Oral mite anaphylaxis explained

Oral mite anaphylaxis (OMA), also known as pancake syndrome, is a disease in which a person gets symptoms after eating food contaminated with particular mites. The disease name comes from reports of people becoming ill after eating pancakes made from contaminated wheat or corn (maize) flour.^[1]

Symptoms and signs

The symptoms are allergic symptoms, especially trouble breathing, swelling of the face and throat, runny nose, cough, difficulty swallowing, and wheals. Anaphylaxis can occur during exposure to NSAID drugs or exercise in people exposed to the mites.

Cause

Dust mites are microscopic arachnids that produce very powerful allergens. If dust mites get into the food, then anyone eating the food is eating the allergens and may have an allergic reaction against them. The specific mites suspected as causing the condition are Dermatophagoides pteronyssinus, Blomia tropicalis, and Suidasia pontifica (Suidasia medanensis).^[2] The latter two are the most likely to have caused the harmful effects, and they live in tropical and subtropical environments.

Because the condition is triggered by eating pancakes and other cooked food, scientists expect that this means that the allergen can withstand the heat of cooking.^[3]

Prevention

Storing flour at low temperature, such as in a freezer, could prevent contamination or kill existing mites in the flour.

Further reading

• Hashizume H, Umayahara T, Kawakami Y . Pancake syndrome induced by ingestion of tempura . The British Journal of Dermatology . 170 . 1 . 213–214 . January 2014 . 24032354 . 10.1111/bjd.12597 . 38221769 .
• Mangodt EA, Van Gasse AL, Bridts CH, Sabato V, Ebo DG . Simultaneous oral mite anaphylaxis (pancake syndrome) in a father and daughter and a review of the literature . Journal of Investigational Allergology & Clinical Immunology . 25 . 1 . 75–76 . 2015 . 25898706 .
• Sánchez-Borges M, Capriles-Hulett A, Caballero-Fonesca F . Oral mite anaphylaxis (pancake syndrome) also observed in children . Annals of Allergy, Asthma & Immunology . 96 . 5 . 755–756 . May 2006 . 16729794 . 10.1016/s1081-1206(10)61079-4 .
• Sánchez-Borges M, Capriles-Hulett A, Caballero-Fonseca F . Additional information on the pancake syndrome . Annals of Allergy, Asthma & Immunology . 101 . 2 . 221 . August 2008 . 18727482 . 10.1016/S1081-1206(10)60215-3 .

Notes and References

1. Sánchez-Borges M, Fernandez-Caldas E . Hidden allergens and oral mite anaphylaxis: the pancake syndrome revisited . Current Opinion in Allergy and Clinical Immunology . 15 . 4 . 337–343 . August 2015 . 26110684 . 10.1097/ACI.0000000000000175 . 11049409 .
2. Barrera OM, Murgas IL, Bermúdez S, Miranda RJ . [Oral anaphylaxis by ingestion of mite contaminated food in Panama City, 2011-2014] . Revista Alergia Mexico . 62 . 2 . 112–117 . June 2015 . 10.29262/ram.v62i2.71 . 25958374 . free .
3. Sánchez-Borges M, Suárez-Chacon R, Capriles-Hulett A, Caballero-Fonseca F, Iraola V, Fernández-Caldas E . Pancake syndrome (oral mite anaphylaxis) . The World Allergy Organization Journal . 2 . 5 . 91–96 . May 2009 . 23283016 . 3651046 . 10.1186/1939-4551-2-5-91 . free .