Post-transplant food anaphylaxis in an adult cord blood transplant recipient (Ms. No. IJHM-D-20-01037R1)

Abstract

Transplant acquired food allergy (TAFA) is a well-known complication following pediatric liver transplantation, but post-cord blood transplantation (post-CBT) TAFA has rarely been reported. Here, we describe a case of new-onset food anaphylaxis after CBT in an adult patient that demonstrates that post-CBT allergen-challenge is not a risk for long-term allergic sensitization even in adult recipients. The patient was a 39-year-old Japanese man with aggressive NK cell leukemia. He had no previous history of allergies. After receiving CBT, the patient had an unbalanced diet with high preference for bread, bananas, miso-soup, cow’s milk, cheese, egg, sesame and buckwheat soba noodles, and experienced repeated diarrhea. Six months later, he developed symptoms such as vomiting, epigastric pain, diarrhea, high fever and hypotension. The condition was initially diagnosed as enterocolitis, but symptoms recurred after consumption of buckwheat. Anaphylaxis induced by buckwheat was confirmed with serum radioallergosorbent tests (RAST), showing allergen-specific IgE for buckwheat (greater than 100 U/mL, Class 6) and egg ovomucoid (Class 4). Nineteen months after a buckwheat and egg-free diet, serum RAST for buckwheat and egg significantly improved. As a result, the patient acquired a tolerance and was able to consume buckwheat and egg without allergic symptoms.

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Acknowledgments

The authors would like to thank the patient and the members of Hematology of University of Occupational and Environmental Health for their cooperation.

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AK: designed the study, collected and analyzed the data, and was the first writer of the paper. TN, KA, MG and TK: collected, analyzed the data and helped AK to write the paper. JT: designed the study, collected and analyzed the data, wrote the paper, and supervised all the process. All authors have reviewed and approved the manuscript.

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Correspondence to Junichi Tsukada.

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The authors have no conflicts of interest to declare. This study received no funding from public, private, or not‐for‐profit sectors.

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Written informed consent was obtained from the patient for the publication of this case report.

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Kawahara, A., Nakanishi, T., Goto, M. et al. Post-transplant food anaphylaxis in an adult cord blood transplant recipient (Ms. No. IJHM-D-20-01037R1). Int J Hematol (2021). https://doi.org/10.1007/s12185-021-03140-8

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Keywords

  • Food allergy
  • Anaphylaxis
  • Cord blood transplantation