Asia Pac Allergy.  2018 Jul;8(3):e30. 10.5415/apallergy.2018.8.e30.

Multiple food allergy – unexpected culprits

Affiliations
  • 1Serviço de Imunoalergologia, Hospital de Santa Maria – Centro Hospitalar Lisboa Norte, Lisbon, Portugal. cristina.ornelas@gmail.com
  • 2Unidade de Imunologia Clínica – Instituto de Medicina Molecular, Faculdade de Medicina – Universidade de Lisboa, Lisbon, Portugal.
  • 3Clínica Universitária de Imunoalergologia, Faculdade de Medicina – Universidade de Lisboa, Lisbon, Portugal.

Abstract

Food allergy has an estimated prevalence of 6%-8% in children. Meat allergy and multiple food allergy due to sensitization to cross-reactive components in infancy is, however, less frequent. A 5-year-old girl was referred to our department with a multiple food allergy history. She had severe immediate worsening of her atopic dermatitis with hen's egg (6 months) and cow's milk introduction (7 months). At the age of 9 months, she presented with recurrent and reproducible atopic dermatitis' worsening and lip edema with the introduction of different meats (chicken, turkey, cow, pork, and rabbit), having the same complaints with fish at 12 months (salmon and hake). At her first appointment she was avoiding hen's egg, cow's milk, meat, and fish (except fresh tuna, codfish, and pollock). We performed skin prick tests (commercial extract and prick-to-prick with whole food) and specific IgE, which revealed sensitization to hen's egg, raw meat (cow, pork, chicken, turkey, duck, lamb, goat, and rabbit; negative for cooked meat), codfish and cow's milk (mild). ISAC was performed, revealing sensitization to 3 cross-reactive components (serum albumins Bosd6, Canf3, and Feld2) and specific food components of chicken's egg/meat (Gald1, 2, 3, and 5), cod (Gadc1), hazelnut (Cora9), and kiwi (Actd1). We present a rare case of multiple food allergy in infancy, where sensitization to cross-reactive components was responsible for most of the children complaints. The detection of serum albumins' involvement was especially important, because it can possibly mean tolerance to these foods in well-cooked forms, substantially improving patient and family's quality of life.

Keyword

Food allergy; Serum albumin; Cross-reactions

MeSH Terms

Albumins
Chickens
Child
Child, Preschool
Corylus
Dermatitis, Atopic
Ducks
Edema
Female
Food Hypersensitivity*
Goats
Humans
Hypersensitivity
Immunoglobulin E
Lip
Meat
Milk
Ovum
Prevalence
Quality of Life
Red Meat
Serum Albumin
Skin
Tuna
Turkey
Albumins
Immunoglobulin E
Serum Albumin
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