Harmful effect of immunotherapy in children with combined snail and mite allergy.
BACKGROUND
With respect to allergy, the possibility of cross-reactivity between snail and mite is well recognized, and anecdotal reports suggesting that allergen immunotherapy with mite extract can worsen snail-induced allergy exist.


OBJECTIVE
We describe the effect of immunotherapy in 4 children with snail-mite allergy.


METHODS
Four children (1 boy and 3 girls; 9-13 years of age) had consistent clinical histories (mild immediate respiratory symptoms after ingestion) and positive skin reactions for allergy to snail. They also had mite-induced asthma and were therefore prescribed subcutaneous specific immunotherapy and subsequently followed.


RESULTS
Several months (8-25) after starting immunotherapy, all children experienced life-threatening reactions, anaphylaxis, and respiratory failure after inadvertent ingestion of snail. Skin reactivity to the fresh food increased in all patients.


CONCLUSIONS
This observation confirms that in patients with combined mite-snail allergy, immunotherapy should be avoided.
Pajno
Giovanni Battista
GB
Pediatric Division II, University Hospital, Messina, Italy.
La Grutta
Stefania
S
Barberio
Giovanni
G
Canonica
Giorgio Walter
GW
Passalacqua
Giovanni
G
D000293:Adolescent; D000818:Animals; D002648:Child; D003429:Cross Reactions; D005260:Female; D005512:Food Hypersensitivity / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D008297:Male; D008925:Mites / Q000276:immunology*; D012908:Snails / Q000276:immunology*