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SEATTLE – A 6-year-old boy with severe asthma who did not respond to treatment turned out to be allergic to marijuana used at his home in what the researchers described as a unique case of his kind.
Although an allergy to marijuana has been reported in adults who use it, it is the first reported case of a young child with a positive allergy test that "It was exposed only to second-hand smoke," said Bryce Hoffman, MD, of the Denver National Jewish Hospital. .
"Nothing helped the boy get better," said Hoffman at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI) 2018. "He had almost daily symptoms of coughing, shortness of breath, wheezing, and then we discovered that family members had recently started smoking marijuana at home. "
Family members stated that they were not using the medication in the same room as the child, but that the information was sufficient to test their allergy, Hoffman said. In addition, the child's grandmother stated that she had used marijuana in full body hives.
The researchers added a saline solution to the same type of cannabis that the family used to create a puddle sample and stabbed the patient's skin with it. They also stung his grandmother's skin and a negative control subject.
The diameter of the patient's wheal was 9 × 8 mm and that of the grandmother was 15 × 8 mm. The subject of control gave a negative result.
The results of additional tests were compared to those of the control subject, including a basophilic activation test of cannabis, as well as peach and tomato, which have been shown in the literature to be cross-reactive to cannabis. said Hoffman.
He had almost daily symptoms of coughing, shortness of breath, wheezing.
"The patient demonstrated the activation of basophils on cannabis with marked differences compared to the control at dilutions of 1:20 and 1: 100," the researchers write in their poster. The peach and tomato tests were negative.
"We felt that it was good evidence that this patient was allergic to cannabis," Hoffman said.
The team asked the family to rid the house of any marijuana to check the results and, three months later, "the boy's symptoms were all improved."
Before the marijuana was removed, the boy had a score of 25 on an asthma control questionnaire, "way above where you want to be," Hoffman said.
Three months after the marijuana smoke was removed from the house, her score was 19. It is important to note that her average R5-R20 score increased from 2.35 to 1.37 – 1.50 is abnormal, noted Hoffman – showing an improvement in the disease of the peripheral airways.
"It has improved in an objective and subjective way," he said.
This discovery suggests to physicians a series of questions about marijuana use in the family, which might not come to mind when the patient with difficult to control is a young child, all the more so as more and more more states are legalizing drugs for medical and recreational purposes, said Hoffman. Medscape Medical News.
Ask questions about the use of marijuana at home
Although many allergists ask questions about cigarette smoke at home, questions about marijuana are not common, he added, especially among younger patients.
We do not know if the problem is marijuana smoke itself or traces on furniture or clothing. This should be part of a future study, he said.
"We also need to find better ways to test it," he said, pointing out that the use of the entire facility has limitations because it has multiple components.
"We all know that marijuana smoke is an irritant.The big news about this is that there are people who are allergic to it.They have a positive allergy test.This is not just an irritation, "said ACAAI President-elect Allen Meadows, MD. , from the Alabama Asthma and Allergy Clinic in Montgomery.
An immune reaction will magnify a very small exposure, whereas for an irritant like tobacco smoke, a small exposure means small symptoms. "I think it's always been assumed that it's the same thing for marijuana smoke," Meadows said. Medscape Medical News.
Although the findings are based on a single case, the findings say, "Wow, we should look at that," he said.
Hoffman and Meadows did not reveal any relevant financial relationship.
American College of Allergy, Asthma and Immunology (ACAAI) 2018 Annual Scientific Meeting: Summary M076. Presented November 16, 2018.
Follow Medscape on Twitter @Medscape and Marcia Frellick @mfrellick
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