Japanese Journal of Allergology最新文献

The case is a 12-year-old girl. She was diagnosed with cashew nut allergy in infancy. She experienced the following allergic symptoms at age 11: sore throat after ingesting gummy bears containing citrus-derived pectin; sore throat, nausea, and severe abdominal pain after ingesting jelly containing yuzu (citrus junos) seeds and peel.Prick to prick test was positive for yuzu seeds and endocarp, lemon seeds, and citrus/apple pectin powder, and basophil activation test was positive for citrus/apple pectin powder. In both oral food challenge tests (OFCs) with jelly containing whole citron and lemon seeds, she had severe abdominal pain and vomiting. In OFC with citrus-derived pectin powder, she had mild sore throat. She ingested apple-derived pectin gummi at home and was asymptomatic.She was diagnosed with cashew nut-associated citrus seed allergy, most likely an allergy to citrin, based on her history and test. Patients with suspected pectin allergy should also be closely examined for citrus seeds.

In cases of moderate to severe atopic dermatitis that does not respond to topical therapy, temporary systemic administration of molecular targeted drugs (biological agents or oral Janus kinase[JAK]inhibitors) may be necessary. However, topical therapy forms the basis of the treatment for atopic dermatitis, and if topical therapy is appropriately established with long-term remission achieved, the use of molecular targeted drugs can be discontinued. In these two cases of severe adolescent atopic dermatitis, successful initiation of remission was achieved through hospitalization, disease education, skincare guidance, and the combined use of appropriate topical therapy and short-term oral JAK inhibitors during the remission induction phase. Subsequently, maintenance of remission was possible with proactive topical therapy alone. As there are many cases where molecular targeted drugs cannot be discontinued, presenting cases where oral JAK inhibitors were successfully discontinued emphasizes the avoidance of indiscriminate long-term use of molecular targeted drugs. This highlights the significance of topical therapy for atopic dermatitis and the importance of avoiding the careless use of molecular targeted drugs, and supporting the transition to adulthood.

Gibberellin-regulated protein (GRP) is a newly discovered allergen in systemic fruit allergies. The kind of fruits which cause allergy is extensive as GRP is universally included in plants. Two children with GRP allergy were reported. Case 1: A 6-year-old boy experienced anaphylaxis while running after school lunch, which included canned peaches. A skin prick test (SPT) and blood examination suggested that he had peach GRP allergy. Six months and three years later, he experienced a similar episode after eating apple and citrus flesh, respectively. Case 2: An 11-year-old boy experienced anaphylaxis while running after consuming canned peaches during school lunch. A SPT implied that he had peach GRP allergy. However, a similar episode occurred after eating strawberry flesh 18 months later.Patients with GRP allergy often have one or more allergies to fruits other than peaches, as in these cases, and relevant fruits differ depending on the case. Particularly, clinicians should recognize that apple and citrus fruits are frequently included in school lunches as fruit flesh and as flavoring or seasoning in ready-made sauces or dressings. Therefore, an appropriate removal strategy should be considered in school lunches depending on each case of GRP allergy.

Herein, we report the case of a 7-year-old girl with a history of atopic dermatitis because of infancy. Her grandfather grew Egoma (Perilla frutescens), and her family frequently consumed food items prepared using Egoma; however, she never consumed them because she did not enjoy these food items; she experienced vomiting, facial swelling, and oral discomfort upon ingesting Egoma during school lunch for the first time. Her food oral challenge test was positive, as well as a skin-prick test with sesame powder. Egoma antigen protein was extracted and reacted with patient serum by immunoblotting, which detected a positive band of approximately 26kDa. She was brought up in an environment with high exposure to Egoma; hence, she most likely developed an allergy to Egoma because of percutaneous sensitization. This is the first time an Egoma allergen analysis has been conducted in Japan, and we consider it to be a valuable case.