title: Think twice: misleading food-induced respiratory symptoms in children with food allergy.
abstract: Reported food-related symptoms of patients may sometimes be misleading. A correct delineation of food-induced symptoms is often difficult and various differential diagnoses have to be considered. We report on two cases of food-induced, predominantly respiratory symptoms (in one case life-threatening) in children with food allergy. First, a two-year-old boy with no history of allergies and suspected foreign body aspiration which was finally diagnosed as an anaphylactic reaction to fish, and secondly a six-year-old girl with multiple food allergies and allergic asthma who during an electively performed oral food challenge developed severe respiratory distress, drop in blood pressure, and asphyxia not due to an anaphylactic reaction but due to choking on an unnoticed sweet. These two cases represent challenging, life-threatening symptom constellations involving food-induced reactions in food allergic children, reminding us to question first impressions.
authors.affiliation: Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Ahrens
authors.forename: A
authors.initials: A
authors.lastname: Mehl
authors.forename: S
authors.initials: S
authors.lastname: Lau
authors.forename: L
authors.initials: L
authors.lastname: Kroh
authors.forename: K
authors.initials: K
authors.lastname: Magdorf
authors.forename: U
authors.initials: U
authors.lastname: Wahn
authors.forename: K
authors.initials: K
authors.lastname: Beyer
authors.forename: B
authors.initials: B
authors.lastname: Niggemann
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology; D000707:Anaphylaxis / Q000150:complications / Q000175:diagnosis*; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D053120:Respiratory Aspiration / Q000150:complications / Q000175:diagnosis*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000209:etiology
keywords: asphyxia; food allergy; oral food challenge; respiratory symptoms