IJFIRH - 2026, Volume - IV, Issue - I [January to March 2026]

e-ISSN No- 3048-6270

Published by Homoeopathic Chronicles

INTEGRATIVE MANAGEMENT OF LIFE-THREATENING NUT ALLERGY AND RECURRENT ANGIOEDEMA: A PEDIATRIC HOMEOPATHIC CASE REPORT

Lakshmi Engineer1

1Senior Homeopathic Consultant, Virtual clinic, Dr Batra's Positive Health Clinic Pvt. Ltd. (Email id: drlakshmi.engineer@drbatras.com), Mobile: 7208950140 / 9004212305

Article Received: 23 Nov 2025 - Accepted: 10 Jan 2026 - Article published online: 21 Jan 2026

DOI: https://doi.org/10.59939/3048-6270.2026.v4.i1.2

ABSTRACT

Angioedema is characterized by sudden, localized swelling of the deeper layers of the skin or mucosa, often triggered by IgE-mediated hypersensitivity to allergens like nuts. When involving the airway or occurring alongside anaphylaxis, it becomes a life-threatening medical emergency. This case presents a 4-year-old boy suffering from severe angioedema, multiple nut allergies, and recurrent urticaria since infancy. The objective was to evaluate the efficacy of a combined approach using individualized homeopathic constitutional treatment and medically supervised oral immunotherapy. The child, who had a history of severe anaphylaxis requiring adrenaline, was treated with Calcarea carbonica and Tuberculinum bovinum based on his miasmatic and constitutional totality. Results after two years of treatment demonstrated a remarkable shift in the allergic threshold; the patient developed stable tolerance to previously life-threatening allergens, with no further angioedema or anaphylactic episodes over the last 24 months. Furthermore, significant improvements were noted in his respiratory health and emotional stability. In conclusion, integrated homeopathic management effectively modulates the immune response, offering a holistic recovery for pediatric patients with severe allergic diathesis.

KEYWORDS: Nut allergy, Anaphylaxis, Urticaria, Homeopathy, Desensitization, Child allergy, Miasmatic treatment.

INTRODUCTION

Angioedema is a clinical condition characterized by localized, non-pitting, and self-limiting swelling of the deep dermal and subcutaneous tissues. In pediatric populations, food allergies especially nut allergies represent a significant immunological disorder that often persists lifelong and can trigger severe angioedema or life-threatening anaphylaxis. Conventional management typically emphasizes strict avoidance and emergency suppression of symptoms; however, homeopathy offers a constitutional approach that targets the underlying immune hypersensitivity at its root1.

Current medical literature, such as systematic reviews in the Journal of Alternative and Complementary Medicine, explores the role of homeopathy in modulating allergic responses. Furthermore, research in the Indian Journal of Research in Homoeopathy highlights the effectiveness of constitutional remedies in managing pediatric allergies2-5. This case is significant as it demonstrates how individualized homeopathic therapy, when integrated with gut-healing dietary interventions and medically supervised oral immunotherapy, can restore immune balance and build allergen tolerance.

PATIENT INFORMATION

Demographic Information

The patient is a 4-year and 9-month-old male child. Born on April 28, 2018, he is originally from Brazil and currently resides in Kolkata, West Bengal, India. At the time of the initial consultation, he was of average growth with a lean and active constitution.

Chief Complaints

The primary clinical concern involved recurrent urticaria and hives that had persisted since infancy. The child suffered from severe food allergies, particularly to various nuts including peanuts, walnuts, cashews, almonds, and pistachios. A critical clinical event occurred in October 2020, when the ingestion of walnuts triggered a severe anaphylactic episode. This life-threatening reaction was characterized by angioedema (swelling of the lips), vomiting, throat irritation, generalized hives, and scratching of the feet.

