Abstract

LOBATO, Mariana; PALHINHA, Ana; ROMEIRA, Ana Margarida  and  PINTO, Paula Leiria. Pancake syndrome and hypersensitivity to NSAIDs: A case report. Rev Port Imunoalergologia [online]. 2021, vol.29, n.3, pp.215-218.  Epub Sep 30, 2021. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2021.09.067.

Anaphylaxis triggered by ingestion of dust mite contaminated flour, namely wheat flour (WF), is a rare entity. We describe the case of a twelve-year-old male patient with a previous history of allergic rhinitis and suspicion of non-steroidal anti-inflammatory drugs hypersensitivity, who developed two anaphylactic reactions to an unidentified trigger. Both episodes took place after ingestion of food that was subsequently tolerated. We performed cutaneous skin prick tests to aeroallergens and to the food ingested previously to the reactions, with positive results to numerous mite species and WF from the implicated package and with negative results to commercial extracts of wheat, gliadin, WF with/without baker’s yeast from new packages. We assumed the diagnosis of “pancake syndrome” and confirmed the ibuprofen hypersensitivity with a positive drug provocation test. We present this case because identifying this syndrome requires a high level of suspicion and it should be considered in the differential diagnoses of anaphylaxis of unknown cause.

Keywords : Anaphylaxis; mite allergy; non-steroidal anti-inflammatory drugs hypersensitivity; pancake syndrome; wheat flour.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )