people who want access to information, because I believe that that is important.

My anaphylaxis story 2:00

This article is near and dear to my heart. And there are a lot of articles like this, unfortunately. But this one is the first one that I read, probably about six years ago, some of my followers will know that that was quite a bit before I realized I had salicylate sensitivity. Let's talk about why this is being brought up on the channel. First of all, it's part of my story. So, I get to pick what comes out on the videos. I had an anaphylactic reaction about six years ago. It was 2014. Maybe early 2015. So, you Low-Sal folks will know exactly where I'm going with this. But the newbies will have to wait until the punch line at the end. So, I got into a car accident. And I had chronic back pain, which also was kind of really messed up because I have a muscular condition called Dystonia. So, my back was injured but then my dystonia flared up. And I also didn't know why I was getting dystonia flare ups, which I have found later to be from salicylates. Anyway, so this one morning I woke up, I felt like garbage, I could barely walk, I had to go to school, and sit in class for like six hours that day, and I was in so much pain. So, I got up, I took two Aleve. I went to school, and then I messaged my massage therapist. I was like, oh my gosh, I cannot walk. I can't even sit in my chair. Like if you have any openings or like mercy or grace or goodness in your heart, please, please see me or tell me who I can go see like in your clinic or whatever. So, he was like; Oh, I'm free. I can do an hour and a half massage, which is great because I never did hour and a half-massages before but I really knew the extra work. So, hour and a half massage. They used oil like usual. So, I did verify later what they use in the clinic. But anyway, so I had oil on my body for an hour and a half. I've already taken two Aleve. I also had Icy hot on my body which contains methyl salicylate. Guess they were going on? Okay. And then after that, after my massage was done an hour and a half. I was dating my husband at the time so we were not yet married. I was kind of realizing that I wasn't so sensitive to wheat products. He was like well, maybe you can maybe you're really not gluten intolerant. Maybe you know there's something else which he was right. So, I decided to you know, make This one of those days, so now, it was like, two in the afternoon, three in the afternoon. It was really late. And I was really hungry. And there was a really good Chinese restaurant that I remember going to like 15 years ago, next to the massage parlor. And so, I went and I had Mongolian beef, which for you low-Sal folks that have never tasted a chili. Mongolian beef is spicy. It's got broccoli, it has got red chilies. I made sure it was still pretty low in gluten. So, you know I had rice, there's probably a little bit of gluten in the sauce.

And so anyway, so I ate that. And then I was driving away. I also took I think two more leave during that time. And then I was driving home down the back country road. And about 10 minutes after leaving the restaurant. About 15 minutes from my destination. I had an anaphylactic reaction. I started realizing that I was like, wow, my tongue is like, wow, that mint that after mint was like really like cooling hot at the same time. And I was like, oh, I didn't get a mint. When I left the restaurant, like my mouth was just this weird cold and hot sensation, like kind of burning. And then I realized that like my tongue was swelling and like it was just really crazy. And I was by myself. I was starting to have problems breathing, I could barely breathe. And so, I'm driving home. And I know that like the nearest clinic is probably about 15-minutes away. And fortunately, I had two Benadryl in my car. So, I was able to dish out the little Benadryl out of my purse and chew it. I chewed two of them, and it slowed the reaction down. I made it to the clinic in time and I was treated by them. Which included already take had taken Benadryl. It included adding some cortisone. And then I still had flare-ups oddly enough, like after the Benadryl would wear off the cortisol. So, like after like four hours, the reaction kind of came back. We kept doing that about every four hours or so. So, I had to get really creative that night until like the next morning, probably about until 10. I kept having these flare-ups.

