Source: International Congress 2014 – Clinical allergy
Disease area: Airway diseases

Abstract

Cannabis (C) is a popular smoked drug deriving from Cannabis sativa (CS). We report 6 clinical cases of immediate hypersensitivity related to CS.Subjects were young adults (27-41 years; 2M/4F) current or former C smokers. Symptoms were:plant food allergies due to cross-reactive lipid transfer proteins (LTP) (n= 5) (Metz-Favre C et al. Eur Ann Allergy Clin Immunol. 2011 Dec;43(6):193-5), rhinitis/asthma (n= 3), contact urticaria/eczema (n=3) and effort anaphylaxis (n=1). All had positive CS sIgE (median 8.05 (4.35-21.9) kU/L) (Ebo D et al. Int Arch Allergy Immunol. 2013;161:220-8). In 1 case, SPT with crude CS was made and strongly positive. All subjects were atopic.Up to now, C consumption has been associated with respiratory side effects such pneumomediastin, pneumoconiosis and chronic bronchitis. The lung cancer risk is probable but not yet demonstrated and cases of IgE mediated hypersensitivity have increased. Interestingly, CS has been shown to have bronchodilator effects. Different route of exposure are possible: the skin and the respiratory tract during CS preparation and consumption but also through exposure to CS pollen that is anemophilous and transportable over long distances. To date, several causal allergens associated with CS allergy has been proposed: an oxygen-evolving enhancer protein, a ribulose-bisphosphate carboxylase and a LTP. Our cases were all sensitized to LTP but other CS potential allergens has not been tested.CS smoking is able to induce different kinds of IgE mediated hypersensitivity: conjunctivitis, rhinitis, asthma, contact urticaria and anaphylaxis. Questioning about smoking habits should be part of every allergologic clinical history taking into account the high frequency of C smokers and its sensitizing potential.

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Citations should be made in the following way:
V. Doyen, F. Debaugnies, C. Ledent, F. Corazza, O. Michel, M. Mairesse (Brussels, Belgium). Emerging allergies to cannabis. Eur Respir J 2014; 44: Suppl. 58, 4027

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