Food anaphylaxis in toddlers: own clinical experience in diagnostic measurement and identification of underlying causes

Abstract

The article presents current data on the reasons for the occurrence, peculiarities of the course, and diagnostic principles of anaphylaxis in toddlers. The determination of protein group enables to prognosticate the risk of development of food anaphylaxis. A comprehensive method is the ALEX in vitro multiplex allergy test. In the first reported case, anaphylaxis appeared after the consumption of a milk formula (cutaneous and respiratory symptoms; five months) and buckwheat (cutaneous, gastrointestinal, and respiratory symptoms; 11 months). On examination, the storage proteins of buckwheat Fag e 2 were detected – 22.82 kUA/L and major components of milk Bos d 4 (α-lactalbumin) – 41.37 kUA/L, Bos d 5 (β-lactoglobulin) – 41.12 kUA/L, Bos d 8 (casein) – 32.84 kUA/L. In the second case, anaphylaxis (cutaneous, gastrointestinal, respiratory, and neurological symptoms) developed after eating cake. On examination, the following storage proteins were detected: hazelnut Cor a 14 – 6.80 kUA/L, walnut Jug r 1 – 3.76 kUA/L. In the third case, anaphylaxis (cutaneous and respiratory symptoms) occurred after contact with dried fish (carp, cod) which the affected child was holding in the hands. On examination, parvalbumins were detected, including Atlantic cod – Gad m 1 – 46.67 kUA/L, carp – Cyp c 1 – 42.61 kUA/L, Atlantic herring – Сlu h 1 – 49.05 kUA/L, Sal s 1– 45.58 kUA/L, Atlantic mackerel – Sco s 1 – 48.82 kUA/L, tuna – Thu a 1 – 43.12 kUA/L, and swordfish – Хір g 1 – 43.83 kUA/L. Based on a complex examination, the patients received thorough dietary and lifestyle recommendations, as well as information about health risks and the need for an epinephrine autoinjector.