title: Anaphylaxis Conundrum: A Trojan Horse Phenomenon.
abstract: Anaphylaxis is a serious and potentially life-threatening allergic reaction that may follow the ingestion of foods. Although these reactions usually follow a common clinical pattern and often demonstrate IgE sensitization to the antigen in question, both the clinical presentation and causative allergen may be atypical, surprising, and difficult to identify. Failure to identify the actual cause of the reaction can compromise treatment and complicate long-term care. Here, we present a patient who had symptoms of anaphylaxis after eating salmon, but confirmation of the causative allergen was not readily apparent. This particular case serves as an insightful lesson for patients undergoing evaluation for anaphylaxis and also provides a framework for navigating through a case involving identification of an underlying allergen.
authors.affiliation: Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
authors.forename: Ann
authors.initials: A
authors.lastname: Esquivel
authors.affiliation: Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis. Electronic address: Wwb@medicine.wisc.edu.
authors.forename: William W
authors.initials: WW
authors.lastname: Busse
mesh_terms: D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000175:diagnosis* / Q000209:etiology; D000818:Animals; D017163:Anisakis / Q000276:immunology*; D000947:Antigens, Helminth / Q000276:immunology*; D005260:Female; D029941:Fish Proteins / Q000276:immunology*; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008875:Middle Aged; D012474:Salmon / Q000276:immunology* / Q000469:parasitology
chemical_list: D000485:Allergens; D000947:Antigens, Helminth; D029941:Fish Proteins; D007073:Immunoglobulin E
keywords: Anaphylaxis; Anisakis allergy