Study · Journal of investigational allergology & clinical immunology · 2025

Sunflower seed allergy reactions vary and epinephrine often underused

What it found

In 47 people with sunflower seed allergy, reactions ranged from mild to severe, and symptoms could change on repeated exposures.

Only 4 of 18 emergency cases received epinephrine.

What they found

Studies in people

Severe reactions common

23 out of 47 patients (49%) had severe or life-threatening reactions, including bronchospasm, laryngeal edema, gastrointestinal symptoms, collapse or hypotension.

Epinephrine underused

Emergency medical services were requested for 18 patients (38%), but only 4 patients (8%) received epinephrine.

Variability on repeat exposure

Among 16 patients with more than one reaction, 10 (62%) reported different clinical profiles on each exposure.

Other allergies precede

Most patients had a history of other food allergies before sunflower seed allergy, most often to peach (34%), peanut (30%), and nuts (walnut 25%, hazelnut 19%, almond 17%, pistachio 11%).

IgE and lipid transfer proteins

Levels of sunflower seed IgE were strongly correlated with levels of IgE to nonspecific lipid transfer proteins, but reaction severity did not differ significantly by sensitization to these proteins.

What the authors conclude

“Our findings reveal a variability of clinical presentations of sunflower seed allergy on repeated exposures and an underuse of epinephrine in anaphylaxis.”
Galleani C, Diéguez MC, Cabanillas B, Martín-Arriscado Arroba C, Enríquez-Matas A, Crespo JF, 2025

Also in their conclusions

  • They highlight the importance of strict avoidance of sunflower seed and accurate prescription and administration of epinephrine in allergic patients.
  • They state that sunflower seed allergy should be considered as a potential cause of life-threatening reactions.
  • They call for further research to investigate the allergenic content of sunflower seed, determine clinical cross-reactivity among different seeds and other foods, and develop component-resolved diagnostics.

How it was done

Sunflower seed is a common edible seed and its consumption is growing, but there were few data on the prevalence and clinical manifestations of sunflower seed allergy.

They evaluated 47 patients diagnosed with sunflower seed allergy at a hospital allergy department in Madrid over 5 years. They collected clinical history, skin prick tests, and specific IgE measurements.

What it can’t tell you

  • This was a retrospective study of patients at one hospital, so it cannot show how common sunflower seed allergy is in the general population.
  • It cannot prove that any particular protein or sensitization pattern causes severe reactions.

The paper

Title
Sunflower (Helianthus annuus) Seed Allergy
Type
Study
Evidence
Studies in people
Summarised from
Full text
Cite
Galleani C, Diéguez MC, Cabanillas B, Martín-Arriscado Arroba C, Enríquez-Matas A, Crespo JF (2025). Sunflower (Helianthus annuus) Seed Allergy. Journal of investigational allergology & clinical immunology. doi:10.18176/jiaci.0965Free full textPubMed 38085525DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error