Recurrent angioedema due to lysozyme allergy.

Area of Science:

• Allergy and Immunology
• Food Science

Background:

• Investigating adverse reactions to pharmaceutical preparations containing multiple ingredients.
• Understanding potential cross-reactivity and food allergies related to common food components.

Observation:

• A 54-year-old woman presented with acute allergic symptoms including dyspnea and edema after consuming a medication containing lysozyme.
• Previous episodes of similar symptoms were linked to raw egg and cured cheese ingestion.
• Diagnostic tests revealed specific immunoglobulin E (IgE) antibodies against lysozyme.

Findings:

• Skin prick tests were positive for lysozyme and egg white, with positive prick-to-prick tests for raw egg.
• Oral challenges with papain, bacitracin, and lysozyme-free cheeses were tolerated.
• The patient's allergic reactions were attributed to lysozyme present in the medication, raw egg, and certain cheeses, likely via an IgE-mediated pathway.

Implications:

• Highlights lysozyme as a potential allergen in both pharmaceutical products and food.
• Suggests the importance of considering lysozyme content in patients with unexplained food or drug allergies.
• Underscores the need for careful ingredient review in managing allergic reactions.