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.
Department of Chest Diseases, Division of Pneumology and Allergology, "A. Cardarelli" Hospital, Naples, Italy. gennaro.liccardi@tin.it
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Liccardi
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De Falco
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Gilder
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D'Amato
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D'Amato
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