 Medical, Family, and Psychosocial History

The patient's medical history illustrates a classic atopic march, beginning with eczema at seven weeks of age, which was treated with topical hydrocortisone. This was followed by milk intolerance and egg white allergy causing vomiting and hives. Respiratory comorbidities included asthmatic episodes with wheezing, cough, and cold, which required the use of inhalers once or twice a year during winter. He also exhibited environmental sensitivity to cat dander, which triggered puffed eyes and wheezing. Gastrointestinal symptoms such as chronic constipation and nocturnal flatulence were also present.

The family history reveals a strong genetic predisposition to allergic and autoimmune conditions; his father suffers from asthma and cat dander allergy, his paternal aunt has eczema, and his maternal grandmother has vitiligo. Psychosocially, the child is described as hyperactive, highly expressive, and intelligent for his age, though he prone to public tantrums and exhibits a strong emotional dependence on his mother. He also experienced disturbed sleep patterns, including night terrors, shouting, and bruxism.

Relevant Past Interventions and Outcomes

Previous medical interventions for acute episodes included the use of antihistamines for peanut-induced hives at eight months and emergency hospitalization with an adrenaline injection for the 2020 anaphylactic event. For chronic management, topical steroids were applied for eczema, and inhalers were used for seasonal respiratory distress. In terms of prior homeopathic treatment, the use of Sulphur was noted in his medical records. Dietary interventions included the cessation of formula milk after it caused immediate vomiting during infancy. Despite these interventions, the underlying hypersensitivity remained until the current integrative homeopathic and desensitization protocol was initiated.

CLINICAL FINDINGS

Physical Examination and Observations

The physical examination revealed a child with a lean and active constitution, growing at an average rate for his age. While his general appearance was healthy, several physical parameters indicated systemic imbalances characteristic of an allergic diathesis. His appetite was noted as good, though he suffered from chronic constipation and significant flatulence that worsened at night. A notable physical finding was profuse, non-offensive perspiration during the night, localized specifically to the neck and back. Despite his allergic tendencies, he was identified as a chilly patient who paradoxically displayed a strong preference for cold drinks and ice, even during the winter months. His thirst was recorded as low.

Clinical History and Homeopathic Symptom Totality

The selection of the homeopathic remedy was based on a comprehensive totality of symptoms, integrating physical generals with distinct mental and behavioral traits. The key symptoms used for clinical decision-making included:

• Cravings: A very strong desire (+++) for cheese, chocolates, and ice cream.

• Sleep Disturbances: Significant night terrors, characterized by shouting "No" in his sleep, and bruxism (teeth grinding).

• Behavioral Profile: A hyperactive and social personality coupled with high intelligence for his age. He exhibited "mature thinking" (e.g., a love for fixing toys and vehicles) but also displayed emotional dependence on his mother and threw public tantrums for toys.

• Thermal State: A chilly disposition with a low thirst for water.

• Miasmatic Background: The history of suppressed eruptions (infantile eczema treated with steroids) and a strong family history of autoimmune and allergic disorders (asthma, eczema, vitiligo) were critical in diagnosing the underlying miasmatic state.

The dominant miasm was diagnosed as Syco-Psoric with syphilitic tendencies, reflecting the child's hypersensitivity (Psora), chronic constipation and cheese cravings (Sycosis), and the destructive, life-threatening nature of the anaphylactic responses (Syphilis). This detailed clinical history led to the prescription of Calcarea carbonica as the primary constitutional remedy.

DIAGNOSTIC ASSESSMET

Diagnostic Methods

The diagnostic process integrated conventional clinical findings with specialized homeopathic assessment. The primary diagnostic method relied on a detailed clinical history of IgE-mediated reactions, including the 2020 hospitalization for anaphylaxis where emergency adrenaline was administered. Physical examination findings identified a lean and active child with specific physical markers: profuse nocturnal perspiration on the neck and back, chronic constipation, and a chilly thermal state. To monitor the success of the intervention, a supervised oral immunotherapy program was utilized as a diagnostic tool to test allergen threshold, starting with a 3 mg nut solution.

