Clinical Experience
IgE-mediated reactions
Coriander may occasionally induce symptoms of food or skin allergy in sensitised individuals (4, 8-12).
According to the CICBAA data bank in France, in skin-specific IgE tests for spice carried out in 589 patients with food allergy and suspected food allergy to spices, frequent sensitisation to Apiaceae were observed: Coriander, Caraway, Fennel and Celery.
Nevertheless, food allergy to spices was infrequent: 2% of all food allergies (13). Serum-specific IgE to Coriander and/or Curry, Mace, Celery, and White Pepper was measured in 150 sera from patients with suspected food allergies (8).
As Coriander is frequently a component of spice blends, it may be that allergic reactions occur to Coriander but are not attributed to this spice. In reporting on a study documenting the experience of urticaria, angioedema or anaphylaxis occurring after meals in Chinese or Indonesian restaurants, the authors maintain that these symptoms are more often due to IgE-mediated Type I food allergy, caused by consumption of Shrimp, Peanut or spices, in particular those of the Parsley family (e.g., Coriander), than to MSG (11).
Unexpected Coriander culpability is supported by other reports: a 42-year-old woman developed anaphylaxis after a meal. Skin-specific IgE tests were positive for Coriander and Curry. Serum-specific IgE was positive for a number of spices including Coriander. The allergen responsible did not appear to be a 2S albumin, an allergen common in seeds (2). Similarly, a 14-year-old girl developed anaphylactic symptoms on 2 occasions following a meal made with teriyaki sauce. She experienced difficulty breathing and a sensation of throat swelling and generalised urticaria. Wheezing was documented. Skin-specific IgE tests were positive to teriyaki sauce, and to the ingredient Coriander. Oral challenge with Coriander was positive, resulting in additional symptoms of rhinorrhoea and itching of the neck (14).
Coriander, like other spices, results in allergic skin manifestations, including contact urticaria, more commonly than other allergic reactions (15). Allergic contact dermatitis, in particular of the hands, has been reported (16). Skin-specific IgE tests with common spices performed in 1,120 atopic and 380 non-atopic patients showed that skin-specific IgE was almost exclusively found in atopic patients. Curry and Paprika produced reactions most frequently. When the components of curry were tested separately, Coriander, Caraway, Cayenne and Mustard were responsible for the vast majority of the positive reactions (1).
A study reported that skin-specific IgE tests with commercial powdered spices are commonly positive in patients with allergy to Birch or Mugwort pollen. An evaluation of skin-specific IgE tests with Coriander, Caraway, Paprika, cayenne, Mustard, and White Pepper, done twice at 2-month to 2.9-year intervals in 49 patients, demonstrated that all the spice extracts, except for White Pepper, elicited positive reactions in half those with positive reactions to native spices. Three-fourths of the patients with positive skin tests to native spices were positive to Birch pollen, and half to a vegetable. Mild clinical symptoms from spices were reported by a third. Fourteen out of 21 patients with positive reactions to Coriander were also positive to Cayenne (15).
Similarly, in a study with skin-specific IgE tests for powdered commercial spices performed on 70 patients with positive skin-specific IgE tests to Birch and/or Mugwort pollen and Celery, positive results were demonstrated in more than 24 patients to Aniseed, Fennel, Coriander and Cumin - all members of the same botanical family as Celery, Apiaceae (17).
Although the studies have concentrated on immediate-type reactions, delayed-type hypersensitivity mechanisms may occur, as shown by patch tests (10).
Occupational allergy to Coriander may occur in individuals working in the food industry, and in liqueur and spirit manufacturers. After 3 years of occupational exposure to powdered Coriander in a factory, packing spice, a woman developed symptoms of immediate hypersensitivity with respiratory symptoms to Coriander. She complained of rhinitis and irritation of the throat. Skin- and serum-specific IgE tests and nasal and bronchial challenge tests were positive (8).
Occupational asthma was described in a 27-year-old who developed rhinitis and asthma symptoms 1 year after starting to prepare a particular kind of sausage. Positive skin-specific IgE for Paprika, Coriander, and Mace were demonstrated, but absent for other common sausage ingredients: mites, pollens, and molds. Serum-specific IgE antibodies to Paprika, Coriander, and Mace were demonstrated. Immunoblot analysis showed the presence of 50 and 56 kDa allergenic proteins from the Coriander extract. Specific bronchial inhalation challenges showed an immediate asthmatic reaction to extracts from Paprika, Coriander, and Mace. The authors point out that in this patient, occupational asthma was due to spices from botanically unrelated species (3).
Occupational protein contact dermatitis to Coriander, Carrot and Potato was reported in a 22-year-old chef, who had developed pruritic hand dermatitis from handling raw Potatoes, Tomatoes, Carrots, and Curry. Dermatitis developed on his face if juice of these vegetables splashed on it (18).
Occupational asthma and rhinitis to licorice (dust), Mace, Aniseed, Coriander and iris root in was reported in an Anise liqueur factory worker (19).
Occupational asthma to dust from spices was described in a 26-year-old man working with spices in the food industry. Skin-specific IgE tests with Curry, Coriander, and Mace were strongly positive. Serum-specific IgE antibodies against Coriander, Curry, Mace, Ginger, and Paprika powder could be demonstrated. No cross-reactivity between Coriander and Ginger or Paprika could be demonstrated (20).
Other reactions
Coriandrin, a furoisocoumarin, occurs naturally in Coriander and has very weak skin photosensitising activity as compared with psoralen (21).
Coriander leaves may be contaminated with bacteria. An outbreak of restaurant-associated salmonella infection in California in 1999 was described. Three patients were hospitalised. An association was found between illness and eating Cilantro at a restaurant. At room temperature, Salmonella Thompson grew more rapidly and to a higher concentration on chopped Cilantro, compared with whole-leaf Cilantro. Freshly made salsa (pH 3.4) supported growth of Salmonella Thompson. The authors concluded that Cilantro should be served promptly after chopping (22).
Anecdotal reports claim that excess intake of the seed may have narcotic effects.