Unusual Presentation of Congenital Neuroblastoma as Persistent Respiratory Distress and Fever from Age of 13 Days in an Infant: A Case Report

groups: those who have chicken meat only allergy [1,3] , and a second group, a subset of 'bird– egg syndrome' with allergies to chicken meat, egg yolks, and other bird allergens from serum and feathers [4,5]. The most reported symptoms of allergy to chicken meat are urticaria [6] , oral allergy syndrome [7] , and non-IgE mediated colitis [8]. A few cases of anaphylaxis due to chicken meat have been reported: allergy to chicken meat only beginning from childhood in two cases [6,9] ; allergy to chicken meat only in two adults [1,3] ; a single case report of a child with bird–egg syndrome [4]. Our case represents the third reported case of chicken meat anaphylaxis in children with no allergies to eggs or feathers. In our patient, SPTs were found to be positive with commercial allergenic extracts of egg white, egg yolk, and chicken. However, he was able to tolerate eggs. His SPT with the feather mixture was negative. Gal d 5 (alpha-livetin) is believed to be the causative antigen of bird–egg syndrome [10]. Although IgE reactivity against Gal d 5 can be reduced 88% by heating [1] , skin PPTs performed with both raw and cooked chicken and turkey meat were positive in our patient. Recently, muscle alpha-parvalbumin and myosin light chain 1 (MLC) have been identified as new allergens in chicken meat allergy [3]. Unfortunately, we could not carry out a further investigation to determine allergenic components such as immunoblotting or mass spectrometry. However, the patient's tolerance of eggs led us to believe that allergens such as MLC might be the responsible antigens in our patient's case. The causative antigen in chicken meat only allergy is not known for certain. Antibiotics given to chicken via chicken feed have been thought to be responsible [1]. However, our patient had no known antibiotic allergy. The patient had never before consumed turkey. However, since IgE binding to alpha-parvalbumin and myosin has been identified in turkey meat [3] , we advised him not to eat turkey meat due to cross-reactivity. We have presented this case because of the rarity of allergy to chicken meat and because we wish to attract attention to chicken meat allergy without bird–egg syndrome. References 1. Zacharisen MC. Severe allergy to chicken meat. et al. Allergy to chicken meat without sensitization to egg proteins: a case report. A, et al. Chicken serum albumin (Gal d 5*) is …