title: Popsicle-induced anaphylaxis due to carmine dye allergy.
abstract: BACKGROUND
  IgE-mediated hypersensitivity is a suggested mechanism to explain adverse reactions from carmine-containing products.
  
  
  OBJECTIVE
  To describe a patient who experienced anaphylaxis after ingestion of a popsicle colored with carmine and to provide additional evidence that the adverse reaction was IgE-mediated.
  
  
  METHODS
  The patient and her husband underwent skin prick tests to the popsicle and carmine. The patient also received skin prick tests and/or open oral challenge to each of the other components of the incriminated food. Topical application of cosmetics with and without carmine to the patient's forearm was also performed. To confirm carmine-specific IgE, a Prausnitz-Kustner (P-K) test was performed using the patient's husband as recipient. Twenty control subjects also were tested to carmine by skin prick test.
  
  
  RESULTS
  The patient showed 4+ skin prick test responses to the popsicle and carmine. Skin prick tests and/or open oral challenge to each of the other components of the popsicle were negative. The patient's husband's and 20 control subjects' skin prick tests to carmine were negative as was the patient's husband's skin prick test to the popsicle. Skin prick test reactivity to the popsicle and carmine were successfully transferred to the patient's husband in P-K format. Cosmetics applied to the patient's forearm elicited no immediate response.
  
  
  CONCLUSIONS
  The positive skin prick tests to the popsicle and carmine and the successful (P-K) transfer of skin prick test reactivity support a carmine-specific, IgE-mediated mechanism in explaining our patient's popsicle-induced anaphylaxis.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Baldwin
authors.forename: A H
authors.initials: AH
authors.lastname: Chou
authors.forename: W R
authors.initials: WR
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D002329:Carmine / Q000009:adverse effects; D004396:Coloring Agents / Q000009:adverse effects; D005260:Female; D005505:Food Coloring Agents / Q000009:adverse effects*; D006801:Humans; D007054:Ice Cream / Q000009:adverse effects*; D008297:Male; D012882:Skin Tests
chemical_list: D004396:Coloring Agents; D005505:Food Coloring Agents; D002329:Carmine