[Alimentary anaphylactic shock: implication of penicillin residues]

The case of a 64 y.o. female is reported. She experienced formerly four anaphylactic shocks. Two shocks occurred after ingestion of pork and beef meat. Any food allergy to animal proteins was discarded. A high degree of sensitivity to penicillin G was proved by a positive prick test to penicillin G 1 Ul/ml, which induced a systemic reaction. RAST to penicillin G was class 4. The leucocyte histamine release test showed a high level of spontaneous histamine release. A double blind, placebo controlled, oral challenge with penicillin mixed to milk induced wheezing and a fall of blood pressure at the cumulative dose of 20 Ul. The hypothesis of food induced anaphylaxis, linked to penicillin residues in meats, is highly plausible. The significance of the phenomenon of spontaneous histamine release is discussed. It might point to frequent ingestions of hidden penicillin residues in the diet.