Lupin Allergy

Lupin is a legume and belongs to the same plant family as peanuts. In some countries, it is widely grown as a flowering plant for animal feed. In other countries, lupin beans, which are actually the seeds of lupin, are used in the human diet. Lupin beans are high in antioxidants, dietary fiber, and protein and low in starch. Lupin beans can be processed into flour or bran and is used to add fiber, texture, and protein in food manufacturing. The beans may be eaten whole, boiled, or dry and are a common snack in Europe and Asia. Lupin is a particularly common food in the Mediterranean region and in Asian countries. In this global world, lupin is now becoming more common in North America, although most Americans have not heard of lupin.

Lupin is used as an ingredient in a variety of products. These products are very diverse and may include baked goods (e.g., bread, biscuits, rolls, cakes, cookies), pasta, sauces, salads, lupin hummus spreads, chocolate spreads, stews, and ice creams. Some fish and meat dishes (e.g., sausage, hamburger) may also contain lupin. Drinks may also contain lupin as a milk or soy substitute. Lupin is gluten-free and may be found in gluten-free products as a substitute for wheat, rye, or barley. Lupin-derived ingredients are good alternatives for gluten-containing flours and are regularly being used in gluten-free products. It should be noted that there are various other names for lupin some of which may include lupin seed, lupine, lupini, lupinus, altramuz, hasenklee, tarwi, termes, termos, and turmus.

Lupin allergy is much more common in individuals with a history of a peanut allergy, though it can occur in individuals who can tolerate peanut products. Cross-reactivity between peanut and lupin, as investigated by rates of skin prick testing, has been reported to be as high as 44%. Still, for most individuals, lupin beans and lupin flour is safe to eat, although there is an increasing number of case reports of allergic reactions after exposure to lupin-containing products. The severity of allergic reactions to lupin vary from very mild localized reactions in the mouth to severe life-threatening anaphylaxis.

Symptoms:

The symptoms of an allergic reaction to lupin is similar to that of other food allergies. They can manifest as itchy mouth, itchy tongue, itchy throat, itchy eyes, watery eyes, sneezing, nausea, vomiting, diarrhea, abdominal pain, itchy skin, hives and/or other rashes. More severe life-threatening anaphylactic reactions are less common but may present as wheezing, coughing, chest tightness, shortness of breath, dizziness, drop in blood pressure, increased heart rate, and/or loss of consciousness. Uncontrolled asthma is a risk factor for a more severe reaction. Skin exposure to lupin flowers may also cause a contact dermatitis reaction in some sensitized individuals.

Diagnosis:

When the history is suggestive of lupin ingestion and the onset of symptoms occur after exposure to lupin-containing products, the diagnosis can be confirmed by skin allergy prick tests, either to a commercially available testing reagent or with the suspect food itself. Specific antibodies to lupin can also be detected in some laboratory tests. In some cases, an oral food challenge, which is a supervised feeding of gradually increasing amounts of a lupin-containing food, may be conducted in the allergist’s office to determine whether a patient is able to eat and tolerate lupin.

Treatment:

As is the case with other food allergies, avoiding exposure to lupin is the only known way to prevent adverse reactions. It is important to carefully read the labels of packaged foods and also to be aware of possible symptoms of allergic reactions. As of 2006, the European Commission has required that food labels indicate the presence of lupin in food. It should be noted however that in many countries (e.g., U.S., Canada, Australia) emphasis for allergen labeling for lupin is not mandatory as it is for some of the more common food allergens (e.g., peanuts, tree nuts, soy, milk, eggs). It is also important to emphasize that individuals with a history of a severe systemic reaction to lupin should carry a self-injectable epinephrine device (e.g., EpiPen, Auvi-Q, Adrenaclick) and should receive training in its proper usage. If the self-injectable epinephrine device is used, the individual should go immediately to the closest emergency room.

If you think that you may have lupin or any other food allergy, the board certified allergists at Black & Kletz Allergy would be happy to help you.  We have 3 convenient offices in the DC metro area with office locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All of our offices offer on-site parking.  Our Washington, DC and McLean, VA locations are Metro accessible. There is also a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  Please call us for an appointment. Alternatively, you can click Request an Appointment and we will respond to your request within 24 hours by the next business day.  The allergists at Black & Kletz Allergy have been treating both adults and children in the Washington, DC metropolitan area for allergies, asthma, sinus disease, and immunologic disorders for more than half a decade.  We strive to provide top-of-the-line allergy relief in a compassionate and professional environment.