Intravenous Lipid Emulsion-Induced Soy Allergy and Atopic Dermatitis in an Infant: A Case Report

<b><i>Introduction:</i></b> Intravenous lipid emulsions (ILE) containing soy protein may cause reactions in allergic patients. We present a case report of atopic dermatitis (AD) and soy allergy triggered by intravenous lipid emulsion containing soy in an infant with short bowel syndrome (SBS). <b><i>Case Report:</i></b> A 9-month-old female infant with SBS who had been fed total parenteral nutrition (PN) since birth was consulted for severe AD. Laboratory tests revealed eosinophilia, elevated total IgE, and soy-specific IgE was found positive at 3.56 KU/L. Lipid emulsion containing 20% soybean-oil in PN was replaced with soy-free. The patient's AD lesions resolved rapidly. The food provocation test with re-administration of a soy-containing lipid emulsion confirmed the diagnosis of soy allergy by causing recurrence of eczematous lesions. <b><i>Conclusions:</i></b> This case demonstrates that ILE can cause soy sensitization and trigger AD without oral exposure. Food allergies should also not be forgotten in patients who receive only PN.