Two cases of transplant-acquired food allergy who developed resensitization after a negative oral food challenge

Akiko Nakaoka; Takayasu Nomura; Kazuyoshi Ozeki; Tomotaka Suzuki; Shigeru Kusumoto; Shinsuke Iida; Shinji Saitoh

doi:10.1186/s13223-023-00784-5

Two cases of transplant-acquired food allergy who developed resensitization after a negative oral food challenge

Allergy Asthma Clin Immunol. 2023 Mar 22;19(1):24. doi: 10.1186/s13223-023-00784-5.

Authors

Akiko Nakaoka¹, Takayasu Nomura², Kazuyoshi Ozeki¹, Tomotaka Suzuki³, Shigeru Kusumoto³, Shinsuke Iida³, Shinji Saitoh¹

Affiliations

¹ Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
² Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan. tnomura@med.nagoya-cu.ac.jp.
³ Department of Hematology and Oncology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.

Abstract

Background: Cases of food allergy after hematopoietic stem cell and solid organ transplantation in previously nonallergic transplant recipients were reported as transplant-acquired food allergy (TAFA), but information about its long-term outcome is still limited. A phenomenon where patients reacquire food allergy by resuming daily consumption after a negative oral food challenge has not yet been reported.

Case presentation: We report two cases of TAFA after liver transplantation and cord blood transplantation. In each case, the threshold of daily consumption to cause allergic symptoms decreased when a negative oral food challenge was obtained.

Conclusions: Our cases show an importance of gastrointestinal tract as a route of food sensitization because thresholds that caused allergic reactions decreased during their resuming process. We need to be careful with possible resensitization once a negative substantial dose was confirmed.

Keywords: Cord blood transplantation; Liver transplantation; Oral food challenge; Resensitization; Transplant-acquired food allergy.