Japanese Journal of Allergology

Children are thought to have high plasticity in the immune system. Thus, it is expected that allergen immunotherapy for children may have higher efficacy than adults and has real disease-modifying potential to allergic diseases. For clinical efficacy in ameliorating allergic symptoms, however, current systematic reviews have not shown any superior effect in children, partly because of less number of studies in this age group. On the other hand, preventive effects against asthma inception in children with allergic rhinitis and sensitization “spreading” to new allergens have been reported, implicating that allergen immunotherapy has a potential to stop “allergy march” in children. To make the therapy more effective, it is preferable to start it as early as possible, hopefully in infancy. But it is still difficult at present because of relatively frequent adverse events and invasive manner of administering allergen extracts for young children. We need safer and more effective methods in performing immunotherapy for children.

View full abstract

Show abstractHide abstract

We here report a 34-years old male who had nattou-(fermented-soybean) induced late-onset anaphylaxis following SCUBA diving to about 20m in the ocean off a small remote Japanese island (Kuroshima, Okinawa). He had eaten nattou for breakfast at 7 : 30 am. He traveled by boat to the dive site, dove twice and then ate lunch at 12 : 30 on the diving boat (no nattou at lunch). After lunch at 14 : 30 he dove again (third dive of the day) during which time itchiness started. Back on the diving boat, urticarial was noticed. At 15 : 30, while washing his diving gear at the diving shop near the harbor, he fainted. A physician arrived on the scene at 15 : 45. Chest sound was clear and SpO2 was 98%, and blood pressure was 60/-mmHg. Intra-venous hydrocortisone was given, however, his recovery was not satisfactory. Then he was transferred to the Yaeyama Hospital by helicopter at 17 : 45. The examination of diving computer analysis reveals no sign of increased residual nitrogen, denying the possibility of decompression syndrome. Prick to prick test shows a strongly positive response to nattou. Nattou-induced late-onset anaphylaxis following SCUBA diving was suspected.

View full abstract

Download PDF (339K)

Register with J-STAGE for free!