Allergy to green pepper: a case report of anaphylaxis

Case Report: We present a 39-year-old nonatopic woman that in December 2016 after eating a seafood paella with green pepper immediately presented asthenia, nasal obstruction, facial erythema, incoerctable vomiting and diarrhea. She was attended in an emergency service and treated with received treatment with adrenaline, dexchlorpheniramine and methylprednisolone. Later she ate a grilled loin sandwich in a bar and she had the same symptoms in a few minutes (she asked the waiter at the bar and the chef had cooked her sandwich in the same pan where he had cooked green pepper just before). After that, she suffered from abdominal pain, nausea, abdominal distension without diarrhea two hours after she ate an omelet sandwich with certain flavor of green pepper. At present even the casual smell of pepper causes her nausea. The woman eats everything including spices and just avoids pepper. Methods: Skin prick tests were performed using extracts from food (nuts, fish, mollusk, fruits, vegetables, legumes), aeroallergens (mites, pollens and epithelia) and purified proteins (Pru p 3, profilin, polcalcin, alfalactoalbumin, betalactoglobuline, casein). We also performed prick by prick to raw and cooked green pepper. SDS-PAGE immunoblotting according to Laemli under reducing conditions (with 2-mercaptoethanol) was performed to study the molecular mass of the IgE- reactive proteins. Extracts from green pepper and green pepper seed were used. Results: The prick tests were all negative and the prick by prick test to raw and cooked green pepper was positive in both cases. The immunoblotting showed IgE binding bands of 80 kDa, 67 KDa and 55 kDa with the green pepper extract, and 68 kDa and 29 kDa bands with the green pepper seed extract. Conclusions: We present a case of anaphylaxis by green pepper ingestion. IgE-reactive proteins from green pepper and green pepper seed were detected. The patient signed a written informed consent for presentation and publication of the case report.