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Harmful effect of immunotherapy in children with combined snail and mite allergy
Giovanni Battista Pajno1, Stefania La Grutta, Giovanni Barberio
1Pediatric Division II, University Hospital, Messina, Italy.
Background:
With respect to allergy, the possibility of cross-reactivity between snail and mite is well recognized, and anecdotal reports suggesting that allergen immunotherapy with mite extract can worsen snail-induced allergy exist.
Objective:
We describe the effect of immunotherapy in 4 children with snail-mite allergy.
Methods:
Four children (1 boy and 3 girls; 9-13 years of age) had consistent clinical histories (mild immediate respiratory symptoms after ingestion) and positive skin reactions for allergy to snail. They also had mite-induced asthma and were therefore prescribed subcutaneous specific immunotherapy and subsequently followed.
Results:
Several months (8-25) after starting immunotherapy, all children experienced life-threatening reactions, anaphylaxis, and respiratory failure after inadvertent ingestion of snail. Skin reactivity to the fresh food increased in all patients.
Conclusions:
This observation confirms that in patients with combined mite-snail allergy, immunotherapy should be avoided.