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Anaphylaxis to supplemental oral lactase enzyme

Overview of attention for article published in Allergy, Asthma & Clinical Immunology, December 2016
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  • Above-average Attention Score compared to outputs of the same age (53rd percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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4 tweeters

Citations

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3 Dimensions

Readers on

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18 Mendeley
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Title
Anaphylaxis to supplemental oral lactase enzyme
Published in
Allergy, Asthma & Clinical Immunology, December 2016
DOI 10.1186/s13223-016-0171-8
Pubmed ID
Authors

M. R. Voisin, R. Borici-Mazi

Abstract

Anaphylactic reactions involving IgE mediated hypersensitivity have been frequently reported for a number of uncommon foods. However, cases of anaphylaxis to over the counter vitamins and oral supplements have been rarely published. Lactose intolerance affects approximately 20% of Canadians and roughly 70% of the world's population of any age. Lactose intolerance develops primarily due to the absence of the enzyme lactase and treatment involves avoidance of lactose-containing foods or ingestion of commercially available lactase enzyme preparations prior to their consumption. This case report represents the first documented evidence of anaphylaxis after exposure to supplemental lactase enzyme preparation. A 38 years old Caucasian female presented with a history of self-diagnosed adult-onset lactose intolerance and a suspected allergy to lactase containing tablets. She reported an episode of bilateral orbital swelling, shortness of breath, and throat constriction after oral ingestion of a supplemental lactase enzyme tablet. Her symptoms slowly resolved with the administration of inhaled salbutamol and oral diphenhydramine. She handled lactase tablets for years to her children who were lactose intolerant, but had never ingested the tablets herself prior to the reported episode. In clinic, physical examination was benign, and skin prick testing to a slurry of the lactase tablet revealed a strongly positive reaction wheal size of 10 mm and flare of 60 mm with normal controls. The patient reported throat tightness and constriction after skin prick testing and required cetirizine treatment and observation in clinic. Subsequent skin testing was performed with individual ingredients of the lactase tablet provided by the manufacturer and Aspergillus niger, a common bacteria used in lactase preparations. Only concentrated lactase enzyme elicited a positive response. The patient was diagnosed with lactase tablet induced anaphylaxis due to synthetic lactase enzyme IgE mediated allergy, and was advised to avoid all products containing lactase enzymes as an ingredient and to carry an epinephrine auto-injector. This is the first documented case report of an anaphylactic reaction to supplemental lactase enzyme. This case report reinforces the importance of thorough allergy assessment, education on avoidance of triggers, in particular with uncommon allergens.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 18 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 3 17%
Student > Bachelor 3 17%
Researcher 3 17%
Other 2 11%
Student > Postgraduate 2 11%
Other 2 11%
Unknown 3 17%
Readers by discipline Count As %
Medicine and Dentistry 5 28%
Biochemistry, Genetics and Molecular Biology 4 22%
Agricultural and Biological Sciences 2 11%
Nursing and Health Professions 2 11%
Immunology and Microbiology 1 6%
Other 1 6%
Unknown 3 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 January 2017.
All research outputs
#7,031,580
of 12,456,513 outputs
Outputs from Allergy, Asthma & Clinical Immunology
#307
of 456 outputs
Outputs of similar age
#159,816
of 358,399 outputs
Outputs of similar age from Allergy, Asthma & Clinical Immunology
#33
of 49 outputs
Altmetric has tracked 12,456,513 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 456 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.2. This one is in the 31st percentile – i.e., 31% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 358,399 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 53% of its contemporaries.
We're also able to compare this research output to 49 others from the same source and published within six weeks on either side of this one. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.