Anaphylaxis is often linked to peanuts, shellfish, or bee stings. However, three cases presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2026 Annual Scientific Meeting demonstrate that severe allergic reactions can stem from unexpected sources, including everyday products like energy drinks, hair oils, and children’s toys.
A 15-year-old boy developed hives, wheezing, and breathing difficulties within minutes of consuming a new energy drink. He received two doses of epinephrine, along with albuterol, an antihistamine, and IV fluids in the emergency department before his symptoms resolved. The cause was identified as cod-derived collagen in the drink, with a review of the label revealing it contained 5 grams of collagen. The teenager had a history of eczema, asthma, and allergic rhinitis, and had previously experienced mild throat itching and lip swelling after eating canned tuna, though he tolerated salmon without issues. Skin prick tests for tuna, cod, and flounder were all negative, highlighting the complexity of fish allergies.
Fish Allergens in Everyday Products
Allergist Annabelle Rowland, MD, observed that fish collagen is increasingly present in beverages and supplements. Standard fish allergy tests often fail to detect this, as they target different proteins and contain minimal collagen. This case shows the difficulty in identifying such allergies, as individuals may test negative but still react. Dr. Rowland noted, “Collagen from fish is showing up in a growing number of products, from drinks to supplements. Standard fish allergy tests mostly look for a different fish protein and contain very little collagen, so a person can test negative and still react.”
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In another instance, a 10-year-old girl with eczema experienced anaphylaxis after applying cold-pressed castor oil to her scalp. She had previously used heat-pressed castor oil without issues. Skin prick tests confirmed a reaction to the cold-pressed variant, marking the first reported case of pediatric anaphylaxis from topical castor oil application.
Processing Methods and Allergy Risks
A third case involved an 11-year-old girl who developed hives, swelling, and throat tightness after handling a squishy squeeze ball toy. She received epinephrine and later experienced a similar reaction to a different toy. Blood tests revealed latex sensitization, though no other trigger was identified. This marks the first reported case of anaphylaxis linked to squishy toys, which are often marketed as non-toxic rubber but may contain undisclosed chemical additives.
Concerns Over Toy-Related Anaphylaxis
These cases highlight the importance of recognizing unusual allergy triggers. Individuals experiencing severe allergic reaction symptoms should seek immediate emergency care. For further information on anaphylaxis, visit AllergyandAsthmaRelief.org.
