Severe reaction in a child with asymptomatic codfish allergy: food challenge reactivating recurrent pancreatitis.

Italian Journal of Pediatrics
Katia PellegrinoGiovanni Cavagni

Abstract

An 8-year-old child during the first year of life manifested severe atopic dermatitis and chronic diarrhea with mucorrhea and rectal bleeding; a fish-free diet was started based on weakly positive skin-prick tests to codfish extract. At the age of 4 years the child began to suffer of recurrent pancreatitis. When he came to our attention for the evaluation of his fish allergy, he was asymptomatic; a weak reactivity to codfish was observed (SPTs: cod, 4 mm, sIgE ImmunoCAP: cod, 1.30 kU/l). The food challenge test with cod was negative. When the child ate cod again, within 5 minutes, developed anaphylactic reaction and complained of abdominal pain compatible with pancreatitis (enzyme serum levels risen and parenchymal oedema at ultrasonography), that resolved within 7 days after specific therapy. This case raises two issues: the elimination diet in asymptomatic food allergy on the basis only of SPT and the ethicality of food challenge in gastrointestinal chronic disease.

References

Dec 1, 1992·International Journal of Pancreatology : Official Journal of the International Association of Pancreatology·A de Diego LorenzoE Cos Arregui
Mar 1, 1990·Pancreas·A Matteo, H Sarles
Dec 22, 1998·Allergy·G GastaminzaM E Camino
Feb 20, 2007·Acta Paediatrica·Carmen A Sánchez-RamírezRocío Macías-Rosales
Jun 26, 2007·Allergy·A MuraroUNKNOWN EAACI Task Force on Anaphylaxis in Children
Jun 10, 2008·The Journal of Allergy and Clinical Immunology·Gideon Lack
Aug 2, 2008·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Philippe A EigenmannEva Sodergren

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Citations

Feb 27, 2013·Clinical Reviews in Allergy & Immunology·Michael F Sharp, Andreas L Lopata
Apr 20, 2016·The Journal of Allergy and Clinical Immunology. in Practice·Kiyotake OguraMotohiro Ebisawa
Nov 1, 2017·Digestive Diseases and Sciences·Murli ManoharAnil Mishra
Feb 24, 2021·BMJ Case Reports·Nora Hernandez GarcilazoTyler Kemnic

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Atopic dermatitis is a chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. Discover the latest research on atopic dermatitis here.

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