Food Protein-induced Enterocolitis Syndrome Due to Cuttlefish in a Child  with Anaphylaxis to Crustaceans

Simona Barni; Marta  Vazquez-Ortiz; Mattia Giovannini; Giulia  Liccioli; Lucrezia Sarti; Giulia Lascialfari; Laura Pisano; Silvia Boscia; Francesca Mori

doi:10.18502/ijaai.v22i2.12682

Simona Barni Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Marta Vazquez-Ortiz National Heart & Lung Institute, Imperial College London, London, United Kingdom
Mattia Giovannini Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Giulia Liccioli Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Lucrezia Sarti Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Giulia Lascialfari Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Laura Pisano Immunology and Molecular Microbiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Silvia Boscia Immunology and Molecular Microbiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Francesca Mori Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

DOI: https://doi.org/10.18502/ijaai.v22i2.12682

Keywords: Anaphylaxis; Cuttlefish; Enterocolitis; Pediatrics; Shellfish

Abstract

Shellfish is defined as any edible marine invertebrate and refers to crustaceans and mollusks. Crustaceans belong to the phylum Arthropods. Mollusks belong to the phylum Mollusca.

This report illustrates a rare case of a 6-year-old girl with challenge-proven acute food protein–induced enterocolitis syndrome (FPIES) to cuttlefish (phylum Mollusca, class Cephalopoda), anaphylaxis to crustaceans (phylum Arthropoda), and tolerance to other mollusks, including clams and mussels (phylum Mollusca, class Bivalvia). The association of IgE-mediated food allergy and acute FPIES seen in this case is rare.

To our knowledge, this is the first case of FPIES to cuttlefish reported in a child.

This challenge highlights the need for further research into the allergens and mechanisms underpinning FPIES at a molecular level, enabling a better understanding of cross-reactivity patterns and the development of diagnostic and predictive tests to assist in clinical practice