# Fenugreek: New Therapeutic Resource or Emerging Allergen?
## Appendix A
### Case 4  
A 36-year-old female visited our outpatient clinic complaining of episodes of lingual oedema, velvety, and urticarial rash after the ingestion of peach, melon, watermelon, and cherry juice. Subsequently, she eliminated these foods from her diet. Further episodes ofvelvety oral cavity and pharynx appeared after the ingestion of peanuts, walnuts, and fennel. She reported ingesting peas, beans, chickpeas, and lentils without any adverse reaction. SPT for inhalants was positive for pellitory, grass, mugwort, olea, cat fur, and house dust mites. SPT for foods was positive for peanuts and strawberries. The SPTs for fresh foods were positive for pistachio, fenugreek, mango, pomegranate, fennel, celery, and yellow melon. Case 5  
A 22-year-old male underwent an allergy visit at our outpatient clinic to investigate several food allergy episodes: vomiting and diarrhea after peanuts; erythema on the face and trunk after pistachio and beer; gut discomfort after lentil and strawberry; oral itching and throat constriction after peach and nuts; and rhinitis and erythema on the face and trunk after tomato. We performed SPT for food allergens and found positive results for tomato, lentil, peach, walnut, hazelnut, almond, and strawberry. Fresh foods tested were positive for pistachio, fenugreek, mango, pomegranate, and fennel. The patient also reported rhinitis symptoms, and the SPT for aeroallergen was positive for pellitory, grass, and mugwort. Case 6  
A 38-year-old woman came to our observation following several episodes of food allergy: lip angioedema after peach; sore mouth and oral itching after a meal of hazelnut cream, zucchini, garlic, corn, and dragon fruit; throat constriction after lemon and red berries; and episodes of oral itching after a meal based on lettuce, arugula, radicchio, plum, pumpkin, eggplant, parsley, mushrooms, and potato. The patient also reported previous sensitization to soy. SPT for allergens in foods was positive for mustard, soy, corn, rice, lentil, peach, hazelnut, peanut, and strawberry. Fresh foods tested were positive for pistachio, fenugreek, pomegranate, fennel, and celery. Case 7  
A 29-year-old female visited the outpatient clinic with suspected food allergy. She reported an appearance of tightness in the throat, dyspnea, swelling of the tongue after peach, pistachio, and walnut ingestion, and an appearance of nonitchy rash, diarrhea, and abdominal cramps after ingestion of spiced potatoes. She also complained of rhinitis symptoms. The SPT for inhalants was positive for pellitory, grass, mugwort, and olea, and the SPTs for foods were positive for peach and hazelnut. We also tested fresh foods with positive results for pistachio, fenugreek (Figures 2 and 3), cashew, mango, and pomegranate. Case 8  
A 31-year-old male reported nausea and vomiting after ingesting apple, constriction in the throat after ingesting banana, and a second episode after aperitif with alcohol, nuts, and pizza with pistachio. He also reported rhinitis symptoms with positive SPTs for cypress. SPTs for foods were positive for mustard, lentil, and apple. SPTs for fresh foods were positive for pistachio, fenugreek, mango, pomegranate, grapes, fennel, lupine, anise, banana, zucchini, and eggplant. Case 9  
A 36-year-old male from Bangladesh reported several episodes of food allergy: angioedema and vomiting after corn ingestion; itching of the oral cavity after eggplant and green peas; urticaria, angioedema and vomiting after eating zucchini, tuna, and mozzzella; and urticaria after ingesting rice, mutton, fish, and a spice mix including turmeric, coriander, ginger, chili pepper, and maybe other unidentified spices. We performed SPT for foods with positive results for mustard, oat, rice, lentil, peach, and peanut. In consideration of the fact that due to eating habits, the patient consumed a lot of spices and that an episode occurred after a meal seasoned with various spices, we decided to test other spices not available as commercial extracts, with positive results for fenugreek, cumin, turmeric, and coriander.