Camel's milk allergy

INTRODUCTION: Camel's milk is a safe and therapeutic nutrient. Camel's milk allergy is almost unknown. OBJECTIVE: To identify the clinical and laboratory features of camel's milk allergy. METHODS: In this retrospective study, the records of patients with camel's milk allergy were reviewed. Data collected included age, sex, clinical presentation, concomitant allergies, family history, laboratory tests (complete blood cell count CBC, white blood cell WBC count, total immunoglobulin E IgE, food specific IgE), and skin-prick tests (SPT) to camel's milk and other foods. RESULTS: Nine patients (four male patients, five female patients; mean age ± SD 4.3 ± 2.4 years) presented with cutaneous urticaria and/or angioedema (five patients 55.6%) and anaphylaxis (four patients 44.4%). Allergic reactions occurred within the first 15 minutes of ingesting camel's milk in all the patients (100%). Concurrent allergies were observed in 77.8% of the patients, of whom, five patients (71.4%) had atopic dermatitis (AD) and two patients (22%) had cow's milk allergy that exacerbated AD. All the patients (100%) had a family history of allergies. The family farm was the source of camel's milk in all the patients (100%). The WBC count was 9425 ± 1452.8 (mean ± SD) cells/μL, and eosinophils was 612 ± 455.4 (mean ± SD) cells/μL, and the median IgE was 301.5 kU/mL. A camel's milk SPT resulted in a wheal of 8.7 ± 4.9 (mean ± SD) mm. CONCLUSION: Camel's milk allergy is a distinct, yet very rare, disease entity. Cutaneous and systemic allergic reactions are the main clinical manifestations. Concomitant other allergies, viz., AD, and positive family history are risk factors. Early life exposure to camel's milk is a possible risk factor. High blood eosinophil counts and total IgE levels were observed in patients with camel's milk allergy. In the presence of a consistent and specific clear-cut history of camel's milk-related symptoms, a SPT was a dependable confirmatory test.