Patients allergic to garlic often present dermatitis, rhinitis, asthma, and urticaria after ingestion of garlic, contact with garlic, or exposure to garlic dust. Garlic-related anaphylaxis is rare, and the impact of heating on garlic allergens is not very clear. We report a case of anaphylaxis induced by ingestion of raw rather than cooked garlic with manifestations different from previous reports, and we hypothesized that heating could reduce the allergenicity of garlic. Serum total immunoglobulin E (IgE) and specific IgE were tested using the Phadia CAP System FEIA (Phadia, Uppsala, Sweden). Protein extracts from raw and cooked garlic were analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. Serum-specific IgE for garlic was 8.16 kUA/L. IgE banding proteins could only be detected in raw garlic extract, because allergens in garlic were mostly degraded into small fragments after heating, as shown in SDS-PAGE profile. In conclusion, raw garlic could induce life-threatening anaphylaxis. However, most of its allergens are heat labile, and patients allergic to garlic might tolerate the cooked one well.
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