When searching eTOCs or browsing the web, I can’t help but be drawn to slightly strange or bizarre medical cases. Not the ‘Pregnant man gives birth to a baby girl‘ genre of stories, although I will confess to a morbid fascination, but also disgust, at ‘Urgh look at this freak’ tales.
Given that I’m generally looking at clinical websites or the websites of journals I instead tend to pick out intriguing sounding case studies or clinical trials that have unexpected outcomes. This week’s weird medical story was brought to my attention by the British Medical Journal, which highlighted a case study that suggests that peanut allergy could be be transferred by lung transplantation.
The case, published in the Journal of Heart and Lung Transplantation, is of a middle-aged woman who developed peanut allergy following a lung transplant from a donor who had died of anaphylactic shock after eating a peanut-related food. Although the transplant recipient did not previously have any allergy to peanuts, following the transplant she experienced anaphylactic shock herself and had to steer well clear of nuts.
Interestingly, transfer of food allergies from donor to recipient has been seen in liver transplantation. The phenomenon is thought to be due to either the transfer of IgE antibodies bound to cells within the donor liver or to relate to post-transplant use of the immunosuppressant agent tacrolimus. An instance of allergy transfer following bone marrow transplant also suggests that transfer of IgE antibodies or immunosuppression might be to blame.
The report in the Journal of Heart and Lung transplantation is the first instance of allergy being transferred by lung transplantation, however. As the study authors say, “This case emphasizes the importance of considering donor allergy transfer when caring for all solid-organ transplant recipients.” I wonder if similar cases will start to appear in kidney transplant recipients and so on. Certainly this case could mean that finding an organ donor match could become more complicated, as it seems that potential donors with allergies might need to be struck off the list.