D2.263 - Anaphylaxis induced by goat’s and sheep’s milk: an allergen that we should keep under surveillance
Background
Goat’s-sheep’s milk (GSM) is responsible for anaphylaxis, but few data are available. Our aim was to characterise GSM-induced anaphylaxis, compare its phenotype to that of other foods.
Method
We retrospectively analysed GSM-induced anaphylaxis cases recorded by the Allergy-Vigilance Network (2002-2024), compared the main characteristics of GSM-induced anaphylaxis to those of anaphylaxis induced by other foods.
Results
Of the 3285 cases of food-induced anaphylaxis, 97 (3%) cases (mean age: 13.5 y [SD: 11.9]) were induced by GSM. 73 (75.3%) occurred in children (< 18 y) and 57 (58.8%) in males. 56 (57.8%) patients had a known allergy to GSM, 13 (13.4%) had a history of cow’s milk allergy. Grade 3 reactions were recorded in 33 cases (34.0%) and grade 4 reactions in 4 (4.1%) cases (two deaths).
Compared to cow’s milk-induced anaphylaxis, GSM-induced anaphylaxis was more likely associated with an older age (mean age [year]: 7.1 vs 13.5, p<10-3) and a history of asthma (17.4% vs 44.5%, p<10-3). Compared anaphylaxis induced by all other foods, GSM-induced anaphylaxis was more likely associated with a younger age (mean age [year]: 25.1 vs 13.5, p<10-3), a history of asthma (26.1% vs 44.5%, p<10-3), a more severe reaction (grade 3: 29.7% vs 34.0%; grade 4: 1.0% vs 4.1%; p=0.007).
Conclusion
Allergists should be aware that GSM-induced anaphylaxis is relatively frequent and can be severe, even in individuals without any cow’s milk allergy. This allergen should be included in the mandatory food allergen list as a distinct allergen and not only as a milk product.