Diagnostic Challenges

A significant challenge in this case was the high risk of life-threatening reactions during the assessment of allergic thresholds. Because the child had a history of severe anaphylaxis requiring adrenaline, any direct exposure to allergens for diagnostic purposes necessitated strict medical supervision and a controlled environment. Additionally, the child’s young age (4 years 9 months) and hyperactive nature presented challenges in accurately relaying subjective sensations, requiring the practitioner to rely heavily on maternal observations regarding his night terrors, behavioral tantrums, and physical cravings.

Diagnostic Reasoning

The diagnostic reasoning followed the homeopathic principle of totality of symptoms,"where physical, mental, and miasmatic layers were synthesized. While the conventional diagnosis was Severe Nut Allergy and Recurrent Angioedema, the homeopathic reasoning explored the underlying allergic diathesis.

• Miasmatic Diagnosis: The case was identified as Syco-Psoric with syphilitic tendencies. The Psoric element was evident in the hypersensitivity and skin eruptions; the Sycotic element in the chronic constipation and cheese cravings; and the Syphilitic element in the destructive, life-threatening nature of the anaphylactic response.

• Remedy Selection: Calcarea carbonica was reasoned to be the constitutional remedy due to the child's chilly nature, desire for cold foods, cravings for eggs/cheese/chocolate, and head-sweat during sleep. Sulphur was considered based on past history but was superseded by the current constitutional picture. Tuberculinum bovinum was selected as an intercurrent remedy to address the deep-seated miasmatic block and family history of respiratory allergies.

Prognostic Characteristics

The prognosis was initially guarded due to the severity of the anaphylactic reactions and the history of suppressed eczema with topical steroids, which often complicates homeopathic treatment. However, favorable prognostic indicators included the child's high vitality, the absence of irreversible structural damage, and the presence of clear General symptoms (cravings, thermal preferences) that allowed for a precise homeopathic prescription. The gradual increase in the allergic threshold moving from 3 mg to the daily consumption of 2 peanuts served as a positive prognostic marker for long-term immune stabilization.

THERAPEUTIC INTERVENTION

Totality of Symptoms

1. Sensitive child with recurrent allergies and urticaria.

2. Desire for cheese, chocolates, and cold foods.

3. Night terrors, grinding teeth, shouting “No” in sleep.

4. Hyperactive, social, affectionate, and emotional dependence on mother.

5. Constipation with flatulence, worse at night.

6. Chilly patient with low thirst.

7. History of suppressed eruptions (eczema).

8. Family history of allergic and autoimmune diathesis.

REPERTORIAL RESULT 

Types of Intervention

The management of this case involved a multimodal integrative approach combining homeopathic treatment, immunotherapy, and nutritional support. The primary intervention was individualized constitutional homeopathy aimed at modulating the immune hypersensitivity. This was supplemented by preventive measures including a gut-healing diet and a medically supervised oral immunotherapy (OIT) program for allergen desensitization.

Type of Homeopathy and Medication Details

The treatment utilized individualized classical homeopathy. The remedies administered were single-constituent medicines selected based on the patient's unique physical and mental totality.

• Primary Remedy: Calcarea carbonica (prepared from the middle layer of the oyster shell).

• Intercurrent Remedy: Tuberculinum bovinum (a nosode).

• Scale and Form: The remedies were administered in the Centesimal (C) scale and Millesimal (M) scale, dispensed in globule form (galenic).

Administration of Intervention

• Initial Dose (Feb 2023): Calcarea carbonica 200C, a single dose, followed by a placebo for 15 days.

• Miasmatic Dose (Jul 2023): Tuberculinum bovinum 1M, single dose.

• Desensitization (Oct 2023): Initiation of a tolerance-building program with a 3 mg nut solution under strict medical supervision.

• Constitutional Boost (Mar 2024): Calcarea carbonica 1M, single dose.

Changes in Intervention with Rationale

• Introduction of Tuberculinum (July 2023): Administered as an intercurrent remedy to address the deep-seated miasmatic block and family history of respiratory allergies, once the initial physical symptoms (constipation/sleep) showed mild improvement.

