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A 19‐year‐old female presented with a 1‐year history of intermittent lip swelling and itching occurring within minutes of biting open the wrapper of a Mars ® chocolate bar. During these episodes she would also develop rhinorrhoea, sneezing and itchy eyes. She did not get these symptoms if her mother opened the wrapper and passed over the chocolate hence excluding the chocolate being the cause. On further questioning, she had had similar oral symptoms when blowing up balloons and drinking from certain disposable cups. She had also experienced itching and swelling of her fingers and hands within minutes of wearing rubber gloves and remembered similar symptoms when she used Copydex ® glue (which contains latex) during school art classes. Eating bananas and avocado also led to itching of her mouth and lips. She was born with Vater syndrome, a condition characterized by the sporadic association of specific birth defects including vertebral, anal, cardiac, tracheo‐oesophageal and renal anomalies with varying degrees of severity amongst affected individuals. Due to a congenital tracheo‐oesophageal fistula, she had a number of operations as a child: tracheo‐oesophageal fistula repair at 3 months and 18 months and Nissen fundoplication at the age of 2 years for
Clinical & Experimental Dermatology – Wiley
Published: Mar 1, 2005
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