Cases reported "Food Hypersensitivity"

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21/56. eosinophilic esophagitis.

    BACKGROUND: Esophagitis is an increasingly diagnosed disease. patients with gastroesophagic reflux, dysphagia, vomiting or abdominal pain, with a torpid response to the treatment, could be suffering from it. MATERIAL AND methods: A 37 year-old male patient with background of gastroesophagic reflux and dysphagia for solids since 2002, self-limited diarrhea episodes and intolerance to alcoholic drinks due to epigastric pain. Skin prick tests, specific IgE, histamine release test and basophil activation test were carried out. RESULTS: Skin prick test to the usual allergens with negative result; prick-prick tests to egg white and yolk, milk and apple with positive result to egg white; total serum IgE within normal levels, specific IgE to egg white with positive result; histamine release test (HRT) and basophil activation test (BAT) with positive result to egg white and yolk. CONCLUSION: The patient was diagnosed eosinophilic esophagitis. The commercial food extracts have a great variability in their allergenic composition, which could result in false negative results in the prick test. Prick-prick with the natural food is a more sensitive technique than prick in the diagnosis of food allergy. There are other useful in vitro techniques, apart from specific IgE, in the diagnosis of food allergy. In our case, an exclusion diet of the involved food was more effective than other treatments for remission of the symptoms.
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22/56. Oral rush desensitization with tomato: a case report.

    Adverse food reaction in which no immunological mechanism is demonstrated should be termed nonallergic food hypersensitivity or food intolerance. We present the case of a 12-year-old girl with a clinical history of abdominal pain, nausea, and general malaise after tomato intake which completely remitted with antihistamines. The patient underwent a complete allergy evaluation: skin prick tests, serum specific IgE and IgG4 tests to tomato, and double-blind placebo-controlled food challenge. Skin prick tests and specific IgE to tomato were negative while the food challenge was positive. At the end of the workup, the patient underwent an oral rush desensitizing treatment. At the end of the treatment the patient could eat a maintenance dose of 100 g of tomato daily with no side effects at all. This successful result suggests that the oral desensitizing treatment can be used in patients with nonallergic food hypersensitivity.
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23/56. Allergic reactions due to mizolastine.

    BACKGROUND: An IgE-mediated allergic reaction to an antihistamine sounds like a paradox and is rare. OBJECTIVE: To describe 2 patients with anaphylaxis caused by mizolastine. In one patient, differential diagnosis from food allergy was necessary, whereas in the other patient, the history was clear. methods: history and in vivo skin testing were used for diagnosis. A challenge test to mizolastine was also proposed, but both patients refused to give consent. RESULTS: Skin test results were positive to mizolastine, whereas tests to the inert ingredients of the mizolastine tablets and to other H1 and H2 blockers had negative results. CONCLUSIONS: In vivo tests are highly sensitive, and they confirmed the diagnosis of the uncommon antihistamine allergy.
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24/56. anaphylaxis to pinon nuts.

    A 21-year-old white male developed life threatening systemic anaphylaxis within seconds of ingesting a small amount of a cookie containing pinon nuts. Skin testing, ELISA, and basophil histamine release studies demonstrated pinon nut-specific IgE. electrophoresis of the pinon nut extract demonstrated 30 bands, three of which (in the 66 to 68,000 dalton range) bound IgE in the patient's serum in an immunoblot. Ingestion challenge was not performed due to the severity of the patient's reaction. Although used for centuries in certain cultures, pinon nuts are now being eaten more frequently in the American diet. physicians should be aware of the potential for anaphylactic reactions following ingestion of this food.
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25/56. A pediatric case of anaphylaxis caused by matsutake mushroom (tricholoma matsutake) ingestion.

