title: Anaphylactic Reactions to Novel Foods: Case Report of a Child With Severe Crocodile Meat Allergy.
abstract: Availability of "exotic" foods is steadily increasing. In this report, we describe the first case of anaphylaxis to crocodile meat. The patient was a 13-year-old boy with severe immunoglobulin E-mediated allergy to chicken meat. When tasting crocodile meat for the first time, he developed an anaphylactic reaction. Cross-reactivity between chicken and crocodile meat was suspected to have triggered this reaction. Basophil activation and immunoglobulin E testing confirmed the boy's allergic reaction to crocodile meat proteins. Molecular analysis identified a crocodile α-parvalbumin, with extensive sequence homology to chicken α-parvalbumin, as the main cross-reactive allergen. We conclude that crocodile meat can be a potent food allergen and patients with allergy to chicken meat should be advised to avoid intake of meat from crocodile species. Both foods and people travel around the world and accessibility to exotic foods is steadily growing. As a result, novel allergic cross-reactivities are likely to become a challenge in the management of food allergy and, as our report illustrates, cross-reactivity has to be considered even between foods that might not intuitively be perceived as related.
authors.affiliation: Institute of Environmental Medicine, natalia.ballardini@ki.se.|Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.|St John's Institute of Dermatology, King's College London, London, United Kingdom.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ballardini
authors.affiliation: Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Nopp
authors.affiliation: Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Hamsten
authors.affiliation: Institute of Environmental Medicine.|Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.|Centre for Allergy Research, and.
authors.forename: Mirja
authors.initials: M
authors.lastname: Vetander
authors.affiliation: Institute of Environmental Medicine.|Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Melén
authors.affiliation: Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Caroline
authors.initials: C
authors.lastname: Nilsson
authors.affiliation: Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.|Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark; and.
authors.forename: Markus
authors.initials: M
authors.lastname: Ollert
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust and King's College London, London, United Kingdom.
authors.forename: Carsten
authors.initials: C
authors.lastname: Flohr
authors.affiliation: Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
authors.forename: Annette
authors.initials: A
authors.lastname: Kuehn
authors.affiliation: Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marianne
authors.initials: M
authors.lastname: van Hage
mesh_terms: D000293:Adolescent; D000485:Allergens; D000489:Alligators and Crocodiles; D000707:Anaphylaxis / Q000175:diagnosis*; D000818:Animals; D003429:Cross Reactions; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E; D008297:Male; D008460:Meat
chemical_list: D000485:Allergens; D007073:Immunoglobulin E