Background: Food additives are intentionally-added ingredients in order to modify physical, chemical, biological, or sensory characteristics of foods. Allergic reactions caused by additives are uncommon in children, and their prevalence is not known; however, they can be severe.
Case report: An 8-year-old male presented with anaphylaxis and recurrent anaphylactic shocks due to multiple triggering factors such as food additives and medications. Point-of-care skin tests were performed with several additives, with positive results. Personalized emergency treatment was indicated in view of the possibility of anaphylaxis (adrenaline, diphenhydramine and dexamethasone) and environmental care for aeroallergens. Owing to a history of adverse reaction to salbutamol (giant or generalized urticaria), formoterol dry powder was indicated, which was well tolerated. Organic food exclusive consumption was recommended.
Conclusions: The diagnosis of allergy to additives should be suspected when the patient has a suggestive medical history, allergy to multiple foods or medications, reaction with manufactured foods, unrelated to organic products.
Antecedentes: Los aditivos alimentarios son ingredientes agregados intencionalmente para modificar las características físicas, químicas, biológicas o sensoriales de los alimentos. Las reacciones alérgicas por aditivos son poco frecuentes en niños y se desconoce su prevalencia, sin embargo, pueden ser severas. Reporte de caso: Varón de ocho años que sufrió anafilaxia y choques anafilácticos recurrentes por múltiples desencadenantes como aditivos de alimentos y medicamentos. Se realizaron pruebas cutáneas de lectura rápida a varios aditivos, con resultados positivos. Se indicó tratamiento de urgencia personalizado ante la eventualidad de anafilaxia (adrenalina, difenhidramina y dexamentasona) y cuidado ambiental para control de aeroalérgenos. Debido al antecedente de reacción adversa al salbutamol (urticaria gigante o generalizada) se indicó formoterol en polvo seco, el cual fue bien tolerado. Se recomendó el consumo exclusivo de comidas orgánicas. Conclusiones: El diagnóstico de alergia a los aditivos debe sospecharse cuando el paciente presenta historia clínica sugerente, alergia a múltiples alimentos o fármacos, reacción con alimentos manufacturados, sin relación con productos orgánicos.
Keywords: Additives; Anaphylaxis; Pediatrics.