Severe reaction in a child with asymptomatic codfish allergy
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Recurrent pancreatitis is characterized by a progressive loss of endocrine and exocrine function. In children pancreatic insufficiency generally develop after several years. Pancreatic damage activated by a food allergy is described only in 7 published reports.
Here we describe the case of a child who presented an anaphylactic reaction and reactivation of pancreatitis related to the second intake of codfish after specific challenge. This case underscores the possible relation of an elimination diet, started early in life with severe anaphylactic reaction and reactivation of a chronic disease. We would alert pediatricians to the risk of food challenge test in a child with a chronic disease in remission.

Case report
An 8-year-old child came to our Pediatric Allergy Unit to evaluate his cow’s milk (CM) and fish allergy. During the first year of life he manifested severe atopic dermatitis and chronic diarrhea with mucorrhea and rectal bleeding and for this reason he began a CM-free diet.
The association of diarrhea with atopic dermatitis led to the exclusion from diet of foods frequently considered responsible for allergic hypersensitivity (egg, wheat, tomato and peanuts), even though skin-prick tests (SPTs) were negative, and to eliminate fish, that yielded a weakly positive response to extract from codfish. No clinical improvement was observed. At 4?years of age because of persisting anemia and chronic diarrhea, he was treated with mesalazine. Immediately he developed abdominal pain with raised serum amylase and lipase levels. Pancreatitis was diagnosed and two additional episodes occurred while off therapy.....