Severe pepper allergy in a young child

Spices are ingredients to confer improved taste to foods. As they are derived from plants, they have the potential for inducing allergic reactions. There is a lack of studies to accurately determine the rate of pepper allergy in children. Allergic reactions to pepper in children are rare. This case illustrates such a reaction.

Patient is a 17-month-old boy with mild eczema who developed urticaria, conjunctivitis, facial swelling, and severe cough immediately after ingesting venison prepared in a Southwest/mesquite marinade containing a variety of spices including black and cayenne pepper. His food was not routinely peppered. A similar but less severe reaction with facial urticaria and conjunctivitis occurred after eating roast beef in the same marinade while reintroduction of venison without marinade did not result in recurrence of symptoms.

Skin tests to cayenne and black pepper extracts were positive. Skin testing to crude extracts of the food marinades was negative as well as commercial extracts of onion, garlic, paprika, thyme, and tomato. IgE radioallergosorbent results showed undetectable levels to black pepper, chili pepper, lemon, tomato, garlic, onion, green pepper, and white pepper. Specific IgE to cayenne pepper was detected at 0.11 kU/L.