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Anaphylaxis afterhamster bites: a rarecase?

Akiko Tomitaka1, Kayoko Suzuki2,Hirohiko Akamatsu1 andKayoko Matsunaga1

1Department of Dermatology, Fujita HealthUniversity School of Medicine, Toyoake,Aichi 470-1192, 2Department ofDermatology, Daido Hospital, Nagoya,Aichi, 457–8511, Japan

Key words: anaphylaxis; contact urticariasyndrome; hamster; laboratory animals;pets; rodents.

Case Report

Hamsters are increasingly raised aspets in Japan. We found only 5 casereports of anaphylaxis after hamsterbites (1–4), 3 of which, surprisingly,were from Japan (1–3).

A 36-year-old woman was admit-ted with symptoms of anaphylaxis.She had a past history of atopic der-matitis and bronchial asthma inchildhood. For the last 21⁄2 years shehad been raising 3 hamsters and,though bitten on the hands severaltimes, had developed no symptoms.On the day of admission, one of thehamsters had bitten her left hand.Within a few minutes she felt a warmflush in her left hand, which gradu-ally spread and caused a generalizedurticaria accompanied by pruritus ofher eyes. She began to sneeze and feelitchy 20 min later, and breathing be-came difficult. On admission, shewas pale, and her blood pressure waslow (95/36 mmHg). After a few min-utes she fainted and required emer-gency treatment with i.v. hydrocorti-

sone sodium succinate (500 mg) andantihistamines.

Specific IgE antibodies (CAPRAST FEIA) against Dermatophago-ides pteronyssinus and house dustwere class 5 but specific IgE anti-bodies (AlaSTAT) against mouse epi-thelium, mouse urine, rat epithelium,rat urine, rat serum proteins and ham-ster epithelium were all negative.Prick tests using prick lancets (EWOCARE AB, Sweden) with the threehamsters’ saliva as is and urine, di-luted to 20% in physiological saline(Otsuka Pharmaceutical Co, Ltd,Tokyo, Japan), were performed withthe patient’s informed consent. Wefiltered the solutions to sterilize themthrough a 0.22 mm Millex-GV mem-brane (Millipore, Japan). Readingswere done 15 min later. We usedphysiological saline as a negative con-trol and histamine chloride (WakoPure Chemical Industries, Ltd,Osaka, Japan) 10 mg in 1 mL ofphysiological saline as a positive con-trol. The diameters of wheals were 0mm and 3 mm, respectively. On pricktesting, the patient showed positive re-actions to their saliva with 4 mm, 5mm and 4 mm diameters of wheals,but negative results with their urine.Also with the patient’s informed con-sent, we performed prick tests on herchild, who had been bitten severaltimes by the same hamsters. Thesetests were negative. We concluded thatour patient’s positive prick test reac-tion to the hamsters’ saliva was al-lergic.

Discussion

There are several case reports of ana-phylaxis after bites by rodents (4),mice (5) and mosquitoes (6). The na-ture of the antigen in hamsters’ salivais not known (1–4). As well as al-lergic rhinitis and bronchial asthma,hamsters as pets or laboratory ani-

mals can cause anaphylaxis from im-mediate-type allergy. Our patient hadno recurrence once she had given herhamsters to a friend.

Acknowledgements

The authors thank Dr Steven D. Em-met, Department of Dermatology,University of California San Diego,for his linguistic and academic advice.

References1. Niiyama S, Ishizuka A, Tanei R. A

case of anaphylaxis after bites byhamster. Rinsho Derma 1997: 39:676–677.

2. Kashiwagi H, Yamagami T, Takah-ashi Y, et al. A case of the pet ham-ster induced asthma. Allergy Practice1998: 18: 648–650.

3. Goto Y, Wada R. A case of anaphy-lactic shock due to hamster. EnvironDermatol 2000: 7: 100.

4. Teasdale E L, Davies G E, Slovak A.Anaphylaxis after bites by rodents. BrMed J (Clin Res Edn) 1983: 286:1480.

5. Thewes M, Rakoski J, Ring J. Ana-phylactic reaction after a mouse bitein a 9-year-old girl. Br J Dermatol1999: 141: 179.Sabbah A, Sainte-Laudy J, HassounS, Drouet M, Lauret M G, Loiry ML. A propos de l’allergie aux mous-tiques et de l’utilisation des nouveauxparametres immuno-biologiques. Al-lergy Immunol (Paris) 1997: 29: 126–128.

Address:Akiko TomitakaDepartment of Dermatology,Fujita Health University School of Medi-cineToyoakeAichi 470–1192Tel: π81 562 93 9256.Fax: π81 562 93 2198.E-mail: atomi/fujita-hu.ac.jp