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Delayed-type hypersensitivity to cow's milk protein in Melkersson-Rosenthal syndrome: coincidence or pathogenetic
F S Levy1, A J Bircher, S A Büchner
1Division of Allergy, University of Basel, Switzerland.
Background:
Intolerance to cow's milk protein is frequently seen in children and rarely in adults. Non-IgE-mediated hypersensitivity to cow's milk protein has been suspected in children based on in vitro evidence. Food intolerance may play a pathogenetic role in some cases of Melkersson-Rosenthal syndrome, which is often of unknown origin.
Objective:
We describe an adult female patient who developed a Melkersson-Rosenthal syndrome and at the same time was found to have in vivo and in vitro evidence of a delayed-type hypersensitivity to cow's milk protein.
Methods:
Allergic and immunologic examinations, including skin prick tests, patch tests, serology, lymphocyte transformation tests and biopsies were performed.
Results:
A positive patch test to alpha-lactalbumin, a positive lymphocyte transformation test to whole cow's milk and an immunohistology with infiltration of CD4+ and CD8+ T cells were found.
Conclusions:
There is a possible pathogenetic relation between delayed-type hypersensitivity to cow's milk protein and Melkersson-Rosenthal syndrome in the patient presented.