To the Editor: A 27-year-old man was admitted to the Peking Union Medical College Hospital for wheezing, accompanied by coughing; white phlegm; dyspnea; sneezing; a runny, stuffy, and itchy nose; red itchy eyes; wheals on both arms; abdominal pain and dizziness. His symptoms started 10 min after he bathed and dried his guinea pig. Cetirizine and steroids partially alleviated the symptoms that day and completely alleviated them by the next morning. The patient's history included allergic rhinitis and eczema, and he had no food or drug allergies. His father was allergic to cheese and eggs. He had kept a cat for 20 years, a dog for 5 years, and a guinea pig for 2 years. Physical examination on admission revealed maculopapules, scratches, and scabs scattered around both legs, his nasal mucosa was pale and edematous, and his lung breath sounds were clear. He was diagnosed with anaphylaxis, allergic rhinitis, and eczema. Allergen testing was performed. The skin test was positive for dust mites (++), dust (+), and cats (++). His total IgE was 200 kU/L. Serum-specific IgE (sIgE) results showed the following: Phadiatop, 11.4 pharmacia arbitrary unit/L (grade 3); guinea pig (e6), 22.7 kU allergen (A)/L (grade 4); Dermatophagoides pteronyssinus (d1), 10.6 kU(A)/L (grade 3); Dermatophagoides farinae (d2), 11.4 kU(A)/L (grade 3); hx2 (h2, d1, d2, i6), 12.7 kU(A)/L (grade 3); and cat dander (e1), 0.89 kU(A)/L (grade 2). The sIgE values for hamster (e84), rat (e87), mouse (e88), dog dander (e5), Aspergillus fumigatus (m3), and Alternaria alternata (m6) were all <0.35 kU(A)/L (ImmunoCAP, Thermo Fisher Scientific, San Jose, CA, USA). Lung function tests were forced expiratory volume in 1 s (FEV1), 88%; FEV1/forced volume vital capacity, 114%; and fraction of exhaled nitric oxide, 98 ppb.
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