Flaxseed Allergy Possible Through Ingestion or Contact

ANAHEIM, California — Allergy to flaxseed is rare, but with the booming popularity of the seed it should be on allergists’ radar, specialists suggest. The seed and its oil are increasingly in foods, art supplies, cosmetics, lotions, and animal feed.

Two challenging flaxseed-related cases were presented Friday at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Meeting. The cases add further evidence that flaxseed can cause allergic reaction after both ingestion and contact with the skin.

In one case, an 18-month-old toddler had an allergic reaction after eating oatmeal premixed with flaxseed.

The boy developed a rash over his face and chest 20 minutes after eating the oatmeal, which contained about 1,800-2,200 mg of flaxseed protein. It was the first time he had eaten flaxseed and the rash went away in 4 hours. After blood immunoglobulin E (IgE) levels were tested, the boy was diagnosed with IgE-mediated reaction to flaxseed.

Flaxseed allergy has been reported in adults, but rarely in children, said Alana Xavier De Almeida, MD, a resident in the Jackson Health system in Miami, Florida, who presented the case.

The toddler’s parents were offered an oral flaxseed challenge test to confirm but they declined.

De Almeida told Medscape Medical News she suspects flaxseed allergy is underreported in general because patients or families may not make the connection and may be focused on more common causes for their symptoms.

Artist’s Oil Paints Contained Flaxseed

Another case, also presented Friday by Richard M. Harris, MD, with Allergy and Asthma Associates of Los Angeles Medical Group in California, involved an artist being seen for recurring rashes on her hand who eventually was referred for allergy testing.

Harris’ team took a history and asked her to bring in all materials she used in her painting including charcoal, paint, and brush-cleaning solutions. A review of the items showed that her oil paints contained linseed/flaxseed-based oil.

“People don’t think to look for it,” said Harris.

Patch testing was done using test wells taped on the back. The test showed significant reaction at 48 and 72 hours.

Harris told Medscape Medical News the allergy led to painful fissuring of the patient’s fingers that affected her painting for at least a year before flaxseed was identified as the relevant allergen and she was advised to switch to a nonlinseed paint.

Allergy to flaxseed is not new; cases have been documented in literature for many decades.

In a report published in 2010, Andrew O’Keefe, MD, an allergist in St. John’s, Newfoundland, Canada, and colleagues detailed four cases of flaxseed allergy in children ages 17 months to 8 years old. Symptoms reported among the cases included urticaria, tingling, vomiting, and angioedema of the lips.

Another example was reported in 2022 in the Journal of Allergy and Clinical Immunology Global. Mark Holbreich, MD, an allergist in private practice in Indianapolis, Indiana, reported a case of an 11-month-old infant with severe flaxseed anaphylaxis. The paper concluded “that flaxseed sensitization most likely occurred through skin exposure resulting from regular contact with (a) flaxseed-stuffed animal.”

Holbreich, who was not part of the research presented Friday by De Almeida or Harris, told Medscape Medical News, “It’s still rare but these two papers suggest that allergists need to be aware.

“Ours was the first case to report an infant. Flaxseed is increasingly important as a potential cause of anaphylaxis or contact dermatitis,” he said.

Abstract authors and Holbreich declare no relevant financial relationships.

Marcia Frellick is a freelance journalist based in Chicago, Illinois. She has previously written for the Chicago Tribune, Science News, and Nurse.com, and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @MLfrellick

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