Anaphylaxis to rice by inhalation

To the Editor: The ingestion of rice can trigger eczema, bronchial asthma, rhinitis, or gastrointestinal symptoms, but anaphylaxis from the inhalation of rice has not hitherto been described.1 The case we present is unusual in that an 8-year-old child was unconscious with cardiopulmonary collapse and generalized urticaria, the proximate cause of which was the inhalation of steam while rice was being cooked in his presence. To the best of our knowledge, anaphylaxis to rice in children has been described only in the context of exercise-induced reactions.6 Respiratory reactions to cereals are well known from bakers' asthma, in which the airborne transport and the major allergenicity of the 16-kD α-amylase/trypsin inhibitors have been documented.7 Thus it could be that this child, already sensitized by a rice allergen in the range of mo-lecular weights compatible with this family of enzymes, developed a reaction triggered by these allergens.