Possible Casein Allergy?

[2tontess]

Hi, this is my first post so please forgive me if I appear not quite 'with it'!

I have 2 boys age 3 this month and 17 months. Both breastfed until 10 months then onto cows milk (cows milk used in cooking from weaning at 5 months). DS1 has beautiful skin and no problems.

At around 7-8 months DS2 began developing a nasty rash and swollen mouth when eating cheese (we have only recently realised it's cheese, initial thinking was possibly eggs).We mainly use Colliers which is a hard strong cheese. DS2 does not like cheese in normal form but has had it in cooked products, on beans, in sauces etc. This is when he developed the rash. We have taken the stance of not avoiding cheese altogether but not giving him cheese on toast either.

More recently, we had chicken stuffed with something or other and he immediatly broke out in hives, in the space of 2 hours he was plastered and scratching after a couple of nibbles. We immediatly thought there could have been cheese in it and discovered the only cheese related product to be mozarella.

Since then, the urticaria seems to have developed into eczema. I saw the GP who has ref us to paeds and we are using hydrocortisone and diprobase with good affect.

Very stupidly, the other day, I decided to put some cheese on DS2 beans to see what happened, immediatly, as in when he dropped a cheesey bean(!) on his leg, he flared up and the following 24 hours were awful as he broke right out (the guilt will be with me forever!). However, his mouth stayed clear of any rash or swelling. It seems like the eczema is now here to stay as he keeps having minor flares, although the heat isn't helping.

My queries are,
Could it be a Casein allergy? Why cheese? could it be getting worse? He's never reacted to milk/yoghurt etc but it seems to be something that is developing as he grows older. From what I have read, these sort of allergies tend to get better with age?

For the record, DS2 is blond and blue eyed, dad had asthma as a child and I have developed mild hayfever (severe hayfever goes through the family to my grandfather) and oral allergy syndrome (melon) since my early 20's.

If anybody has any help/advice/experience I would be grateful. Sorry it's a bit long!
Tess

[thumbwitch]

if he has no problem with milk or yoghurt, I can't see it being a casein allergy as casein is present in all milk products.

Sounds more like it's specific to cheese, so could be the culture used to produce the cheese, or possibly butyric acid which is in higher quantities in strong cheeses (although not in mozzarella).

Have you had him allergy-tested? just using the creams after the event, while effective, is a bit like sticking-plaster medicine - not really sourcing the problem. I would go back to your GP and demand allergy-testing.

[tatt]

This is a new one on me. Generally processed milk is less of a problem than unprocessed milk. Definitely one for professional advice, preferably an allergy consultant not a paediatrician.

But I googled and found this, which might suggest other things to avoid until you have some professional advice

"Other pharmacologically active substances found in food include histamine, tyramine, tryptamine and serotonin, which may be consumed in foods such as red wine, cheese, yeast extract, avocados and bananas. In susceptible people, these foods can trigger urticaria, facial flushing and headaches. "

Foods with high concentrations of tyramine:
? Aged cheese
? Aged or cured meats (e.g., air-dried sausage)
? Any potentially spoiled meat, poultry, or fish
? Broad (fava) bean pods
? Marmite concentrated yeast extract
? Sauerkraut
? Soy sauce and soy bean condiments
? Tap beer

[2tontess]

Thankyou so much for the knowledgable replies, it is very much appreciated. My GP referred us straight to the paeds at the first appointment and she said they will probably do allergy testing. In the mean time we are to carry Piriton around at all times.

Tatt,thankyou for your googling, it's interesting to see what can trigger reactions. So far DS has been fine with marmite and we always have cured meats. Not tried DS on tap beer yet tho!

DS had cheese on his dinner at a friends on Mon and flared up, worsened Tues after a pizza (which he has been fine with in the past) and today he had the smallest amount of guacamole (contained chilli) on the end of a breadstick and he's awful tonight (eczema has required HC again). I am at a loss as to why this has worsened so suddenly at 17 months.

I've started a food diary, written an 'allergy family tree' and I am cutting the labels off anything DS has eaten which I think has caused him to flare. I have also taken photos of the eczema. Is there anything else that may be helpful for the drs?

I'll let you know if we make any progress.

[ilovemydogandmrobama]

DS recently was seen by the allergy nurse. Sounds as if you're doing everything right -- i.e. food diary, photos.

The nurse did say that a food reaction would normally take place within an hour, so perhaps break it down to what was consumed, and record any reactions in terms of time?

[2tontess]

Hi all, I thought I would provide an update following DS visit to the paed re: cheese allergy.

The paed had spoken with a colleague regarding the GP referral letter and it has been suggested that DS could be reacting to cheese mites (if you google it, you may be put off cheese for life!). When he described how/where I would find cheese mites it immediatly rang bells re: the cheese thats sets DS off. The paed had never heard of cheese mite allergy before speaking with his colleague and he didn't know enough about it to say it was a definate cause.

He also suggested whey as a possibility but as DS is fine with all other dairy products he could could not confirm this.

He offered skin prick testing but as we already know what foods to avoid it seemed silly to put DS through it. Both DH and I are nurses and feel comfortable with managing DS without further intervention.

We also spoke to a different GP recently who suggested we use hydrocortisone on eczema flares for 5 straight days, regardless as to whether the skin improves in a shorter period. I have to say this has been a great piece of advice as DS currently has perfect clear skin all over for the first time in months! We continue to use Diprobase 2-3 times a day too.

Hopefully this may be of some help to others out there.