PMID- 33985563
OWN - NLM
STAT- MEDLINE
DCOM- 20210517
LR  - 20210518
IS  - 1752-1947 (Electronic)
IS  - 1752-1947 (Linking)
VI  - 15
IP  - 1
DP  - 2021 May 14
TI  - Anaphylaxis caused by artisanal honey in a child: a case report.
PG  - 235
LID - 10.1186/s13256-021-02823-4 [doi]
LID - 235
AB  - BACKGROUND: Honey is a rare cause of food allergy, especially in children, but it 
      can cause severe systemic allergic reactions. In the pediatric age group, only a 
      few cases have been reported in the literature. Honey allergy may be caused by 
      pollen content or bee-derived proteins. A role for Compositae has been suggested 
      among pollen allergens. Allergology workup of a patient with suspected honey 
      allergy is not well defined. Here we describe a rare case of anaphylaxis in a 
      5-year-old boy, sensitized to Compositae pollen (ragweed and mugwort), after the 
      ingestion of artisanal honey. CASE PRESENTATION: The Slavic patient was referred 
      to our hospital emergency department for generalized urticaria and breathing 
      impairment. All the symptoms occurred approximately 30 minutes after the 
      ingestion of a meal containing salmon and artisanal honey. The allergology workup 
      revealed that a skin prick-by-prick test with the implicated artisanal honey was 
      positive, while a variety of different commercial honey and salmon products 
      yielded negative results. Skin prick test and serum-specific immunoglobulin E 
      (IgE) results were also positive for Compositae pollen (ragweed and mugwort). 
      Patients sensitized to weed pollens who ingest bee products may experience an 
      immediate allergic reaction because of the cross-reaction between weed pollens 
      and Compositae bee product pollen. In this case, primary sensitization may be due 
      to airborne Compositae pollen. Commercial honey is heavily processed due to 
      pasteurization and filtration, which removes most of the pollen. These 
      observations highlight the role of Compositae pollen in the observed allergic 
      reaction and suggest that the different pollen content in the artisanal honey 
      relative to commercial honey was responsible for the allergic reaction in our 
      patient. CONCLUSIONS: This is the first reported pediatric case of honey-induced 
      anaphylaxis in a child under 6 years of age sensitized to Compositae pollen. 
      Pediatricians should be aware of the potential risk of severe allergic reactions 
      upon ingestion of honey and bee products, especially in patients sensitized to 
      weed pollens. To diagnose honey allergy, obtaining a proper clinical history is 
      essential. In addition, skin prick-by-prick tests are helpful, and may represent 
      a simple method to screen for honey allergy in patients sensitized to Compositae 
      pollen, in light of the potential risk.
FAU - Di Costanzo, Margherita
AU  - Di Costanzo M
AD  - Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, 
      Piacenza, Italy. M.DiCostanzo@ausl.pc.it.
AD  - Department of Translational Medical Science - Pediatric Section, University 
      "Federico II", Naples, Italy. M.DiCostanzo@ausl.pc.it.
FAU - De Paulis, Nicoletta
AU  - De Paulis N
AD  - Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, 
      Piacenza, Italy.
FAU - Peveri, Silvia
AU  - Peveri S
AD  - Department of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy.
FAU - Montagni, Marcello
AU  - Montagni M
AD  - Department of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy.
FAU - Berni Canani, Roberto
AU  - Berni Canani R
AD  - Department of Translational Medical Science - Pediatric Section, University 
      "Federico II", Naples, Italy.
AD  - ImmunoNutritionLab - CEINGE Advanced Biotechnologies, University "Federico II", 
      Naples, Italy.
AD  - Task Force on Microbiome Studies, University of Naples "Federico II", Naples, 
      Italy.
AD  - European Laboratory for the Investigation of Food-Induced Diseases, University of 
      Naples "Federico II", Naples, Italy.
FAU - Biasucci, Giacomo
AU  - Biasucci G
AD  - Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, 
      Piacenza, Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210514
PL  - England
TA  - J Med Case Rep
JT  - Journal of medical case reports
JID - 101293382
RN  - 0 (Allergens)
SB  - IM
MH  - Allergens/adverse effects
MH  - *Anaphylaxis/chemically induced/diagnosis
MH  - Animals
MH  - Bees
MH  - Child
MH  - *Food Hypersensitivity/diagnosis
MH  - *Honey
MH  - Humans
MH  - Pollen
MH  - Skin Tests
PMC - PMC8120922
OTO - NOTNLM
OT  - Anaphylaxis
OT  - Case report
OT  - Compositae pollen
OT  - Food allergy
OT  - Honey
COIS- The authors declare that they have no competing interests.
EDAT- 2021/05/15 06:00
MHDA- 2021/05/18 06:00
PMCR- 2021/05/14
CRDT- 2021/05/14 05:41
PHST- 2020/03/26 00:00 [received]
PHST- 2021/03/24 00:00 [accepted]
PHST- 2021/05/14 05:41 [entrez]
PHST- 2021/05/15 06:00 [pubmed]
PHST- 2021/05/18 06:00 [medline]
PHST- 2021/05/14 00:00 [pmc-release]
AID - 10.1186/s13256-021-02823-4 [pii]
AID - 2823 [pii]
AID - 10.1186/s13256-021-02823-4 [doi]
PST - epublish
SO  - J Med Case Rep. 2021 May 14;15(1):235. doi: 10.1186/s13256-021-02823-4.