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Nitrate anaphylaxis.

C A Hawkins1, C H Katelaris

  • 1Immunology Registrar, Department of Clinical Immunology and Allergy, Westmead Hospital, Australia.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|August 3, 2000
PubMed
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This study documents the first reported case of anaphylaxis to nitrates and nitrites, common food preservatives. A patient experienced severe allergic reactions, confirmed by a double-blind, placebo-controlled challenge, highlighting a new consideration in food allergy diagnosis.

Area of Science:

  • Food Allergy and Immunology
  • Toxicology and Food Safety

Background:

  • Nitrate and nitrite salts are widely used as preservatives and color enhancers in processed meats.
  • Previous literature has not documented cases of anaphylaxis attributed to nitrates or nitrites.

Observation:

  • A 22-year-old male presented with a four-year history of recurrent anaphylaxis linked to takeout food consumption.
  • An elimination diet successfully prevented further anaphylactic episodes.
  • A double-blind, placebo-controlled capsule challenge was conducted in a hospital setting.

Findings:

  • The patient experienced an acute anaphylactic reaction upon challenge with nitrates and nitrites.
  • Separate challenges revealed allergic reactions to artificial colorings and metabisulfite, and a mild urticarial reaction to salicylates.

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  • A literature search confirmed no prior reports of anaphylaxis to nitrates or nitrites.

    • Implications:

    • Processed meats containing nitrate or nitrite salts may trigger angioedema and anaphylaxis.
    • Clinicians should consider these additives when investigating suspected food allergies.
    • This finding expands the spectrum of known food allergens and necessitates careful dietary evaluation.