Asia Pac Allergy.  2016 Oct;6(4):257-259. 10.5415/apallergy.2016.6.4.257.

Immediate systemic allergic reaction in an infant to fish allergen ingested through breast milk

• Arima T
• Campos-Alberto E
• Funakoshi
• Inoue Y
• Tomiita M
• Kohno Y
• Shimojo N

• KMID: 2397023
• DOI: http://doi.org/10.5415/apallergy.2016.6.4.257

Abstract

This is a rare case report of systemic allergic reaction to fish allergen ingested through breast milk. Mother ate raw fish more than 3 times a week. Her consumption of fish was associated with urticaria and wheeze in an infant via breast-feeding. Fish-specific IgE antibodies were detected by skin prick test but not by in vitro IgE test. This case demonstrates that fish protein ingested by mother can cause an immediate systemic allergic reaction in offspring through breast-feeding. Although fish intake is generally recommended for prevention of allergy, one should be aware that frequent intake of fish by a lactating mother may sensitize the baby and induce an allergic reaction through breast-feeding.

Keyword

Allergy; Fishes; Allergens; Breast-feeding; Immunoglobulin E

MeSH Terms

Allergens
Antibodies
Breast*
Fishes
Humans
Hypersensitivity*
Immunoglobulin E
In Vitro Techniques
Infant*
Milk, Human*
Mothers
Skin
Urticaria
Allergens
Antibodies
Immunoglobulin E

Figure

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  Fig. 1 Positive skin prick test to fish allergens.

Reference

1. de Boissieu D, Matarazzo P, Rocchiccioli F, Dupont C. Multiple food allergy: a possible diagnosis in breastfed infants. Acta Paediatr. 1997; 86:1042–1046.

2. Monti G, Marinaro L, Libanore V, Peltran A, Muratore MC, Silvestro L. Anaphylaxis due to fish hypersensitivity in an exclusively breastfed infant. Acta Paediatr. 2006; 95:1514–1515.

3. Lifschitz CH, Hawkins HK, Guerra C, Byrd N. Anaphylactic shock due to cow's milk protein hypersensitivity in a breast-fed infant. J Pediatr Gastroenterol Nutr. 1988; 7:141–144.

4. Wilson NW, Self TW, Hamburger RN. Severe cow's milk induced colitis in an exclusively breast-fed neonate. Case report and clinical review of cow's milk allergy. Clin Pediatr (Phila). 1990; 29:77–80.

5. Des Roches A, Paradis L, Singer S, Seidman E. An allergic reaction to peanut in an exclusively breastfed infant. Allergy. 2005; 60:266–267.

6. Warner JO. Food allergy in fully breast-fed infants. Clin Allergy. 1980; 10:133–136.

7. Schoos AM, Chawes BL, Følsgaard NV, Samandari N, Bønnelykke K, Bisgaard H. Disagreement between skin prick test and specific IgE in young children. Allergy. 2015; 70:41–48.

8. Goldman AS. The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties. Pediatr Infect Dis J. 1993; 12:664–671.

9. Romieu I, Torrent M, Garcia-Esteban R, Ferrer C, Ribas-Fitó N, Antó JM, Sunyer J. Maternal fish intake during pregnancy and atopy and asthma in infancy. Clin Exp Allergy. 2007; 37:518–525.

10. Netting MJ, Middleton PF, Makrides M. Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Nutrition. 2014; 30:1225–1241.