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Case report
Anaphylaxis to goat/sheep’s milk in a 4-year-old boy tolerant to cow’s milk
  1. Pasquale Mulé1,
  2. Sofianne Gabrielli1,
  3. Julia Upton2,
  4. Abrams EM3,4 and
  5. Moshe Ben-Shoshan1
  1. 1Department of Pediatrics, Division of Allergy, Immunology and Dermatology, Montreal Children's Hospital, Montreal, Québec, Canada
  2. 2Department of Pediatrics, Division of Immunology and Allergy, Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
  4. 4Department of Pediatrics, Division of Allergy and Immunology, The University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Pasquale Mulé; pasquale.mule2{at}mail.mcgill.ca

Abstract

Immune-mediated reactions to dairy products may vary depending on the mammalian source. We present a case of anaphylaxis to goat/sheep's milk with tolerance to cow’s milk. A 4-year-old boy of Eastern European descent presented with gastrointestinal and respiratory symptoms within minutes after eating a goat/sheep’s milk-derived food product. The tryptase level measured 1 hour post initial symptoms and 1 month after the allergic reaction were 14.6 µg/L and 5.1 µg/L, respectively (norm: 0.0–13.5 µg/L), confirming the diagnosis of anaphylaxis. A skin prick test performed 1 month after the reaction was highly positive for goat/sheep’s milk, but negative for cow’s milk. Skin prick tests may establish a life-threatening goat/sheep’s milk allergy. Goat/sheep’s milk allergy should always be considered in cow’s milk-tolerant patients who present with an allergic reaction to dairy products, or when undergoing/have completed of oral immunotherapy for cow’s milk allergy.

  • immunology
  • allergy, asthma
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Footnotes

  • Contributors PM: conception and design, analysis and interpretation of data, drafting the article, final approval of the version published. SG, JU and AEM: conception and design, analysis and interpretation of data, revising the article critically for important intellectual content, final approval of the version published. MB-S: planning, conception and design, acquisition of data, analysis and interpretation of data, revising the article critically for important intellectual content, final approval of the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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