Italian Journal of Pediatrics (2012-05-01)

Severe reaction in a child with asymptomatic codfish allergy: Food challenge reactivating recurrent pancreatitis

  • Pellegrino Katia,
  • D’Urbano Leila,
  • Artesani Maria,
  • Riccardi Carla,
  • Mancini Sandro,
  • Bella Sergio,
  • Alghisi Federico,
  • Cavagni Giovanni

Journal volume & issue
Vol. 38, no. 1
p. 16


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Abstract An 8-year-old child during the first year of life manifested severe atopic dermatitis and chronic diarrhea with mucorrhea and rectal bleeding; a fish-free diet was started based on weakly positive skin-prick tests to codfish extract. At the age of 4 years the child began to suffer of recurrent pancreatitis. When he came to our attention for the evaluation of his fish allergy, he was asymptomatic; a weak reactivity to codfish was observed (SPTs: cod, 4 mm, sIgE ImmunoCAP: cod, 1.30kU/l). The food challenge test with cod was negative. When the child ate cod again, within 5 minutes, developed anaphylactic reaction and complained of abdominal pain compatible with pancreatitis (enzyme serum levels risen and parenchymal oedema at ultrasonography), that resolved within 7 days after specific therapy. This case raises two issues: the elimination diet in asymptomatic food allergy on the basis only of SPT and the ethicality of food challenge in gastrointestinal chronic disease.