First reported case in Canada of anaphylaxis to lupine in a child with peanut allergy
Bibliographic record
Abstract
BACKGROUND: Lupine is a member of the legume family and is often used in many food products in Europe (e.g. pasta, pizza, sauces, etc.) as a wheat or soy substitute. Lupine cross-reacts with peanut, and cases of allergic reactions to lupine in peanut-allergic patients have been reported in Europe mainly. In contrast, lupine as an ingredient in food products is relatively new to the Canadian market. CASE PRESENTATION: We describe a 10-year old boy with diagnosed peanut and tree-nut allergy, who developed anaphylaxis to lupine flour in May 2017. A few minutes after eating a pre-made pancake mix that didn't contain any of his known allergens (peanuts, tree nuts), he developed oral pruritis followed by throat tightness, severe stomach ache, lightheadedness, cough, hoarse throat, nasal congestion, sneezing, and fatigue. He refused epinephrine, but was given cetirizine. The symptoms resolved after 3 h, but he was still unwell the following day. In a conversation between the mother and the allergist, it was determined that lupine was likely the cause of the reaction. To confirm, he was brought into clinic for skin testing to lupine. Results were consistent with lupine allergy (pancake mix: 10 × 7 mm, lupine bean: 12 × 6 mm). The family has since reported this to the Canadian Food Inspection Agency, resulting in a product recall and a consumer advisory bulletin published by Health Canada. CONCLUSIONS: This is the first reported case of allergic reaction to lupine in Canada, and highlights the need for education of Canadian families with peanut allergy as well as allergists, regarding the possibility of cross-reactivity between peanut and lupine and its new presence in the Canadian food supply. In addition, a precautionary label for those with peanut allergy who purchase products containing lupine should be considered. This case illustrates also the need for a clear mechanism for consumers and allergists to report emerging food allergens to regulatory bodies such as Health Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".