Perplexing cases of allergy to salami
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| Title: | Perplexing cases of allergy to salami |
|---|---|
| Authors: | Ludman, Sian, Perrin, Yannick Chantal, Caubet, Jean-Christoph Roger J-P, Wassenberg, Jacqueline |
| Source: | Journal of Allergy and Clinical Immunology: In Practice, Vol. 1, No 1 (2013) pp. 97-8 |
| Publisher Information: | Elsevier BV, 2013. |
| Publication Year: | 2013 |
| Subject Terms: | Male, 2. Zero hunger, 0301 basic medicine, Food Hypersensitivity/diagnosis/microbiology, ddc:618, Food Microbiology/methods, Penicillium, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Child, Preschool, Humans, Child, Meat Products/adverse effects/microbiology |
| Description: | TO THE EDITOR: Patients can often present with perplexing allergies to processed foods that in other simpler component forms they can tolerate. In general, further investigation of the ingredients list to isolate the offending agent is necessary. Salamis and some washed rind cheeses (such as raclette cheese) have molds used in their skins and rinds for preservation or to add certain tastes and textures. It must not be forgotten that these molds can and do cause allergic reactions. Salami is a fermented, cured sausage. During the drying and curing phase the skin of the salami is often sprayed with a Penicillium species mold starter to promote flavor and to try to prevent harmful bacteria from multiplying. The type of mold used is different in various production regions (Illtud Llyr Dunsford [Charcutier Ltd], personal communication, June 26, 2012). Salami has also been found to contain house dust mites (HDMs) that can occasionally thrive during the curing process. We present a 5-year-old boy with atopic dermatitis, seasonal allergic rhinitis, and pollen-food syndrome and no history of b-lactam allergy who developed urticaria and swollen eyelids shortly after eating Salami Tipo Milano (Ticino, Switzerland), a generic supermarket brand of salami that he had not previously ingested. Second, a 10-year-old boy with peanut allergy, seasonal allergic rhinitis, atopic dermatitis, and sensitisation to HDM, and no history of b-lactam allergy developed retrosternal pain and the sensation of food blockage after eating Salametto Milano (Rapelli SA, Ticino, Switzerland). He had previously experienced similar feelings after eating raclette cheese. Both children tolerated the foods listed as ingredients in these salamis (including pork, beef, salt, skimmed milk powder, sugar, spices, pepper, garlic, ascorbic acid, sodium nitrite, potassium nitrite). In the first boy, skin prick tests with standard solutions (ALK-Abello, Horsholm, Denmark) to pork, milk, and wheat were negative. Prick-to-prick testing with the salami meat was negative, but testing with the skin of the salami was positive with a 5-mm wheal. After correspondence, the manufacturers stated that there was mold in the salami skin which they identified as Penicillium chrysogenum/notatum. Specific IgE to P chrysogenum/notatum was positive at 1.24 kU/L. Skin prick test and specific IgE were negative to HDMs and other molds. In the case of the second boy, an endoscopy showed eosinophilic esophagitis, with histology showing more than 15 eosinophils per high-powered field. Skin prick testing was negative to the foods listed as ingredients in the salami and Aspergillus. Prickto-prick testing was negative to salami meat, but positive to the skin of the salami with a 9-mm wheal. On investigation P chrysogenum/notatum was again present in the salami skin. Specific IgE results in this boy were P notatum IgE 12.7 kU/L, Dermatophagoides pteronyssinus 2.32 kU/L, Dermatophagoides farinae 3.02kU/L, Acarus siro 0.4kU/L, and Glycophagus domesticus |
| Document Type: | Article |
| Language: | English |
| ISSN: | 2213-2198 |
| DOI: | 10.1016/j.jaip.2012.10.002 |
| Access URL: | https://www.jaci-inpractice.org/article/S2213-2198(12)00017-7/fulltext https://core.ac.uk/display/60886328 https://www.sciencedirect.com/science/article/pii/S2213219812000177#! https://www.jaci-inpractice.org/article/S2213219812000177/pdf https://www.jaci-inpractice.org/article/S2213-2198(12)00017-7/pdf https://www.sciencedirect.com/science/article/pii/S2213219812000177 https://archive-ouverte.unige.ch/unige:35188 |
| Rights: | Elsevier TDM |
| Accession Number: | edsair.doi.dedup.....310e0b9ba18d4956fe3f4b0b11c6baeb |
| Database: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstract: | TO THE EDITOR: Patients can often present with perplexing allergies to processed foods that in other simpler component forms they can tolerate. In general, further investigation of the ingredients list to isolate the offending agent is necessary. Salamis and some washed rind cheeses (such as raclette cheese) have molds used in their skins and rinds for preservation or to add certain tastes and textures. It must not be forgotten that these molds can and do cause allergic reactions. Salami is a fermented, cured sausage. During the drying and curing phase the skin of the salami is often sprayed with a Penicillium species mold starter to promote flavor and to try to prevent harmful bacteria from multiplying. The type of mold used is different in various production regions (Illtud Llyr Dunsford [Charcutier Ltd], personal communication, June 26, 2012). Salami has also been found to contain house dust mites (HDMs) that can occasionally thrive during the curing process. We present a 5-year-old boy with atopic dermatitis, seasonal allergic rhinitis, and pollen-food syndrome and no history of b-lactam allergy who developed urticaria and swollen eyelids shortly after eating Salami Tipo Milano (Ticino, Switzerland), a generic supermarket brand of salami that he had not previously ingested. Second, a 10-year-old boy with peanut allergy, seasonal allergic rhinitis, atopic dermatitis, and sensitisation to HDM, and no history of b-lactam allergy developed retrosternal pain and the sensation of food blockage after eating Salametto Milano (Rapelli SA, Ticino, Switzerland). He had previously experienced similar feelings after eating raclette cheese. Both children tolerated the foods listed as ingredients in these salamis (including pork, beef, salt, skimmed milk powder, sugar, spices, pepper, garlic, ascorbic acid, sodium nitrite, potassium nitrite). In the first boy, skin prick tests with standard solutions (ALK-Abello, Horsholm, Denmark) to pork, milk, and wheat were negative. Prick-to-prick testing with the salami meat was negative, but testing with the skin of the salami was positive with a 5-mm wheal. After correspondence, the manufacturers stated that there was mold in the salami skin which they identified as Penicillium chrysogenum/notatum. Specific IgE to P chrysogenum/notatum was positive at 1.24 kU/L. Skin prick test and specific IgE were negative to HDMs and other molds. In the case of the second boy, an endoscopy showed eosinophilic esophagitis, with histology showing more than 15 eosinophils per high-powered field. Skin prick testing was negative to the foods listed as ingredients in the salami and Aspergillus. Prickto-prick testing was negative to salami meat, but positive to the skin of the salami with a 9-mm wheal. On investigation P chrysogenum/notatum was again present in the salami skin. Specific IgE results in this boy were P notatum IgE 12.7 kU/L, Dermatophagoides pteronyssinus 2.32 kU/L, Dermatophagoides farinae 3.02kU/L, Acarus siro 0.4kU/L, and Glycophagus domesticus |
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| ISSN: | 22132198 |
| DOI: | 10.1016/j.jaip.2012.10.002 |