Tongue swelling and Quinckes edema from rocket (eruca sativa)

Case history: A patient required emergency treatment because of tongue swelling, tightness in the throat, and Quinckes edema of the lips after eating a mixed salad three times over a period of three months. He had a diagnosed sensitization with tree and grass pollen exhibited clinical pollinosis symptoms. Diagnosis: Scratch tests with several kinds of salad as well as other ingredients were negative. The rocket scratch test was positive with a diameter equivalent to histamine control. The specific IgE was slightly positive (0.40 IU/ml, RAST Grade 1). Because the symptoms clearly proved the clinical relevance of the sensitization, a provocation test was not performed. Conclusion: Sensitizations to rocket seem to be rare; there are only a few reports published in the german-speaking countries. As the use of rocket is increasing in central Europe more allergic reactions are to be expected and this allergen should optionally be included in the diagnostic testing.