Intractable sneezing due to IgE-mediated triethanolamine sensitivity

Area of Science:

• Allergy and Immunology
• Environmental Health

Background:

• Sneezing is a common allergic reaction, but isolated, intractable sneezing is rare.
• An 8-year-old girl presented with persistent sneezing, unresponsive to typical allergy treatments.

Purpose of the Study:

• To identify the allergen responsible for intractable sneezing in a pediatric patient.
• To investigate the immunological mechanism underlying the patient's allergic response.

Main Methods:

• Skin prick testing and in vitro immunological assays (leukocyte histamine release, radioimmunoassay) were performed.
• The patient was exposed to various potential allergens, including laundry detergent ingredients.
• Dose-response studies and passive cutaneous anaphylaxis tests were conducted.

Main Results:

• Skin prick tests for common allergens were negative.
• Triethanolamine, a component of a laundry detergent, triggered a positive prick test.
• Dose-dependent leukocyte histamine release and specific IgE antibodies to triethanolamine were confirmed.
• Symptoms resolved upon avoidance of triethanolamine-containing products.

Conclusions:

• Exposure to triethanolamine can cause IgE-mediated intractable sneezing.
• Triethanolamine should be considered as a potential allergen in cases of unexplained persistent sneezing.
• Avoidance of the causative agent is crucial for symptom management.