Anaphylaxis to mint in a 5 year old boy: a case report. Journal Article

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Authors: Middelberg, L. K.; Rabbat, J. C.
Article Title: Anaphylaxis to mint in a 5 year old boy: a case report.
Abstract: RATIONALE: Mint is derived from the aromatic plant Mentha spicata; together with oregano, rosemary, basil and thyme, it is a member of the Lamiaceaefamily. Allergic contact dermatitis to mint is well described. We report the first case of delayed IgE-mediated anaphylaxis to mint in a pediatric patient. METHODS: A 5 year-old boy with a history of asthma presented with multiple adverse food reactions. His first reaction was at age 4; several hours after swallowing a few pieces of mint gum he awoke with 5 episodes of emesis and an erythematous rash to arms and legs. Several hours after chewing mint gum he vomited multiple times. Several hours after eating a chocolate mint he vomited. In contrast to these delayed reactions, the child had immediate reactions of repeated vomiting 30-45 minutes after using mint toothpaste. Subsequent reactions to mint involved repeated emesis, erythematous rash to arms and legs, and diarrhea. RESULTS: Skin prick testing (SPT) was performed to fresh leaves of mint, oregano, rosemary, basil, and thyme; peppermint gum; aeroallergens; milk; egg; wheat; soy; and peanut. Five controls had SPT to fresh mint leaf for comparison. The patient had a positive SPT to fresh mint leaves and to standardized dust mite mix. No control subjects reacted to fresh mint. Serum specific IgE to mint, sage, basil, oregano and thyme were undetectable. The patient was advised to strictly avoid mint; an allergy action plan and epinephrine autoinjector were provided. CONCLUSIONS: We report the first case of delayed IgE-mediated anaphylaxis to mint in a pediatric patient.
Journal Title: Journal of allergy and clinical immunology
Volume: 135
Issue: Supplement 2
Publisher: Unknown  
Date Published: 2015
Start Page: AB200