What is pancake syndrome (oral mite anaphylaxis)?

Up to 40% of the world's population has been diagnosed with an allergic disease. The most prevalent allergy is to house dust mites (http://buff.ly/1jSF5Y6). The pancake syndrome is anaphylaxis caused by ingestion of mite-contaminated food, for example, flour.

A 2005 case report described an 8-year-old boy who developed systemic anaphylaxis shortly after the ingestion of pancakes prepared with commercial pancake flour.

The patient had positive skin prick test to contaminated pancake flour extract and dust mite, but a negative skin test to uncontaminated pancake flour. There was no response to the main ingredients of the pancake mix. Microscopic examination of the contaminated pancake flour revealed the storage mite Blomia freemani.

The scientific name for "pancake syndrome" is oral mite anaphylaxis.

Mind map: Indoor allergens

See more Allergy and Immunology mind maps at AllergyCases.org.

This post was featured in Grand Rounds, the weekly summary of the best posts in the medical blogosphere:

"Watch what you eat. For instance, don’t eat pancakes with mites in them - you could have a bad allergic reaction. When you go to IHOP make sure you ask them to “hold the mites.”

Dust mite allergen avoidance. The main allergen is in the dust mite feces. Use 3 control measures for 3-6 months to see an effect on the allergy symptoms (click to enlarge the image).


Systemic anaphylaxis after the ingestion of pancake contaminated with the storage mite Blomia freemani. Wen DC, Shyur SD, Ho CM, Chiang YC, Huang LH, Lin MT, Yang HC, Liang PH.Ann Allergy Asthma Immunol 2005 Dec;95(6):612-614.
Oral mite anaphylaxis (pancake syndrome) also observed in children. Sánchez-Borges M, Capriles-Hulett A, Caballero-Fonesca F. Ann Allergy Asthma Immunol. 2006 May;96(5):755-6.
Anaphylaxis from ingestion of mites: Pancake anaphylaxis [J Allergy Clin Immunol. 2012] http://buff.ly/VcEthS
Image sources: Heap of pancakes in Sweden; Yellow mite, Wikipedia, public domain.


  1. I have just determined that I will never eat pancakes again.

    My waistline and hips thank you. : )

    (Seriously - blech! How does one know if one's pancake batter is contaminated or not?)

  2. Anonymous11/15/2008

    Thanks a lot for the visuals, I'll never be able to look a pancake in the eye again.

  3. Anonymous11/30/2008

    I'm happy my pancakes don't look like that