Fatal anaphylaxis due to peanut exposure from oral intercourse.

Autor: McKibbin LR; Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada., Siu SK; Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada., Roberts HT; Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada., Shkrum M; Department of Pathology and Laboratory Medicine, University Hospital and Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Jeimy S; Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. jeimysb@gmail.com.
Jazyk: angličtina
Zdroj: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology [Allergy Asthma Clin Immunol] 2021 Oct 18; Vol. 17 (1), pp. 110. Date of Electronic Publication: 2021 Oct 18.
DOI: 10.1186/s13223-021-00611-9
Abstrakt: Background: Intimacy-related allergic reactions, including anaphylaxis, are under-reported due to social stigma, lack of awareness, and misdiagnosis. The differential diagnosis for intimacy-related anaphylaxis is extensive and includes systemic human seminal plasma allergy, exercise-induced anaphylaxis, asthma exacerbation, latex allergy, and transference of food or drug allergens through saliva or seminal fluid.
Case Presentation: Two adolescents met on a popular dating phone application. One individual had a long-standing history of asthma and peanut allergy. Although they never kissed, the male with peanut allergy received fellatio, while the other male had eaten peanut butter before they met. During fellatio, the peanut allergic male developed respiratory symptoms, used his bronchodilator, and collapsed. He remained unconscious despite aggressive interventions by emergency personnel called to the site. The clinical history and autopsy results suggested anaphylaxis to peanut allergen exposure from the intimate exposure as the cause of death.
Discussion and Conclusions: To date, nearly all reported cases of intimacy-related anaphylaxis involve symptomatic women. This is the first report of intimacy-related anaphylaxis involving men who have sex with men and the first report of potential allergen transfer from oral mucosa to a patient receiving fellatio. Based on the paucity of published cases, death from intimacy-related anaphylaxis is exceedingly rare. Post-mortem analysis is inherently difficult, as an elevated tryptase level has myriad potential causes; nevertheless, the authors suggest that intimacy-related anaphylaxis due to peanut allergy is the most likely diagnosis. With increasing popularity of relationship applications, especially amongst stigmatized populations, this case highlights the importance of allergy awareness and patient education to decrease risk, particularly in the adolescent population, who are already at increased risk of severe anaphylaxis. Especially amongst those participating in intimate activities, disclosure of one's allergies warrants discussion, as the outcome can be fatal. Our case demonstrates the crucial need for increased advocacy in food allergy, education around intimacy-related anaphylaxis, and the importance of allergy awareness and prevention across all populations.
(© 2021. The Author(s).)
Databáze: MEDLINE
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