 So I went to the doctor, I went and saw this great allergist, who was like the first allergist that ever took me seriously. And he was so smart. But he just missed the mark just a smidge. So, we're going to talk about oral allergy syndrome with Dust Mite because I got diagnosed with that as like the most probable cause. So, he knew that I already had problems with gluten. So, whenever I eat gluten, I'd get sick. But it was always kind of weird, weird stuff I couldn't like pinpoint it. But when I took gluten out, I felt a lot better. So, I actually have marked my migraines and some stuff. And that is related to the folic acid that they add to wheat products. So, I actually don't have a problem with wheat. I only have a problem with the B vitamins that they add to wheat. So, I have separated that. Later I found out salicylate sensitivity. So supposedly sensitivity is what causes all my big problems. So, between the two of them, I am doing so much better. So, what we ended up doing was we did a full-skin prick test for all the food allergens. We did some blood tests, we did whole bunch of allergy testing. And in all of it every single ingredient in that meal came up as nothing, not a single problem. I am not allergic to the proteins in rice. I know beef is fine. I don't think they tested the beef, rice, chilies. Any fish sauce, soy sauce, we tested a whole bunch of fruits, we tested apple which I have had reactions to, which is high in salicylate, we tested all of these foods, a whole bunch of foods and nothing came up. So, knowing that I was sensitive to gluten or wheat products and also testing positive for dust mite allergy and testing negative to all of these other foods. He said that most probable thing at this point in time is that you have dust mite oral allergy syndrome, which sounds disgusting. And it is, it is kind of disgusting. What it comes down to is basically there are dust mites which I was allergic to, potentially contaminating food and then consuming it and then having a reaction.

Fast forward to me knowing that I had salicylate sensitivity. I will tell you that the reaction was probably a salicylate reaction. If you look through everything that happened that day, all the things that were really high in salicylates were four Aleve, which was obviously way more than you should probably take. But yeah, so that's and said it's not true aspirin. But it is an NSAID and kind of affects the same pathway, methyl salicylate and the icy hot, oils covering my body in oils for an hour and a half. Spicy food, broccoli and some of the other foods that I had that day. So, probably salicylate reaction and not oral allergy.

Aspirin/Mite Correlations 10:51

But still, that doesn't mean just because I got misdiagnosed that it's not relevant to you and besides it's pretty decent story. There is a lot of people in the Salicylate sensitive community that have asthma. There is a thing called Samter’s triad where it's basically I think it's asthma, aspirin sensitivity, and nasal polyps. So, it's like this little trifecta this tri- thing. So those three, all good in common, but asthma, like there's a lot of different contributing factors to asthma. But there is a correlation between aspirin allergy or aspirin sensitivity and dust mites and I wasn't able to track all of them down. I did find one asthma article it was called Aspirin intolerance and allergy to house mites, and it was by Kupczyk, basically that in the cases of people with severe asthma, they tended to have an allergy to aspirin in the asthma was caused, presumably by house mites. So that was one. As I find more, I know, I found better stats than that one. But as I find more, I will add it to the research page: Low-sal-life.com/research. And then there is also children with asthma. Apparently, there's like 80% of children also have dust mite allergy and that was true in my family. My mom had dust mite allergy. I have dust mite allergy, we're both so salicylate sensitive. And my brother, he had asthma and dust mite allergy as a kid. Please let us know down in the comments, I have salicylate sensitivity, and I have dust mite allergy. I have salicylate sensitivity, and I am not allergic to dust mites. Or I don't know I've never been tested. So those are just some things. There's also one other thing, and I'm really excited about this I'm going to be talking about soon in a different video after I read more about it. But there's a lot of, we’re all familiar with oral allergy syndrome from pollen. So, if you have like, I know that I'm very familiar with the birch oral allergy syndrome, where you can eat a lot of foods that are really similar to those on the salicylate list. So, if you're allergic to birch pollen, then you probably could be sensitive to what are some of them. I know banana is on there, apple, avocado, almond, carrot, some of those, right? So, a lot of those are similar to the foods that are on our list, right? So, a lot of people have gone through the birch, like trying to figure out if they have birch oral allergy syndrome or not. And then they eventually find salicylates. So, something that's kind of interesting, but the reason I'm mentioning pollen oral allergy syndrome, as a cross symptom. There's some research to talk about aero contaminants. What's it called? Aero allergens and food sensitivity. If you guys want a head start on it, it is Popescu 2015 really interesting looking at contaminants from dust mites and how people can have food reactions. When being exposed to those allergens, it would have to have Dust Mite allergy. And then you would only have reactions to these other foods where you wouldn't test positive for the protein. Like let's say they looked at shrimp, right? You can test negative for the protein in shrimp, but because of Dust Mite allergy then like it's really closely related so you could still react to it. So that's kind of how that works. This study in particular, I think was looking at shrimp, which is why I mentioned that. So, just some interesting things there you guys can think about and go on your tangents of research and everything.

