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Case Report

Legumes in bread baking: A hidden risk for an IgE-mediated inhalant allergy

Sabine Kespohl, Christian Eisenhawer, Silke Maryska, Ingrid Sander, Irene Mittermann, Martina Aumayr, and Monika Raulf

Volume 9 (2025) p. 58 - 65

Abstract

Allergologie select, Vol. 9/2025 (58-65)

Legumes in bread baking: A hidden risk for an IgE-mediated inhalant allergy

Sabine Kespohl¹, Christian Eisenhawer¹, Silke Maryska¹, Ingrid Sander¹, Irene Mittermann², Martina Aumayr², and Monika Raulf¹

¹Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany, and ²MacroAssay Diagnostics, Vienna, Austria
New protein-rich flour blends from legumes are increasingly being processed for gluten-free bakery products, which may increase the risk of IgE-mediated sensitization through inhalation exposure. In the described case of a 29-year-old baker, work incapacity occurred due to respiratory complaints following exposure to various gluten-free baking ingredients. Occupationrelated sensitization to “chestnut pea flour” (flour from lightly roasted and ground yellow peas) was identified, while the patient showed no IgE sensitization to five other ingredients. Significant allergic respiratory reactions occurred during bronchial challenge test with “chestnut pea” extract. Based on the test results and typical workplace-related symptoms, recognition of occupational disease was recommended. Further identification of potential causal allergens using IgE blot and allergen component-resolved diagnostics revealed IgE bindings to typical storage proteins, 2S albumin and vicilin, as well as to Bet v 1 homologous of “chestnut pea” and non-specific lipid transfer proteins. This case illustrates that the processing of protein-rich legume flours can pose new sensitization risks for workers, which should be considered in the future.Correspondence to:
Dr. Sabine Kespohl, Department Competence Centre for Allergology/Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
Email: [email protected]

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