Sniffing Out Allergies

Figuring out the precise cause of a patient’s allergic reaction—which can be as common as pet dander or as unusual as ginger—can be a long and cryptic process for allergy doctors, often involving extensive detective work. Imagine finding yourself—in Seattle!—allergic to water (rare but real) or, as recent research has uncovered, allergic to certain foods because of water. We asked a few local allergy specialists about their own allergies and their most interesting cases.

Ann Marie Wanner, M.D., The Everett Clinic

Allergic to: Shellfish (distinct from mollusks).

Patient puzzle: An 8-year-old boy who had hives only at grandma’s house—it turned out that he was allergic to the ginger in his grandma’s gingersnaps. He has been Wanner’s only such patient in 20 years of practice.

Arthur B. Vegh, M.D., Puget Sound Allergy, Asthma & Immunology

Allergic to: His own dog. He takes allergy shots to cope.

Patient puzzle: A woman who interpreted some symptoms she was experiencing as tongue swelling, which landed her repeatedly in the ER. “She was so fixated on her throat sensation that she was able to subconsciously make her tongue appear swollen.” Vegh tried treating her for asthma, based on some clues in her chart—and voila, the feeling went away.

Michael E. Weiss, M.D., Northwest Asthma and Allergy Center

Allergic to: No significant allergies, but his wife’s severe allergies—and time she spent in the ICU for a reaction to walnuts—was a reason he became an allergist.

Patient puzzle: A woman with a difficult pregnancy who required
30 blood transfusions over the course of two days; she developed
a temporary “allergy” to nuts as a result of the transfusions.

David M. Robinson, M.D., Virginia Mason Medical Center

Allergic to: Had allergies to grass and cats, which now have been cured with allergy shots.

Patient puzzle: “I continue to be fascinated by a group of conditions know as exercise syndromes (exercise-induced anaphylaxis, etc.) where a person has to be exposed to a particular priming factor (specific foods, NSAID, alcohol, others) and then exercise within a four-hour window
to provoke an allergic reaction.”

Alan Krouse, M.D., Group Health Bellevue Medical Center

Allergic to: Has seasonal nasal allergies.

Patient puzzle: “I continue to be fascinated by a group of conditions know as exercise syndromes (exercise-induced anaphylaxis, etc.) where a person has to be exposed to a particular priming factor (specific foods, NSAID, alcohol, others) and then exercise within a four-hour window
to provoke an allergic reaction.”

Arvin Mokha, M.D., The Polyclinic

Allergic to: Ragweed

Patient puzzle: In light of recent legal changes, Dr. Mokha muses about the changing logistics of testing patients for marijuana allergies. How and where can the clinic obtain a reliable sample for a skin test? Should the patients bring their own samples?