Severe reaction in a child with asymptomatic codfish allergy: Food challenge reactivating recurrent pancreatitis

Katia Pellegrino, Leila Emma Durbano, Maria Cristina Artesani, Carla Riccardi, Sandro Mancini, Sergio Bella, Federico Alghisi, Giovanni Cavagni

Research output: Contribution to journalArticle


An 8-year-old child during the first year of life manifested severe atopic dermatitis and chronic diarrhea with mucorrhea and rectal bleeding; a fish-free diet was started based on weakly positive skin-prick tests to codfish extract. At the age of 4 years the child began to suffer of recurrent pancreatitis. When he came to our attention for the evaluation of his fish allergy, he was asymptomatic; a weak reactivity to codfish was observed (SPTs: cod, 4 mm, sIgE ImmunoCAP: cod, 1.30kU/l). The food challenge test with cod was negative. When the child ate cod again, within 5 minutes, developed anaphylactic reaction and complained of abdominal pain compatible with pancreatitis (enzyme serum levels risen and parenchymal oedema at ultrasonography), that resolved within 7 days after specific therapy. This case raises two issues: the elimination diet in asymptomatic food allergy on the basis only of SPT and the ethicality of food challenge in gastrointestinal chronic disease.

Original languageEnglish
Article number16
JournalItalian Journal of Pediatrics
Issue number1
Publication statusPublished - 2012



  • Anaphylaxis
  • Challenge
  • Codfish
  • Food allergy
  • Pancreatitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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