Eleven cases of omeprazole hypersensitivity: diagnosis and study of cross-reactivity

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Fixed drug eruption due to ibuprofen with patch test positive on the residual lesion

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Selective allergy to sheep's and goat's milk proteins.

BACKGROUND: Cow's milk proteins are amongst the most common causes of food allergy in infants, and caseins are probably the main allergens. The existence of a high degree of cross-reactivity between milk caseins from different animals has been reported. We describe a 2-year-old boy who experienced allergic reactions after eating and touching sheep's cheese, but who tolerated cow's milk and cow's milk dairy products. He had never ingested milk or milk derivatives from sheep or goat. METHODS: Skin prick tests were carried out using whey fractions of cow's milk, whole milk and casein from goat, sheep and cow. We also performed skin prick tests with enzymes used in cheese production. Prick-by-prick tests with cheese made from cow, sheep and goat and their corresponding whole milk were also performed. Total serum IgE and specific IgE to cow's milk proteins, whole cow's milk and sheep's milk were determined. Specific IgE against casein and whole milk from the three different species were determined by ELISA. Inhibition of IgE binding to bovine casein was tested for casein and whole milk from all three species. The proteins of three types of casein and whole milk from cow, sheep and goat were separated by SDS-PAGE and were incubated with the patient's serum. RESULTS: Skin tests were positive to sheep's milk and goat and sheep casein and were negative to all cow's milk proteins and whole cow's and goat's milk. Prick-by-prick tests were positive to goat's and sheep's cheese and were negative to cow's cheese. In ELISA-inhibition, sheep's milk and goat and sheep casein were able to inhibit > 50 % of specific IgE binding to sheep casein. The results of immunoblotting showed that the patient's circulating IgEs recognized only one band in the lanes corresponding to sheep and goat casein. CONCLUSIONS: We report a patient with allergy to sheep's and goat's milk proteins but not to cow's milk proteins. Sheep casein was probably the main allergen causing sensitization in this patient. The results suggest that sheep casein shows a high degree of cross-reactivity with goat casein but not with cow casein. Our patient presented allergic symptoms caused by sheep and goat milk and cheese proteins. However, he was able to tolerate cow's milk and cow's milk dairy products without any ill effects.

Selective allergy to sheep's and goat's milk proteins

Background: Cow's milk proteins are amongst the most common causes of food allergy in infants, and caseins are probably the main allergens. The existence of a high degree of cross-reactivity between milk caseins from different animals has been reported. We describe a 2-year-old boy who experienced allergic reactions after eating and touching sheep's cheese, but who tolerated cow's milk and cow's milk dairy products. He had never ingested milk or milk derivatives from sheep or goat. Methods: Skin prick tests were carried out using whey fractions of cow's milk, whole milk and casein from goat, sheep and cow. We also performed skin prick tests with enzymes used in cheese production. Prick-by-prick tests with cheese made from cow, sheep and goat and their corresponding whole milk were also performed. Total serum IgE and specific IgE to cow's milk proteins, whole cow's milk and sheep's milk were determined. Specific IgE against casein and whole milk from the three different species were determined by ELISA. Inhibition of IgE binding to bovine casein was tested for casein and whole milk from all three species. The proteins of three types of casein and whole milk from cow, sheep and goat were separated by SDS-PAGE and were incubated with the patient's serum. Results: Skin tests were positive to sheep's milk and goat and sheep casein and were negative to all cow's milk proteins and whole cow's and goat's milk. Prick-by-prick tests were positive to goat's and sheep's cheese and were negative to cow's cheese. In ELISA-inhibition, sheep's milk and goat and sheep casein were able to inhibit > 50 % of specific IgE binding to sheep casein. The results of immunoblotting showed that the patient's circulating IgEs recognized only one band in the lanes corresponding to sheep and goat casein. Conclusions: We report a patient with allergy to sheep's and goat's milk proteins but not to cow's milk proteins. Sheep casein was probably the main allergen causing sensitization in this patient. The results suggest that sheep casein shows a high degree of cross-reactivity with goat casein but not with cow casein. Our patient presented allergic symptoms caused by sheep and goat milk and cheese proteins. However, he was able to tolerate cow's milk and cow's milk dairy products without any ill effects (AU)

Introducción: La alergia a proteínas de la leche de vaca es una de las causas más frecuentes de alergia alimentaria en la infancia y las caseínas son probablemente los principales alergenos implicados. Ya ha sido descrita con anterioridad la existencia de alto grado de reactividad cruzada entre las caseínas de distintos animales. Describimos un niño de 2 años que presentó reacciones alérgicas tras la ingesta y el contacto con queso de oveja, pero que toleraba el consumo de leche de vaca y derivados. Nunca había tomado previamente leche o derivados de oveja o cabra. Métodos: Se realizaron tests cutáneos mediante prick con leche y caseína de vaca, oveja y cabra así como con las fracciones de la leche de vaca. También se realizaron tests cutáneos con enzimas empleadas en la elaboración de queso. Se llevaron a cabo prickprick con leche entera y queso de vaca, oveja y cabra.Se determinó IgE total y específica frente a leche de vaca y sus fracciones y leche de oveja. También se determinó mediante ELISA la IgE específica frente a caseina y leche entera de las tres especies. Asimismo se calculó mediante ELISA-inhibición el porcentaje de inhibición de la caseína bovina frente a caseína y leche entera de las tres especies. Se separaron las proteínas de la leche y caseína de vaca, oveja y cabra mediante SDS-PAGE y posteriormente fueron incubadas con el suero del paciente. Resultados: Los tests cutáneos resultaron positivos frente a leche de oveja y caseína de oveja y cabra, y negativos frente a las proteínas séricas de vaca, así como frente a leche entera de vaca y cabra. Los prick-prick fueron positivos frente a queso de oveja y cabra, siendo negativos frente a queso de vaca. En el ELISA-inhibición, la leche de oveja y la caseína de oveja y cabra fueron capaces de inhibir más del 50 por ciento de los sitios de unión de la IgE a la caseína de oveja. Los resultados del immunoblot mostraron que los anticuerpos IgE del paciente reconocían solo una banda en las calles correspondientes a las caseínas de oveja y cabra. Conclusiones: Presentamos un paciente con alergia a proteínas de la leche de oveja y cabra pero no a las proteínas de la leche de vaca. La caseína de la oveja es probablemente el principal alergeno causante de la sensibilización de este sujeto. Los resultados sugieren que la caseína de oveja muestra un elevado grado de reactividad cruzada con la caseína de cabra, pero no con la de vaca. Nuestro paciente presentaba síntomas alérgicos causados por la exposición frente a las proteínas de la leche y queso de oveja y cabra, pero es capaz de tolerar el consumo de leche y derivados de vaca sin ningún efecto adverso (AU)