The second patient is a 3-year-old boy who presented with recurrent allergic conjunctivitis upon exposure to aerosolized powdered ginseng, with evidence of sensitization to American ginseng on SPT (13 × 7 mm wheal), but with no evidence of IgE-mediated allergic reaction during oral challenge with American ginseng powder.<h4>Conclusions</h4>These cases highlight two different allergic responses to American ginseng in pediatric patients. Here, IGHE is linked to atopic conjunctivitis.