Unusual Lysozyme-induced anaphylaxis in an egg-allergic child

A nine-year-old egg allergic child developed anaphylaxis after ingesting the lysozyme-containing over-the-counter-drug Lysopaine®. He complained of a sore throat without fever or cough. His mother administered him one sublingual tablet of the over-the-counter drug Lysopaine®, containing 20 mg lysozyme hydrochloride. A few minutes after intake of the drug, he developed anaphylaxis and received 300 mg intramuscular epinephrine. HE was not exposed to other allergens. The responsibility of lysozyme was confirmed by positive skin prick tests for Lysopaïne® and the presence of specific IgE against lysozyme. When giving this treatment to her son, his mother had no idea that it could contain egg protein and she did not perceive lysozyme as an allergenic protein. However, the box mentioned the presence of lysozyme and also specified “contains lysozyme extracted from egg”. Lysozyme, a minor egg allergen, may induce anaphylaxis in egg-allergic patients. Lysozyme can be found in many commonly consumed industrial food and drug products and its labelling may be misleading. Our observation highlights the importance of properly educating allergic patients to recognize allergens, even minor ones.

The excess costs of childhood food allergy on Canadian families: a cross-sectional study

Background The impact of childhood food allergy on household costs has not been examined in Canada. The current study sought to examine differences in direct, indirect, and intangible costs among Canadian families with and without a food-allergic child. Methods Families with a child with a specialist-diagnosed food allergy (cases) were recruited from two tertiary pediatric allergy clinics in the Province of Manitoba, Canada, and matched, based on age and sex, to families without a food-allergic child (controls). Cost data for the two groups were collected via an adapted version of the Food Allergy Economic Questionnaire (FA-EcoQ). Consideration was given to income, defined as above vs. below the provincial annual median income. Results Results from 35 matched case/control pairs revealed that while total household costs did not significantly differ between cases and controls, food-allergic families did incur higher direct costs ($12,455.69 vs. $10,078.93, p = 0.02), which were largely attributed to spending on food. In contrast, cases reported lower, but not statistically significant, total indirect costs compared to controls ($10,038.76 vs. $12,294.12, p = 0.06). Families also perceived their food-allergic child as having poorer quality of life relative to their healthy peers. Lastly, stratification of the analyses by annual income revealed several differences between the higher and lower income groups. Conclusions Relative to families without a food-allergic child, food-allergic families incurred higher direct costs across a number of different areas.

Mothers of children with food allergies report poorer perceived life status which may be explained by limited career choices

Pediatric food allergy is associated with direct, indirect and intangible costs. However, it remains unclear if intangible costs of pediatric food allergy influence parental career choices. Using data from 63 parents whose children had been diagnosed by a pediatric allergist with food allergy, we sought to (a) establish perceived life status of families with a food allergic child, and (b) to describe any career limitations viewed as attributable to food allergy. Compared to responding parents whose children had one to two food allergies, those with three or more food allergies had significantly poorer perceived life status (ß − 0.74; 95%CI − 1.41; − 0.07; p < 0.05). Overall, 14.3% of parents (all mothers) reported career limitations due to food allergy. Two of the 7 mothers (28.6%) who reported career limitations due to their child's food allergy fell below Statistics Canada cut-off for low-income, after tax dollars (LIM-AT). One of the three mothers who had changed jobs because of their child's food allergy was below the LIM-AT. No fathers reported food allergy-related career limitations. In conclusion, mothers of children with multiple food allergies reported worse perceived life status that may be partly explained by food allergy-related career limitations.