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Severe food-induced vasculitis in two children
Luisa Businco1, Paola Falconieri, Barbara Bellioni-Businco
1Allergy and Immunology Division, Department of Pediatrics, University of Rome, La Sapienza, Italy.
Summary
This study highlights two children with severe vasculitis triggered by specific foods, suggesting food-induced vasculitis may be more common than previously thought.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Rheumatology
Background:
- Food-induced vasculitis is a rare and debated condition, with limited pediatric case reports.
- Existing literature primarily focuses on adult patients, leaving a gap in understanding pediatric cases.
Observation:
- Two children presented with severe vasculitis, one 8-year-old girl and one 23-month-old girl, with cutaneous and joint involvement.
- Skin biopsies confirmed leucocytoclastic vasculitis in both cases, with no identifiable cause from drugs, infections, or autoimmune diseases.
- Case 1 showed elevated immunoglobulin E (IgE) and positive tests for cow's milk and hen's egg, confirmed by elimination-challenge.
- Case 2, despite negative food allergy tests, improved upon avoiding chocolate, with relapse upon accidental ingestion.
Findings:
- Cow's milk and hen's egg were identified as causative agents in Case 1 through allergy testing and challenge.
- Chocolate avoidance led to remission in Case 2, indicating a potential food trigger despite negative standard allergy tests.
- Both cases demonstrated severe vasculitis responsive to dietary modification, supporting the existence of food-induced vasculitis in children.
Implications:
- These cases suggest that food-induced vasculitis, though rare, may be underdiagnosed in pediatric populations.
- Identifying specific food triggers is crucial for managing severe vasculitis in children and preventing recurrence.
- Further research is warranted to elucidate the mechanisms and prevalence of food-induced vasculitis in pediatric patients.