Severe allergic reaction to lactulose in a child with milk allergy.

摘要

In this report, we describe a child who presented with dry cough and wheezing associated with ingestion of lactulose syrup for the treatment of constipation. A 4-year-old boy with severe milk allergy and atopic dermatitis since the first month of life was exclusively breastfed for 6 months. During breastfeeding his skin conditions improved markedly after strict avoidance of egg and milk in the mother's diet. After the child was weaned, the incidental ingestion of ricotta cheese was associated with vomit and urticaria-angioedema. The child successively presented with cough and wheezing associated with ingestion of boiled cow's milk. He did not tolerate extensively hydrolyzed casein formula (vomit, moderate urticaria, and cough after the ingestion of 50 mL), and consequently a soy formula was introduced in his diet at the age of 9 months. He presented successively with 3 episodes of anaphylaxis associated with the ingestion of hidden milk protein in different foods.