Rare presentation of anaphylaxis: Pancake syndrome

Katsunori Masaki, Koichi Fukunaga, Yuji Kawakami, Rubaiyat Haque

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


A 43-year-old woman presented with oral discomfort, sneezing, urticaria, eyelid angioedema, abdominal pain, diarrhoea, dyspnoea and wheeze soon after eating a Japanese flour pancake (okonomiyaki, containing wheat, egg, yam, pork, prawn and squid). Subsequent analysis of the flour used in the pancake revealed the presence of Dermatophagoides farinae (4500 mites/g). The patient tested positive for specific IgE to D. farinae (15.2 kU/L) and D. pteronyssinus (14.0 kU/L) with negative responses to other ingredients in the pancake. Oral ingestion of dust mite in poorly stored foods can cause anaphylactic reactions in patients with allergy.

Original languageEnglish
Article numbere228854
JournalBMJ case reports
Issue number3
Publication statusPublished - 2019 Mar 1


  • allergy, asthma
  • dermatology
  • emergency medicine
  • occupational and environmental medicine
  • primary care

ASJC Scopus subject areas

  • Medicine(all)


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