001556 - Cofactor-induced LTP anaphylaxis

A 28-year-old male presented with anaphylactic shock following the ingestion of grapes, biscuits containing desiccated coconut, methadone, and alcohol. On allergy review,biscuits containing desiccated coconut, methadone, and alcohol has been tolerated since the event without issues. Prior tolerance to alcohol and methadone, as well as grapes and biscuits was observed. Skin prick testing (SPT) yielded negative result to coconut, and unfortunately grape extract was unavailable. Specific IgE (sIgE) testing exhibited positive Pru p3 ( LTP marker), grapes and coconut. This case illustrates the complexities of food allergies, highlighting the phenomenon of co-factor induced lipid transfer protein (LTP) anaphylaxis. Symptoms of cofactor-induced LTP anaphylaxis can vary in severity and may occur rapidly after ingestion as demonstrated in this case, making it essential for clinicians to understand this mechanism for effective diagnosis and management.