J Korean Med Sci.  2022 Mar;37(10):e83. 10.3346/jkms.2022.37.e83.

The First Case of Erythritol-Induced Anaphylaxis in Korea

• Kim S
• Yoo W
• Park HK
• Jo EJ

• KMID: 2526979
• DOI: http://doi.org/10.3346/jkms.2022.37.e83

Abstract

Erythritol is a natural sugar alcohol found in some fruits and fermented foods, which is used as a dietary sweetener because it has few calories. Here, we describe a 36-year-old woman who experienced anaphylaxis upon ingestion of an erythritol-containing drink. She presented to the emergency department with dyspnea and angioedema after drinking a peachcontaining diet beverage. Her blood pressure dropped to 70/40 mmHg and the symptoms improved after administration of an antihistamine, glucocorticoid, and epinephrine. After 10 days, she drank another peach-containing diet beverage and experienced urticaria. No serumspecific immunoglobulin E findings were observed, including against peach components. A skin prick test (SPT) was performed using a peach, the two ingested diet beverages, and another peach-containing beverage. The SPT results for the peach and the peach-containing product were negative, but the wheal sizes for the two diet beverages were > 3 mm. The diet beverages contained erythritol as a food additive. The SPT result was positive for erythritol. The patient was diagnosed with anaphylaxis to erythritol and was instructed to avoid foods containing erythritol. She was prescribed a self-injectable epinephrine pen. To our knowledge, this is the first case of erythritol-induced anaphylaxis in Korea. Physicians should be aware of the possibility of allergic reactions to food additives, and additives should be evaluated to prevent the recurrence of symptoms.

Keyword

Erythritol; Food Additives; Food Allergy; Anaphylaxis

Figure

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  Fig. 1 Results of skin prick tests for erythritol.

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