Horse allergy in childrenBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7256.286 (Published 29 July 2000) Cite this as: BMJ 2000;321:286
- Graham Roberts, research fellow,
- Gideon Lack, consultant (firstname.lastname@example.org)
- Paediatric Allergy and Clinical Immunology, Department of Paediatrics, Imperial College School of Medicine at St Mary's, London W2 1NY
- Correspondence to: G Lack
- Accepted 13 December 1999
Horse dander may be the “hidden” allergen responsible for a child's asthma
Allergy to pets, such as cats and dogs, causes significant morbidity in children.1 Apart from immediate symptoms of hypersensitivity, allergens from pets are associated with chronic childhood asthma.1 2 Clinicians are less familiar with horse allergy. Our clinical experience suggests that it is an important problem, even in an urban environment. Despite a lack of obvious exposure to horse dander this allergen may be responsible for a child's asthma. We present three of the 28 cases of horse allergy seen recently in our clinic.
Case 1—Within minutes of riding a pony at a fête, an eight year old boy developed angio-oedema and respiratory distress. On initial assessment in the accident and emergency department, he was tachypnoeic with a saturation of 90% in air. He improved after treatment with oxygen, nebulised salbutamol, intravenous hydrocortisone, and intravenous chlorpheniramine. Skin prick testing produced a 6 mm weal to horse dander and a 3 mm weal to house dust mite (positive histamine control, 3 mm). He was advised to avoid horses, to carry chlorpheniramine in case of accidental exposure, and to use inhaled salbutamol and intramuscular adrenaline in the event of respiratory symptoms.