oa Current Allergy & Clinical Immunology - Sherbet! two cases of food-additive reactions : case study

Volume 29, Issue 2
  • ISSN : 1609-3607



Food additives are used extensively in the food industry and include thousands of natural and synthetic substances used as flavourants, colourants, preservatives, sweeteners, antioxidants and thickeners. Many patients blame food additives as the cause of a wide variety of symptoms. Early literature (pre-1990s) overestimated the prevalence of food-additive reactions as a result of poorly designed trials. Many of the cases of adverse reactions to food additives in the medical literature are anecdotal or characterised by poorly controlled challenge procedures. More recent evidence suggests that additive-associated reactions are relatively rare, with a prevalence of 0.23% in a population-based study. Relatively few food additives have been convincingly demonstrated to cause urticaria, angioedema, asthmatic reactions or anaphylaxis. Some groups, such as asthmatics with sulphite sensitivity, appear to be at higher risk of food additive reactions. The mechanism of reaction to several food additives is not completely understood. In very few cases, symptoms are typical of IgE-mediated reactions; several other immunological or non-immunological mechanisms may play a role, leading to a variety of presentations. This case report describes two different reactions to food additives in two different children, both occurring while eating 'sherbet'!

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