Sometimes You Need to Be Lucky – Ernst's Story
Since his birth, Ernst was exclusively breast-fed; he started weaning when he was five months old. At 7 months he had already eaten cooked codfish twice, without showing any clinical problem. One day, 2 h after the ingestion of 50 g of steamed sole, Ernst started to vomit repetitively, he became hypotonic, hyporeactive and shortly after he started to suffer from diarrhea. Five hours later the baby recovered completely. After some time, Ernst's aunt, who was a doctor, suggested his parents give him fish again and consequently Ernst ate a homogenized sole baby food. After 4 h symptoms arose again and they were even more serious compared to those previously reported. When the baby was ten months old his parents decided to try again, giving Ernst a sea bream homogenized baby food, and unfortunately the baby fell sick showing all the symptoms mentioned before except diarrhea. As the third attempt failed as well, Ernst's parents brought their child to an allergist. SPTs performed with the culprit food (sole and sea bream) were negative and FPIES was diagnosed without needing to perform any OFC. The allergist recommended that Ernst keep eating everything he ate before (he had already eaten milk, legumes, cereals and poultry, without any problems) except fish, molluscs and crustaceans. Nevertheless, the allergist pointed out that the chances were that the baby was not allergic to every sea creature. Therefore, it could be possible to perform other OFCs with molluscs and crustaceans, but also with codfish, swordfish and tuna, since there was a discrete possibility of passing him without any adverse reaction.
Expert Rev Clin Immunol. 2013;9(8):707-715. © 2013 Expert Reviews Ltd.