    BACKGROUND: anaphylaxis is one of the severest forms of allergic diseases. Some kinds of mushroom are known as causative allergens in food anaphylaxis. Matsutake mushroom (tricholoma matsutake) is a typical edible mushroom available in autumn in japan. We encountered an 8-year-old Japanese girl who developed anaphylaxis after ingesting matsutake mushrooms. methods: We studied the case in detail, by measuring specific IgE antibodies and conducting skin tests, to confirm the diagnosis. We also detected seven cytokines and chemical mediators in the blood in order to study the pathophysiology of the anaphylaxis. RESULTS: We diagnosed anaphylaxis caused by ingestion of matsutake mushrooms based on the following. A skin prick test showed a positive reaction to matsutake mushroom, and specific IgE antibody for matsutake mushroom extract was detected in the patient's serum by fluorometric ELISA. blood levels of chemical mediators including histamine, ECP, tryptase and cytokines such as IL-6, IL-5 and IL-10 but not IFN-gamma also increased significantly during the allergic episode. CONCLUSIONS: We demonstrated that chemical mediators including histamine, tryptase and ECP as well as several cytokines were involved significantly during the episode of anaphylaxis. In addition, eosinophils as well as mast cells played significant roles in the anaphylaxis. Furthermore, CD4 CD25 T regulatory cells that released IL-10 were likely activated during the anaphylaxis. Matsutake mushroom should be considered as a causative allergen in food anaphylaxis.
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26/56. Swiss chard hypersensitivity: clinical and immunologic study.

    Allergy to vegetables and fruits seems to be more prevalent in atopics, especially in birch pollen-sensitized individuals. We report a case of a grass pollen-sensitized woman, in whom the inhalation of vapor from boiling Swiss chard precipitated rhinoconjunctivitis and asthma. Type I hypersensitivity to Swiss chard was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, basophil degranulation, histamine release test, and an immediate bronchial provocation test response to Swiss chard extract. The controls did not react to any of these tests. RAST inhibition assays suggest the presence of some cross-reactivity among Swiss chard and grass pollen antigens, as well as cross-reactivity between vegetables and weed pollens of the chenopod family.
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27/56. Allergy to limpet.

    Allergy to mollusk has rarely been described. The limpet, belonging to Phylum mollusca, is one of the most frequent mollusks in the Canary islands, as in all warm maritime regions. We report two cases of atopic patients who developed anaphylactic reactions after ingestion of this mollusk. Type I hypersensitivity to limpet antigens was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, and histamine release test to cooked limpet extract. The controls did not react to any of these tests. Allergic activity was only found with a cooked limpet extract; this suggests that the offending antigen/s may have been released by cooking this food.
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keywords = histamine
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28/56. Adverse reaction to pomegranate ingestion.

    We present a non-atopic 85-year-old woman, with a late-onset recidivant tongue angio-edema due to pomegranate intake, as proven by a double blind oral challenge test. This is the first case ever reported about adverse reaction to pomegranate. We have been unable to demonstrate an IgE-mediated mechanism (prick test, histamine release test and RAST with pomegranate were all negative). We emphasize the importance of clinical history and oral challenge test in the diagnosis of food allergy.
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29/56. Epiglottic enlargement: two unusual causes.

    We present two patients with airway obstruction due to supraglottic swelling; one was caused by a brown spider bite on an ear (loxoscelism) and the other from eating buffalo fish. In the latter patient it was likely due to scrombroid poisoning, a histamine-like reaction, but may have been an anaphylaxic reaction.
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30/56. Is food allergy a cause of acute pancreatitis?

    We reported two cases of acute recurrent pancreatitis lasting for 8 and 10 years, respectively, and characterized by acute abdominal pain associated with an increased serum level of pancreatic enzymes and in one case transient enlargement of the pancreas on sonography and CT scan. Exocrine and endocrine pancreatic function remained normal. Pain attacks were associated with headache or typical migraine, myalgia, pruritus, and diarrhea. In one case only, the IgE serum level was increased. In both cases, the symptoms were reproduced in the 2 h following the consumption of some particular food and cured for years by the suppression of this food and the use of cromoglycate, but recurred 1 month to 3 years after this treatment was stopped, to be again healed by the same treatment. We suggest that these cases are due to food allergy and that food allergy could be a rare cause of acute recurrent pancreatitis. Responsible foods were beef (twice), milk, potato, fish, and eggs, which is in agreement with the frequency of food allergens in southwestern europe.
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keywords = headache
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