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M Canavan, A Mitchell, A Sharkey, C Whitethorn, B McNicholl, S Robinson, U Ni Riain, V Tormey, E C Mulkerrin, Oral mite anaphylaxis, QJM: An International Journal of Medicine, Volume 111, Issue 3, March 2018, Pages 189–190, https://doi.org/10.1093/qjmed/hcx255
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Case history
Two medical students presented simultaneously to an Irish Emergency Department (ED) with throat tightness, facial swelling and shortness of breath 15 min after eating home-cooked pancakes. They both had increased respiratory rates, oxygen saturations below 94%, urticaria, periorbital oedema and conjunctivitis with wheeze on auscultation and were treated immediately for anaphylaxis. One student had a history of asthma previously triggered by dust and nonsteroidal anti-inflammatory drugs (NSAIDs) and an allergy to oats. The second had a history of asthma, allergic rhinitis and allergies to house dust mites and pollen.
A third student who had also eaten pancakes accompanied her friends to the ED. She had no significant past history but requested assessment 10 min after arriving when she began to develop red, itchy eyes and a sensation of throat tightness.
All three had eaten pancakes made from flour, milk, sugar, eggs, vanilla and butter prior to their presentation. None of the patients had a history of allergy to any of the individual ingredients used. A working diagnosis of ‘pancake syndrome’ was made. The first two students responded quickly to treatment and were well on discharge the next day. The third student had a mild allergic reaction and was discharged on oral steroids after a short period of observation.
