Two strange cases of hypereosinophilia and child's relapsing angio-oedema

Area of Science:

• Pediatric Allergy and Immunology
• Infectious Diseases
• Parasitology

Background:

• Recurrent angioedema and hypodermitis can present diagnostic challenges in pediatric patients.
• Atopic conditions in family history may suggest allergic etiologies, but other causes should be considered.
• Distinguishing allergic reactions from parasitic infections requires comprehensive diagnostic approaches.

Observation:

• Two pediatric patients presented with recurrent angioedema and localized, transient hypodermic infiltrations.
• Clinical examinations revealed good nutritional status but significant laboratory abnormalities.
• Laboratory findings included marked hypereosinophilia and immunoglobulin E (IgE) levels exceeding ten times the normal range.

Findings:

• Standard allergy testing (prick tests) for common inhalant and food allergens yielded negative results.
• Enzyme-linked immunosorbent assay (ELISA) testing showed strong positivity for Taenia Solium metacestodes in both patients' sera.
• These findings strongly suggested a diagnosis of human cysticercosis.

Implications:

• Human cysticercosis should be considered in the differential diagnosis of pediatric angioedema and hypereosinophilia, especially with negative allergy tests.
• Parasitic infections can mimic allergic conditions, highlighting the importance of broad diagnostic considerations.
• Early diagnosis and treatment of cysticercosis are crucial to prevent potential neurological complications and long-term sequelae.