Helminthic infection as a factor in new-onset coffee allergy in a father and daughter

We report a father and daughter who experienced a new onset of food allergy to coffee occurring after helminth infection (Clonorchis sinensis) contracted in China. M.G. is a 55-year-old white Italian man without previous allergy, and V.G. is a 22-year-old woman with allergic rhinitis to grass pollens treated with antihistamines as needed. In May 2005 the father and daughter journeyed to rural areas of China for several weeks. When returning, they were laid over in the Beijing airport for 9 hours. During this period in the airport, they drank a large quantity of green coffee without any other food. A few days later, in Italy, they developed abdominal pain, diarrhea, and urticaria that worsened daily. The feces were initially pultaceous then liquid, accompanied by abdominal colic primarily in the morning. Fecal analyses (parasitologic, cultures, and chemical) and serum tests (Salmonella-Shigellae) were negative, as was abdominal sonography. The only abnormal laboratory values were blood eosinophil counts, 1200/mm3 (father) and 1050/mm3 (daughter), and serum eosinophil cationic protein (ECP), 44 ng/mL (father) and 84 ng/mL (daughter). Both were treated with oral antihistamine (cetirizine 10 mg/daily) with remission of itching, but without effect on diarrhea. In subsequent months their body weight diminished (10 and 8.5 kg, respectively, for the father and daughter)