Severe systemic allergic reaction induced by accidental skin contact with cow milk in a 16-year-old boy. A case report.
The symptoms of food allergy are rarely induced by skin contact. A 16-year-old boy was referred to our Allergology Centre after an episode of systemic symptoms triggered by accidental skin contact with a drop of cow milk (CM) dripped from a sandwich containing fresh cheese. The patient had been allergic to CM from the age of 24 months and had experienced several episodes of urticaria-angioedema after the ingestion of tiny or "hidden" amounts of CM proteins. In vivo and in vitro diagnostic procedures showed intense sensitisation to all CM proteins (1/100 dilutions of allergenic extracts produced large wheals, and class 4 specific IgE antibodies. Total IgE antibodies were elevate (770.0 UI/). A moderate degree of bronchial hyperresponsiveness was found (PC20 metacholine: 3.90 milligrams). This case report suggests that patients with a high degree of sensitisation to CM proteins should be alert to the danger of skin contact and should beware of "hidden" CM allergens.
Liccardi
G
G
Department of Chest Diseases, Division of Pneumology and Allergology, "A. Cardarelli" Hospital, Naples, Italy. gennaro.liccardi@tin.it
De Falco
F
F
Gilder
J A
JA
D'Amato
M
M
D'Amato
G
G
D000293:Adolescent; D000707:Anaphylaxis / Q000276:immunology* / Q000473:pathology; D000818:Animals; D002417:Cattle; D006801:Humans; D008297:Male; D016269:Milk Hypersensitivity / Q000276:immunology* / Q000473:pathology; D008894:Milk Proteins / Q000276:immunology*; D012129:Respiratory Function Tests; D012867:Skin / Q000276:immunology* / Q000473:pathology; D012882:Skin Tests
D008894:Milk Proteins