A CASE OF CARRAGEENAN ALLERGY IN A PEDIATRIC PATIENT

Publication date: November 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 5, Supplement

Author(s): H. Kular, J. Dean, V. Cook

Introduction

Carrageenan is a common food additive obtained from Eucheuma, Chrondrus, and Gigartina species of seaweed. It is used in dairy, processed meat, sauces, pharmaceuticals and other food products as a thickener and stabilizer. It's soluble fiber properties are used to alter the consistency, appearance, and nutritional properties of food. Although it has been reported to cause adverse gastrointestinal effects, reports of IgE-mediated allergy appear limited to a case of anaphylaxis to carrageenan-containing barium enema. We present a unique case of carrageenan allergy in a pediatric patient.

Case Description

A 10-month-old male presented for assessment after developing lip angioedema immediately following ingestion of icing from a fruit cake. He had no associated urticaria, respiratory distress, hypotension, or gastrointestinal symptoms. He had a history of eczema, and was known to tolerate milk, egg, soy, peanuts, hazelnuts, and other cake icing without adverse reactions. Skin prick testing to the cake icing produced a positive wheal measuring 11 by 5 mm. Skin prick testing to cow's milk and melon contained in the cake was negative. A detailed ingredient list revealed carrageenan as an ingredient. Skin prick testing to carrageenan produced a positive wheal measuring 10 by 8 mm. Instructions regarding carrageenan avoidance were provided along with an epinephrine-auto-injector and anaphylaxis action plan.

Discussion

To our knowledge, this is the first reported case describing IgE-mediated reaction following carrageenan ingestion. Carrageenan continues to be a common food additive. This case highlights the importance of recognizing carrageenan as a potential cause of IgE-mediated reactions in unexplained food allergy presentations.

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