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[Alimentary anaphylactic shock: implication of penicillin residues]
G Kanny1, J Puygrenier, E Beaudoin
1Service de Médecine D, Immunologie Clinique et Allergologie, Centre Hospitalier Universitaire de Nancy, Hôpital de Brabois, Vandoeuvre-les-Nancy, France.
Allergie Et Immunologie
|May 1, 1994
Summary
A patient experienced recurrent anaphylaxis after eating meat. Testing revealed high penicillin G sensitivity, suggesting hidden penicillin residues in food caused the severe allergic reactions.
Area of Science:
- Immunology
- Allergy and Immunology
- Clinical Medicine
Background:
- Recurrent anaphylaxis presents a diagnostic challenge, especially when common food allergens are ruled out.
- Investigating potential environmental or iatrogenic triggers is crucial for identifying rare causes of food-induced anaphylaxis.
Observation:
- A 64-year-old female experienced four anaphylactic shocks, two following meat consumption.
- Standard food allergy testing for animal proteins was negative.
- Skin prick tests and IgE assays (RAST) demonstrated high sensitivity to penicillin G (class 4).
- Leukocyte histamine release tests showed elevated spontaneous histamine release.
Findings:
- A double-blind, placebo-controlled oral challenge confirmed penicillin allergy, inducing anaphylactic symptoms (wheezing, hypotension) at a low dose.
- The patient's history and diagnostic results strongly support a hypothesis of food-induced anaphylaxis.
- Penicillin residues in ingested meats are the likely causative agent.
Implications:
- This case highlights the potential for hidden penicillin residues in the food supply to trigger severe allergic reactions.
- Elevated spontaneous histamine release may indicate heightened sensitivity to environmental allergens or contaminants.
- Clinicians should consider non-food allergens, such as medication residues, in cases of unexplained anaphylaxis.