Asia Pac Allergy.  2018 Apr;8(2):e13. 10.5415/apallergy.2018.8.e13.

An unusual case of infant seizures with anaphylaxis to wheat

• Chong KW
• Ling S
• Loh W

• KMID: 2410221
• DOI: http://doi.org/10.5415/apallergy.2018.8.e13

Abstract

Wheat allergy is one of the commonest food allergies in childhood and it typically presents with IgE mediated reactions, including anaphylaxis. Seizures are not typically reported to be a direct manifestation of anaphylaxis, though it can occur secondary to hypoxia following significant haemodynamic compromise. We describe a case of a previously well infant, who presented with anaphylactic shock to wheat and responded well to the initial management, but subsequently developed a cluster of brief generalised tonic clonic seizures without any ongoing haemodynamic instability. The tryptase level that was performed at 4-5 hours post reaction was raised at 49.1 µg/L. Skin prick test to wheat, wheat specific IgE, the omega-5 gliadin IgE were positive. Extensive work-up was performed to look for an underlying cause of seizures and all returned negative. To our knowledge, this is the first case report describing an unusual presentation of multiple seizures in a young infant, in association with an anaphylactic episode. In the absence of any other seizure provoking factor and underlying cause, we believe the association is more likely causative than coincidental.

Keyword

Anaphylaxis; Wheat hypersensitivity; Seizure; Child

MeSH Terms

Anaphylaxis*
Anoxia
Child
Food Hypersensitivity
Gliadin
Humans
Immunoglobulin E
Infant*
Seizures*
Skin
Triticum*
Tryptases
Wheat Hypersensitivity
Gliadin
Immunoglobulin E
Tryptases