Sesame Food Allergy: Questions and Answers

How prevalent is sesame allergy?

Sesame allergy may affect 0.1% to 0.4% of the general population, higher in food allergic patients. Sesame seeds can be made into a paste called tahini (used in hummus) and a Middle Eastern confection called halvah.

What is the prevalence of sesame allergy in food allergic patients?

2.1% in children, 5.8% in adults.

Food allergy may be a matter of geography after all -- sesame is second only to cow's milk as a cause of anaphylaxis in Israel. The most common food allergens in Israel are egg, cow's milk, and sesame.

The mean age of first allergic reaction to sesame is around 12 months and the main symptom is urticaria/angioedema (60% of cases).

What is the prognosis of sesame food allergy (SFA)?

Tolerance develops in only 20% of the patients (similar to peanut allergy).

Sesame food allergy appears early in life, but unlike cow's milk and egg allergy, persists in 80% of cases (similar to peanut allergy).

How do you diagnose sesame food allergy (SFA)?

Typical reactions combined with positive sesame (skin prick test (SPT) are reliable for diagnosis. A research letter published in 2011 JACI suggested that diagnosing sesame allergy is possible by an immediate-reading “contact test” with sesame oil.

Skin test with “Tahini” sauce can be used to evaluate food allergy to sesame, especially if the skin test with sesame extract and sIgE are negative (http://buff.ly/ZJf17J).

In conclusion, sesame may share the same 'notoriety and fate' as peanut - a major cause of severe food allergic reactions with a low chance of resolution (20%) in later life.

References:

Diagnosing sesame allergy by an immediate-reading “contact test” with sesame oil. JACI, 2011.
Sesame Food Allergy may affect 0.1–0.2 % of the population, only one fatality has been reported  http://goo.gl/oh1Y1

Food allergy is a matter of geography after all: sesame as a major cause of severe IgE-mediated food allergic reactions among infants and young children in Israel. Dalal I, Binson I, Reifen R, Amitai Z, Shohat T, Rahmani S, Levine A, Ballin A, Somekh E. Allergy. 2002 Apr;57(4):362-5.
The pattern of sesame sensitivity among infants and children. Dalal I, Binson I, Levine A, Somekh E, Ballin A, Reifen R. Pediatr Allergy Immunol. 2003 Aug;14(4):312-6.
Sesame food allergy and sensitization in children: the natural history and long-term follow-up. Cohen A, Goldberg M, Levy B, Leshno M, Katz Y. Pediatr Allergy Immunol. 2007 May;18(3):217-23. Epub 2007 Mar 7.
Allergy to sesame, coconut. AAAAI Ask the Expert, 2007.
Sesame, from Wikipedia, the free encyclopedia.
Sesame Allergies on the Rise in U.S. WebMD, 03/2009.

Food Allergy in Lebanon: Is Sesame Seed the “Middle Eastern” Peanut. World Allergy Organization Journal http://goo.gl/Ux1im
Image sources: Wikipedia, public domain.