A boy with an episode of anaphylaxis to dairy products at 7 months of age was started on an elimination diet for eggs, milk, wheat, and peanuts. He inadvertently ingested a wheat-containing sakura rice cake at his nursery school at the age of 19 months and developed his second episode of anaphylaxis. At the age of 25 months, he ate French fried potatoes containing wheat at a fast food restaurant, and developed a third episode of anaphylaxis. At the age of 29 months, he ingested nuts that his mother had at home and developed a fourth episode. He developed a fifth episode at age 45 months when he ate boiled barley and rice served at kindergarten. After the third episode of anaphylaxis, although his weight was 11 kg, an epinephrine auto-injector was prescribed.
The second and fifth episodes of anaphylaxis developed when he was given improper food due to lack of awareness at the nursery school and kindergarten. The third and fourth episodes were caused by the mother's carelessness. Parental and care giver lack of knowledge was instrumental in each episode. We will review and report on similar examples, as well as measures to prevent recurrences.