Case study 15:02

So, let's talk about the study. Because it's kind of fun and kind of disgusting.  Now I've got a couple. So, this study is called Anaphylaxis after ingestion beignets. For those that don't know, beignets are kind of like a doughnut, like a French doughnut contaminated with Dermatophagoides farinae. So these are a wheat dust mite. Basically, I have to say that this is probably one of the best Perfect Storm case studies ever. And I love it because it's set up the case study it like that the situation is just perfect, perfect storm. I also want to give props to the doctor Anne Erben who is just like the most diligent allergist ever. She is amazing. If this was written…When was this written? Is this old? It doesn't even have the date on here. 1993. Yeah. So, if you live, go and find this lady because she deserves a gold medal for being diligent.

So, the summary of this is a man who was 48 years old. 48. Yeah. A man who is 48 years old, comes to the hospital with an anaphylaxis reaction. So, he's having trouble breathing. He's itchy. He has a flushed feeling. He's been nauseous 15 minutes after eating these beignets that he made. He had a few bathroom trips, and then was just like super sick and having difficulty breathing. So, they treated him per the gold standard. They gave him an EpiPen. They gave him Benadryl and they gave him prednisone, so a cortisol steroid to help his inflammation. So over 90-minutes, he became better and more stable, and started doing better. Before he got sick, 15 minutes before he got sick, he had eaten these homemade beignets. So, the reason why this happens to be a perfect study is because this man ate beignets the restaurant several weeks before I think three to four weeks before he made before this day, right? And so, he ate a whole bunch, right? So, he went had no problem eating them at the restaurant. So, then he bought two boxes. He brought them home, put them in a shelf, left them unopened. Next, he went on this day and opened box number one and ended up immediately sick. So obviously like what else did you eat today? What else have you done today? Like all those questions, right? He was like I don't know. Like I ate these beignets, I got sick. I've eaten them before but you know, this is what happened. So, they were curious about this beignet mix and fortunately he had some left, so he didn't use the whole box. He only used a partial amount of the box which is amazing. So lucky, so lucky. Okay, science thanks you universe! Okay, so they had a partial open box of the box he ate and then they had an unopened box that was completely intact and unopened. Okay, so they retrieved both boxes and then they put them under the microscope and in the flour that he ended up eating and getting sick off of. This is the creepy part, the creepy-crawly part. It had live mites crawling around in the wheat flour. And in the unopened box, there were no mites, nor any dead mites. So, you basically have a control and you have one with these mites. So, what they ended up doing was, they took, it said that they pulled out 12 mites out of the, oh no two dozen. A sample just a sample of the mite infested beignets mix was sent to a university for testing. All of them were D. farinae, so the wheat mite, they also checked the unopened box and found that it wasn't.

