Beer anaphylaxis

Beer is an alcoholic drink consumed worldwide. Its basic ingredient is malted barley, although other cereals can be added. Barley is malted by soaking and germinating the grains. Hops add a bitter flavor, and yeast is essential for fermentation. Despite its high consumption, allergy to beer is infrequently reported. In 1980, Van Ketel described 2 patients with acute reactions after drinking beer. The results of scratch testing were positive to malt. Keller and Schwanitz reported a patient with urticaria after drinking beer or eating bread, with positive skin test responses to beer and flours. Gutgesell and Fuchs described a case of contact urticaria from beer. Vidal and Gonzalez-Quintela reported a case of cereal-induced asthma caused by inhalation and ingestion of barley and beer ingestion. Recently, 3 cases of urticaria and angioedema from beer were described by Santucci et al. We report 3 cases of acute allergic reactions to beer documented by allergy testing and double-blind placebo-controlled food challenge or a convincing history of anaphylaxis.