Chewing gum as an unusual cause of systemic allergic reaction

Chewing gum allergy is a rare condition in emergency settings. A 48-year-old man presented to the emergency department with generalised itchiness which was more prominent on the periorbital areas, nausea, vomiting, and dyspnoea after taking chewing gum. Vital signs showed hypotension with a blood pressure of 72/45 mmHg, and heart rate 95 beats per minute. Auscultation of the chest revealed diffuse rhonchi and coarse crackles. There was blanchable skin rash over the body especially on the abdomen. As the symptoms were compatible with systemic allergic reactions after chewing gum, the patient was given supplemental oxygen, subcutaneous adrenaline, intravenous methylprednisolone and nebulised salbutamol. The patient responded dramatically. He was discharged with oral hydroxyzine (Atarax tablet) prescription. Although there are lots of well-known allergic substances including foods and drugs, we may encounter allergic reactions associated with rare allergens like chewing gum. (Hong Kong j.emerg.med. 2010;17:293-296)