Abstract
IntroductionFood allergy is the most common cause of anaphylaxis in children and recent studies suggest increased prevalence of both food allergy and anaphylaxis. Among foods, fruits are rarely implicated as the cause of anaphylaxis. Furthermore, anaphylaxis to fruit in the first months of life is rare. Although banana allergy has been well described in adults, there are only two case reports of anaphylaxis to banana in children.Case presentationA 4-month-old Hispanic baby boy with a history of eczema presented to our emergency room with vomiting, urticaria and cyanosis following first exposure to a banana. He improved with administration of intramuscular epinephrine. Skin prick tests showed positive results for both fresh banana (4mm wheal/15mm erythema) and banana extract (8mm wheal/20mm erythema).ConclusionsBanana is not considered a highly allergenic food. However, as food allergy becomes more common and solid foods are being introduced earlier in babies, banana may become an important allergen to consider in cases of babies presenting with anaphylaxis.
Highlights
Food allergy is the most common cause of anaphylaxis in children and recent studies suggest increased prevalence of both food allergy and anaphylaxis
Case presentation: A 4-month-old Hispanic baby boy with a history of eczema presented to our emergency room with vomiting, urticaria and cyanosis following first exposure to a banana
As food allergy becomes more common and solid foods are being introduced earlier in babies, banana may become an important allergen to consider in cases of babies presenting with anaphylaxis
Summary
Food allergy is the most common cause of anaphylaxis in children, with the usual foods implicated being: peanut, tree nuts, shellfish and milk [1]. Case presentation A 4-month-old Hispanic baby boy with a history of eczema presented to our emergency room with vomiting, urticaria and cyanosis within 5 minutes of eating banana. This was his first known exposure to banana. During a 6-hour observation period following the administration of epinephrine and was discharged home with a prescription for injectable epinephrine and out-patient consultation to an allergist (Figure 1) He had a follow-up visit in the allergy clinic 6 months after his initial reaction. He had a positive skin test to banana extract with an 8mm wheal and 20mm of erythema. He continues to avoid banana in his diet and has had no further reactions
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