Severe reaction in a child with asymptomatic codfish allergy: Food challenge reactivating recurrent pancreatitis

• Main Authors: Pellegrino Katia, D’Urbano Leila, Artesani Maria, Riccardi Carla, Mancini Sandro, Bella Sergio, Alghisi Federico, Cavagni Giovanni
• Format: Article
• Language: English
• Published: BMC 2012-05-01
• Series: Italian Journal of Pediatrics
• Subjects: Food allergy; Codfish; Pancreatitis; Challenge; Anaphylaxis
• Online Access: http://www.ijponline.net/content/38/1/16

<p>Abstract</p> <p>An 8-year-old child during the first year of life manifested severe atopic dermatitis and chronic diarrhea with mucorrhea and rectal bleeding; a fish-free diet was started based on weakly positive skin-prick tests to codfish extract. At the age of 4 years the child began to suffer of recurrent pancreatitis. When he came to our attention for the evaluation of his fish allergy, he was asymptomatic; a weak reactivity to codfish was observed (SPTs: cod, 4 mm, sIgE ImmunoCAP: cod, 1.30kU/l). The food challenge test with cod was negative. When the child ate cod again, within 5 minutes, developed anaphylactic reaction and complained of abdominal pain compatible with pancreatitis (enzyme serum levels risen and parenchymal oedema at ultrasonography), that resolved within 7 days after specific therapy. This case raises two issues: the elimination diet in asymptomatic food allergy on the basis only of SPT and the ethicality of food challenge in gastrointestinal chronic disease.</p>