![]() ![]() In these children, the prevalence of latex allergy varies from 1% to 49%, and it can reach 72%. 4 When present is children, latex allergy is usually found in risk groups, such as children with atopic background and specially children with spina bifida who undergo multiple surgeries from birth and, who are prematurely and frequently exposed to latex. 3 In one study with 1877 children of 7 years old submitted to skin prick test with latex, only 4 children were sensitized. In fact, in the general pediatric population the sensitization and allergy to latex are rare. ![]() ![]() 2Īs stated, it was also unexpected that ImmunoCAP ISAC revealed positive for Hev b 3-a specific allergen of latex. These proteins are, in fact, responsible for life-threatening reactions as they are generally resistant to proteolysis and denaturation. 1 Further investigation with ImmunoCAP ISAC has shown the presence of Jug r 1 e Cor a 9, which are storage proteins and therefore justifies the severity of the initial reaction. In this case, we described a previously healthy child, with no history of allergic disease, which presented as first manifestation of allergy and anaphylactic reaction that occurred after contact with a tree nut and also was sensitized to a latex allergen (Hev b 3) that is not associated with cross-reactivity to tree nuts. Treatment included strict elimination of peanuts and tree nuts from diet and self-injectable adrenaline. ImmunoCAP Specific for latex molecular allergens (Hev b 9, Hev b 11, Hev b 6.02, Hev b 6.01, Hev b 5, Hev b 3, and Hev b 1) was performed, which confirmed positivity only for Hev b 3 (2.31 kU/L).Ī challenge test was performed with a latex glove: first with finger glove and then with whole glove, which were negative. For a better understanding of the clinical situation, we performed ImmunoCAP ISAC that was positive for storage proteins of walnut and hazelnut, Jug r 1 and Cor a 9, with values of 0.6 and 33 ISAC Standardized Units (ISU-E), respectively, and for a specific allergen of latex (Hev b 3: 1.9 ISU-E). Initial diagnostic exams revealed a positive skin prick test to walnut (wheal mean diameter 5 mm same as histamine diameter) and specific IgE for cashew nut 21.1 kU/L walnut 10 kU/L hazelnut 2.94 kU/L, and almond 0.46 kU/L. The previous year she had an episode of labial swelling after ingesting a chocolate with hazelnut. Also, we emphasize the importance to latex sensitization with potential future clinical relevance and the sensitization to Hev b 3, which is not documented to be involved in cross-reactivity phenomena/latex–fruit syndrome or present in an otherwise healthy child.Ī 5-year-old Caucasian girl with no significant past medical history and with a family history of allergic disease (mother and 7-year-old brother with allergic rhinitis to pollens) was referred to Pediatric/Allergology Consultation after an episode of sialorrhea, perioral urticarial rash, tongue swelling, and immediate vomiting after oral contact with cashew nut. It is interesting that anaphylaxis was the first manifestation of allergy in a healthy child. ![]() ImmunoCAP ISAC was positive for storage proteins of walnut and hazelnut (Jug r 1 e Cor a 9) and for a specific allergen of latex (Hev b 3). Investigation revealed the following: positive skin prick test to walnut and positive specific IgE for cashew nut, walnut, hazelnut, and almond. We present the case of a previous healthy 5-year-old girl referred to Pediatric/Allergology Consultation after an episode of sialorrhea, perioral urticarial rash, tongue swelling, and immediate vomiting after oral contact with cashew nut. Cross-reactivity can occur not only with foods that are in the same biological family but also between certain fruits or vegetables and latex (latex–fruit syndrome). Food allergy affects many young children and tree nut allergy is accountable for a large number of severe, life-threatening anaphylactic reactions. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |