Soy allergy: Using components to get the full picture
John, a 15 year old with known peanut and birch allergy, visits his healthcare provider after experiencing itching in the mouth and nasal congestion after eating Asian food that contains soy products.
John's healthcare provider conducts a full clinical history and physical examination and decides to test using soy components.
A boy with a peanut and birch allergy visits his healthcare provider after experiencing symptoms when eating food that contains soy products.
Patient History
Family History
- Atopic father—rhino-conjuctivitis and asthma.
John's Personal History
- Known peanut allergy.
- Known birch allergy.
- No known issues with soy in the past.
John’s ImmunoCAP™ Test Results
These results together with this patient's case history and symptoms, help confirm the diagnosis.
| Allergen | Type |
John's Results |
Soy |
Whole Allergen |
1.5 |
Gly m 4 |
Allergen Component |
1.9 |
Gly m 5 |
Allergen Component |
1.4 |
Gly m 6 |
Allergen Component |
2.2 |
Peanut |
Whole Allergen |
72.1 |
Ara h 1 |
Allergen Component |
22.4 |
Ara h 2 |
Allergen Component |
23.1 |
Ara h 3 |
Allergen Component |
13.4 |
Ara h 8 |
Allergen Component |
3.7 |
Ara h 9 |
Allergen Component |
<0.1 |
Differential Diagnosis
The results for Gly m 5 and Gly m 6 indicate that John has an increased risk of severe reaction if soy is ingested, even in small amounts. The results for Ara h 1, Ara h 2, Ara h 3 also indicate that John has an increased risk for severe reaction to peanut. The test results also indicate a clinically relevant cross-reactions between birch pollen and Gly m 4.1
REFINED DIAGNOSIS
- Soy allergy, peanut allergy, and test results indicate a clinically relevant cross-reactions between birch pollen and Gly m 4.
HEALTHCARE PROVIDER MANAGEMENT PLAN
John's healthcare provider:
- Refers him to a dietitian for help in adjusting his diet.
- Advises him to strictly avoid soy and nuts and always carry his emergency adrenaline autoinjector.
- Arranges follow-up education and training on autoinjector use for John and his family.
FOLLOW UP
- John with his father are seen by his healthcare provider one year later. John has had no further episodes, and is doing well. John's healthcare provider checks his autoinjector technique and is satisfied.
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- Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, et al. EAACI Molecular Allergology User's Guide. Pediatr Allergy Immunol. 2016;27 Suppl 23:1-250.
