Rare case of Chinese restaurant syndrome with dermatological symptoms: A report

Chinese food has wide fan base and is liked across the world, Chinese food contains a particular ingredient as the major additive agent, monosodium glutamate (MSG), a monosodium salt of glutamic acid, which is used in the dish to enhance the savory flavour known as Umami in Japanese.

Given the increased consumption of Chinese food, especially in the young generation, it is important to recognize Chinese restaurant Syndrome (CRS) Chinese food, containing the ingredient MSG as the main additive agent, results in CRS causing a variety of symptoms in susceptible individuals. The spectrum of symptoms ranges from headache, sweating, abdominal pain, and urticaria to angioedema in severe cases.

Researchers reported one such case with unique dermatological manifestations in a young male, developed on the consumption of Chinese food, noticed first-time as per knowledge of the researchers. The findings of the case reports is published in Journal of Associations of Physicians of India (JAPI).

The case study reports

• An adolescent male presented to the Emergency Department with high-grade fever, cough, shock, congested throat, and generalized skin rashes.

• After giving the history of ingestion of Chinese food prior to symptom onset, he was suspected for a case of CRS

• The diagnosis was further supported by raised absolute eosinophil count (AEC) and immunoglobulin E (IgE) levels in the blood.

• The patient was given intramuscular adrenaline and intravenous corticosteroid in the emergencys department for anaphylaxis, followed by oral antihistaminic.

• The dermatologist prescribed oral antihistaminic and local antibiotic ointment for the skin lesions.

• After 5 days of hospitalization, the patient improved clinically with the resolution of skin rashes and with improvement in laboratory parameters, thus discharged with advice to avoid food causing this allergic reaction.

Researchers concluded that “Early recognition and appropriate treatment are necessary as severe reactions have been reported, which may result in fatal outcomes if not treated in time. Our patient presented with similar symptoms upon consumption of Chinese food, with raised AEC and serum IgE levels in the blood, with unique dermatological manifestation, which is not described in the literature on CRS as far as we are aware.”

Reference: Shastri M, Raval DM, Rathod VM. Monosodium Glutamate (MSG) Symptom Complex (Chinese Restaurant Syndrome): Nightmare of Chinese Food Lovers!. J Assoc Physicians India 2023;71(6):93–95.