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Bacolod City, Philippines Monday, April 27, 2015
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Medicine 101
with Radela Yvonne R. Cortes

Of Pancakes & Allergies…

A few days ago, I had a patient who was admitted for anaphylaxis ( a severe form of allergy) after eating pancakes prepared from an expired pancake mix. Prompt appropriate medical treatment saved his life. And I guess he will never touch pancake , whether expired or not, for the rest of his “second “ life.

Pancakes are a little bit notorious when it comes to adverse food reactions. Last 2009 , a new syndrome called “Oral Mite Anaphylaxis” was reported in the World Allergy Organization Journal. This is a severe allergic reaction seen after eating foods made from wheat flour that are contaminated with mites. Most common implicated foods are pancake, pizza, pasta, bread and sponge cake. In this study by Dr Mario Sanchez-Borges, 53.3 percent of the patients ate pancake made from mite-contaminated wheat flour, thus, another term for this is the “Pancake Syndrome”. Interestingly, this syndrome is more frequent in tropical and subtropical countries probably because the temperature and humidity is ideal for mite reproduction. Persons who have hypersensitivity reactions to non-steroidal anti-inflammatory drugs ( NSAIDs)), as well as those who have history of allergic diseases, are predisposed to develop the “Pancake Syndrome” more than the general population.

In 2001, The American Journal Of Forensic Medicine & Pathology reported the death of a 19-year-old white male after eating pancake from an expired pancake mix. Investigation revealed that the expired mix had a very high mold content. The patient was also reported to be highly allergic to molds and penicillin. This time, the anaphylaxis was caused by the molds, and not by the mites.

Does the expiry date really matter?

Merriam-Webster defines expiry date as: “the date after which a product (a food or medicine) should not be sold because of an expected decline in quality or effectiveness”. I am pretty sure majority of us have eaten expired food products and have taken expired medicines, and yet lived to tell the tale. The expiry date warns that the “freshness” or “effectiveness” may not be 100 percent anymore. This means that it may or may not be safe to consume. In fact, the US Federal law requires expiration dates only on infant formula and some baby products. The other products are labeled voluntarily by the manufacturers.

In the above-mentioned case, the cause of death was anaphylaxis secondary to molds ,to which he was allergic to. However, there are expired pancakes which may not contain molds as well. Some researchers have pointed out, that whether the pancake was expired or not, if it contains molds, and the person who ate it has allergy to molds, then an allergic reaction is bound to occur.

As a reminder to all pancake-lovers, store the flour in sealed containers and put them in refrigerators since low temperatures inhibit the reproduction of mites. Mites can get inside an open packaged mixture and even in a closed packaged mixture during the processing itself. Know where you are allergic to. If you have mold allergies, don't try premixed pancake. Lastly, look at the expiration dates. Items on sale are usually those that are near-expiry. If you have expired items in your house, throw it away. Remember, a few pesos worth of savings is not enough to risk your life.*

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