A Girl with Food Allergy had a History of Anaphylaxis in which Total and Specific IgE Decreased below the Detection Threshold

Abstract

We present a case of a girl with food allergies whose total IgE and food- and environmental-antigen-specific IgE levels declined below the detection threshold over time and who finally achieved food allergy remission despite a history of anaphylaxis.

During infancy, she experienced allergic symptoms due to ingestion of wheat, milk, and chicken eggs. At the age of 3, she consumed 8 g of udon noodles during an oral food challenge test and developed an anaphylactic shock. At the age of 4, her maximum level of total IgE was 495 IU/mL, wheat-specific IgE was 55.8 UA/mL, and Dermatophagoides farinae (Der f) specific IgE was >100 UA/mL. However, by the age of 5, her levels of total and specific IgE tended to decrease, and at the age of 6, her total IgE and food- and environmental-antigen-specific IgE levels decreased below the detection threshold. Subsequently, she was able to ingest wheat, milk, and chicken eggs without any symptoms. Of the 50 outpatients with milk-specific IgE and milk allergy who were followed up, 13 patients with Der f-specific IgE were followed up and evaluated. No patient exhibited a decrease in Der f-specific IgE levels below the detection threshold.

It is expected that elucidating the mechanism of IgE level-negative conversion in such patients will lead to the development of new treatment methods.