So, what they were able to do, and this is really fun, because it goes to the full process of how they identified that he wasn't allergic to the beignet mix, right. So, he's had all these ingredients before without problems, including eating that beignet mix at the restaurant. So, they knew that he wasn't sensitive to the ingredients, they still did their due diligence, and tested every single ingredient in the full beignet, including the ones stuff he made at home, and did a skin prick test with it, he did not react to any of those. So, they were feeling pretty good that he's not allergic to wheat, he's not learned to baking powder, or whatever else he ate in that mix. They did, then tested him with mites, and he did react. And then they also took the beignet mix with the mites and kind of ground it down and made their own allergen mix test with it. So, after they took the initial box grounded into a test, he reacted to that. They also did the same with the other beignet mix, and he did not react to that. So basically, they have confirmed in several different ways that he is definitely reacting to D. farinae. They also did a couple other tests, which I'm not going to go into but there's the Elisa and Elisa and inhibitions and the the rast and inhibitions. But I just want to show you this, this graph, which you can just see how drastic it is. So they tested him for the mite infested mix, the non-infested mix and the D. farinae extract that they were able to get from, you know, their allergen testing kits. And you can see that the reaction aligns D. farinae and a mite infested mix align very well while the non-infested mix did not. So, I think that's really all that matters.

Dealing with allergies /food can be contaminated 21:56

I do want to say that mites are a natural part of our ecosystem. Some people do have mite allergy like myself, so there, unfortunately, it's really hard to remove them from a home. I remember being told that hardwood floors were the way to go because you can keep them clean and your carpet doesn't trap any of the mites in the carpet. Well now I read an article like this last year that said hard you know, now that I bought a house without a single carpet in it, except for on the porch, which is like the weirdest place ever. Now they say that hardwood floors are not good for mites either because when the air vents come on, and basically air rates the dust into the house, and so people have either like this, there's either the same amount of dust like in the air or that people are having the same types of reactions, so it doesn't matter. So, kind of interesting, but there are chemicals and natural chemicals to help you remove dust mites from your house. And oddly enough, they are all salicylic products. So, eucalyptus is one of the natural ones. I think methyl salicylate is another one. Yeah, so, unfortunately, the best way to break up their little bodies and their poop is with salicylates. So that really sucks. I am on the hunt for other options that are Low-Sal but other fun stuff.

My favorite part of this study, and I totally don't blame this guy. It says in the discussion. The patient, however, did react to the extract of the infested beignet mix, which we talked about. The patient declined a challenge with Beignet made from non-infested next, but he continues to eat foods with similar ingredients without typical thing. That's the Omnivore's Paradox. We're like, you want to eat something but it could also kill you too. Like okay, I don't blame him. I'd stay away from beignets for quite some time.

Okay, and we'll just wrap up some other stuff that they have in this article, it says and this is just par for the course. I mean, we eat a lot of insects (and critters), there's no reason to be phobic of having insects in your food. Obviously for me, if I'm allergic dust mites having wheat with dust mites in it, could be a problem. And then of course there's the idea that maybe there could be a correlation between aspirin sensitivity or salicylate sensitivity and dust mites. So, do leave in the comments, I want to hear are you guys sensitive to dust mites? Okay. This says insect parts can contaminate spices and other foods, drugs, dyes, additives, bacteria and bacterial products occasionally contaminate foods. The complexity of modern food processing and preparation also provides a means for contamination of one food by another. Recently, adverse reactions were reported to non-dairy foods in six milk allergic children. In every case, cow's milk protein was implicated as the causative agent. So, things just slip in there. Thus, allergic reactions to food containing substances not mentioned on the food labels have been previously reported. D. farinae, or a dust mite sensitivity has been commonly linked to asthma and allergic rhinitis, so nose problems, but to our knowledge, this is the first report of anaphylaxis resulting from ingestion of food contaminated by D. farinae.

So good. Alright, guys, I hope you enjoyed that. This is another research article that is not available in the public domain. Go figure. So, I will link this the abstract to my website. There's other research articles that I'm adding for dust-mite allergy this week, so that you guys can kind of do some stuff with that. You can look into it more if you're interested. I think that's it. Yeah. Oh, and then if you want a full copy of it, just email me. So, I think that's it for now. I will see you guys later. Thanks so much for watching. Do let us know if you have dust mite allergy down below or if you've had oral allergy syndrome, dust mite oral allergy syndrome. And if you don't sleep tonight, I'm really sorry. Come back and comment on the video. Because I like stories. Okay, that's it for now. Have a wonderful day. Bye, guys.