Erythritol sweetener linked to anaphylaxis in one woman
What it found
A 36-year-old woman in Korea had a severe allergic reaction after drinking a diet beverage containing erythritol.
Skin tests later confirmed she reacted to erythritol itself.
What they found
Studies in people
First reaction
After drinking a peach-containing diet beverage, the woman had trouble breathing and swelling of the face. Her blood pressure dropped to 70/40 mmHg and her symptoms improved after treatment with an antihistamine, a steroid and epinephrine.
Second reaction
Ten days later she drank a different diet beverage and developed hives and general itching. She improved after an antihistamine and a steroid.
Skin tests
Skin prick tests for peach and a peach-containing product were negative, but the two diet beverages gave positive wheals of 6 x 4 mm and 3 x 3 mm. Both drinks contained erythritol.
Erythritol skin test
Skin prick tests with erythritol solution were positive at 20 mg/mL (wheal 4 x 3 mm) and 200 mg/mL (wheal 6 x 5 mm). Three healthy adult controls had negative responses.
Diagnosis and advice
The woman was diagnosed with anaphylaxis to erythritol. She was told to avoid foods containing erythritol and was prescribed a self-injectable epinephrine pen.
What the authors conclude
“Physicians should be aware of the possibility of allergic reactions to food additives, and additives should be evaluated to prevent the recurrence of symptoms.”
Also in their conclusions
- They say this is the first case of erythritol-induced anaphylaxis in Korea.
- They advise that physicians should be aware of the possibility of allergic reactions to food additives.
- They say additives should be evaluated to prevent the recurrence of symptoms.
How it was done
The authors report this case because allergic reactions to food additives are uncommon and hard to diagnose, and no case of erythritol allergy had been reported in Korea before.
They described a 36-year-old woman who went to the emergency department twice after drinking peach-flavoured diet beverages. They did skin prick tests with peach, the two drinks, another peach drink, and erythritol solutions at 2, 20 and 200 mg/mL, plus three healthy adult controls.
What it can’t tell you
- This is a single case report, so it cannot show how common erythritol allergy is or who might be affected.
- The authors did not perform an oral food challenge, so they could not confirm the diagnosis that way.
- The authors could not confirm whether the woman had been exposed to erythritol before her first reaction.
Who paid
- Funding
- Funded by Pusan National University Hospital (from the PubMed record).
- Conflicts
- The authors have no potential conflicts of interest to disclose.
- Authors work at
- Pusan National University Hospital, Korea; Pusan National University College of Medicine, Korea
The paper
- Title
- The First Case of Erythritol-Induced Anaphylaxis in Korea
- Type
- Case report
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Kim S, Yoo W, Park HK, Jo EJ (2022). The First Case of Erythritol-Induced Anaphylaxis in Korea. Journal of Korean medical science. doi:10.3346/jkms.2022.37.e83Free full textPubMed 35289142DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error