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Researchers link goat cheese allergy to skin lotion containing goat’s milk

Researchers in Australia determined a connection between a patient who experienced anaphylaxis to eating goat cheese and her application of a moisturizer containing goat’s milk to treat eczema several weeks earlier.

“The research was prompted when [the patient] was referred to us for investigation of her episode of life-threatening anaphylaxis of unknown cause,” researcher Robyn E. O’Hehir, FRACP, PhD, FRCPath, FRCP, professor and director, department of allergy, immunology and respiratory medicine, Alfred Hospital and Monash University, Melbourne, told Healio.com. “We were able to demonstrate in the laboratory dose-dependent basophil activation to both the goat’s milk extract and the moisturizer, but no activation with the control cow’s milk or in basophils from a nonatopic control individual.

 

Robyn E. O'Hehir

“Furthermore, to verify the causal link, we were able to demonstrate that preincubation of her serum with goat’s milk was able to completely inhibit IgE binding to the moisturizer.”

The patient, aged 55 years, had developed generalized allergic reaction, characterized by urticaria and rapid oral and upper airway angiodema after eating salad with goat’s cheese. She received an injection of intramuscular adrenaline at an emergency department.

The patient had lifelong extensive atopic eczema and seasonal asthma. Four months before the anaphylactic episode, she frequently applied a skin moisturizer containing goat’s milk, but stopped when she experienced acute erythema and itch.

“Investigational serum-specific IgE was strongly positive for goat’s milk (65.7 kU/L) and negative for mustard [a salad ingredient],” the researchers reported.

Other salad ingredients were subsequently ingested without reaction, and the patient regularly consumed cow’s milk products.

“The data clearly support the route of sensitization as being the topical application of the moisturizer containing the food allergen with subsequent anaphylaxis when the allergen was again encountered in a food,” O’Hehir said.

Clinicians should “recommend bland skin care products, avoiding those that contain food allergens,” O’Hehir said. “Patients with eczema should be advised to apply moisturizers regularly to intact skin with the topical steroids or calcineurin inhibitors used on the broken, inflamed skin.”

Disclosure: The study authors received research support from the Alfred Research Trusts.