• Potency Increase (March 2024): Calcarea carbonica was graduated from 200C to 1M to match the patient's improved vitality and to further stabilize the immune system after six months without urticaria or wheezing.

• Initiation of Desensitization (October 2023): Once the constitutional remedy had stabilized the vital force and reduced overall hypersensitivity, the supervised nut solution was introduced to build physical tolerance.

DISCUSSION

The primary strength of this case management is the integrative and longitudinal approach. By combining individualized constitutional homeopathy with medically supervised oral immunotherapy and gut-healing dietary interventions, the treatment addressed both the acute hypersensitivity and the underlying chronic predisposition. The 24-month follow-up period provides robust evidence of the stability of the immune system's recalibration, as the patient transitioned from life-threatening anaphylaxis to daily allergen consumption.

A limitation of this report is that it describes a single clinical case; therefore, the findings cannot be generalized to all pediatric patients without broader clinical trials. Additionally, the success of the desensitization phase relied on a highly controlled environment and parental compliance, which may vary in different clinical settings.

The findings of this case are supported by an increasing body of research into the homeopathic management of allergic disorders. Individualized homeopathy is theorized to work through ultra-low dose signaling that modulates the immune system's sensitivity.

Immune Modulation: Research published in the Journal of Alternative and Complementary Medicine suggests that homeopathy may influence the Th1/Th2 cytokine balance, which is often skewed toward a Th2 (allergic) response in atopic patients1.

Constitutional Success: Studies in the Indian Journal of Research in Homoeopathy have documented that remedies like Calcarea carbonica are particularly effective in pediatric allergic march cases due to their deep-seated action on the nutritional and metabolic processes of the body2.

Integrative Safety: Recent literature on Oral Immunotherapy (OIT) highlights that while OIT is effective, it carries a high risk of adverse reactions; this case suggests that concurrent homeopathic treatment may act as a buffer, improving the safety profile and success rate of desensitization protocols6.

The rationale for the successful outcome is based on the homeopathic Law of Similars and Hering’s Law of Cure. The initial suppression of eczema with topical steroids led to an inward progression of the disease (asthma and severe food allergies). The application of Calcarea carbonica and Tuberculinum bovinum reversed this trend.

The assessment of causes identifies the Syco-Psoric miasm a hereditary and acquired state of hypersensitivity (Psora) and over-reactivity/coordination loss (Sycosis). The destructive nature of the anaphylactic reaction indicated a Syphilitic edge. By addressing these layers, the vital force was empowered to move from a state of anaphylaxis to a state of functional tolerance.

CONCLUSION

The primary take-away is that constitutional homeopathy does not merely suppress allergic symptoms but restores systemic balance, offering a holistic recovery that spans physical, respiratory, and emotional health. This integrated approach provides a promising, safe, and effective pathway for treating complex allergic diathesis and the atopic march in children.

INFORMED CONSENT

The patient’s parents agreed to the use of his demographic information, clinical history, and progress photographs, provided that his anonymity and confidentiality are strictly maintained.

REFERENCES

1.  Banerjee D, et al. Homeopathy in Allergic Disorders: A Systematic Review. J Altern Complement Med. 2021.

2.  Sharma V, et al. Role of Constitutional Remedies in Pediatric Allergies. Indian J Res Homoeopathy. 2019.

3.  Bernstein JA, et al. Angioedema in the emergency department: a practical guide to differential diagnosis and management. Int J Emerg Med. 2017.

4.  Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018.

5.  Bell IR, Boyer NN. Homeopathic Medications as Clinical Context for Health Outcomes: A Narrative Review of Outcomes of Clinical Trials. J Altern Complement Med. 2013.

6.  Pajno GB, et al. Oral immunotherapy for IgE-mediated food allergy: a systematic review and meta-analysis. World Allergy Organ J. 2017;10(1):21.

Corresponding Author - Lakshmi Engineer, Senior Homeopathic Consultant, Virtual clinic, Dr Batra's Positive Health Clinic Pvt. Ltd. (Email id: drlakshmi.engineer@drbatras.com), Mobile: 7208950140 / 9004212305