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Oral provocation test with banana: a rare cause of anaphylaxis in a four year old child

Mehmet Semih Demirtaş, Erdem Topal, Ferhat Çatal.

Abstract
Objective: Food allergy is the most common cause of anaphylaxis in children and recent studies suggest that the prevalence of food allergies has increased. Among foods, fruits are rarely the cause of anaphylaxis. Although banana allergy has been identified among the causes anaphylaxis in adults, the incidence of banana anaphylaxis reported in children is very rare. In this case report a patient who developed anaphylaxis after banana ingestion was discussed.
Case: A 4-year-old boy male patient admitted with widespread itching, swelling of the eyelids, urticarial rash in body following exposure to banana. In oral provocation test performed in order to confirm the diagnosis made with banana, urticarial papules were detected. Urticaria, swelling of the eyelids and wheezing complaints occured in the body in 10 minutes after banana was given. Bilateral rhonchus was presented in auscultation and the blood pressure of the patient measured was normal. The patient was diagnosed with anaphylaxis and 0.01 mg / kg IM epinephrine nebulizer with short-acting beta 2 agonists and antihistaminic treatment were given. The patient who recovered during follow-up was discharged with antihistaminics and 3-day oral methylprednisolone therapy. Recommendations were made to patient and adrenaline auto-injector was prescribed and its use was described.
Conclusion: Although rare, children may develop anaphylaxis with bananas. Therefore, oral provocations for diagnostic purposes should be performed by experienced centers and necessary precautions should be taken against the reactions that may occur.

Key words: Bronchial provocation tests, banana, receptors, leukotriene



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