Two cases of food allergy: Boerhavia diffusa (Sarana)

Abstract

Case report

Back ground: Sarana (Boerhavia diffusa) is a commonly consumed leaf in Sri Lanka. We report 2 patients who developed anaphylaxis following ingestion of this plant, which we confirmed with specific allergy tests.

Patient 01: A 54 year old male patient developed 2 episodes of anaphylaxis after meals. His first meal had consisted of lentils, sarana, fish and rice. The second meal consisted of cooked sarana, rice, pineapple, eggs and papadam. A skin prick test (SPT) was done according the guidelines set by the European Academy of Allergy and Clinical Immunology. The patient developed a 7mm reaction to the raw extract of Sarana and a 4mm reaction to the cooked extract. He did not react to any other tested food.

Patient 02: A 37 year old male reported one episode of acute urticaria and one episode of anaphylaxis. The food common to both meals was Sarana.  Except for Sarana and woodapple, he had consumed all other food subsequently without any problem. The SPT was carried out for all suspected food items. The results of the SPT showed a 4mm reaction to the cooked Sarana extract.

Discussion: Allergy to Boerhavia diffusa has not been reported before. Both our patients reported hypersensitivity symptoms only after consumption of Boerhavia diffusa and their skin prick tests showed positivity only to Boerhavia diffusa confirming this plant as the cause of their allergy.