Codfish allergy in adults. Identification and diagnosis

Area of Science:

• Allergy and Immunology
• Clinical Diagnostics
• Food Hypersensitivity

Background:

• Immediate allergic reactions to codfish can significantly impact quality of life.
• Accurate diagnosis of food allergies is crucial for effective management.
• Common diagnostic tests include skin prick tests (SPT), RAST, and histamine release tests.

Purpose of the Study:

• To evaluate the diagnostic accuracy of SPT, RAST, and histamine release tests for codfish allergy.
• To compare these tests against oral food challenges in patients with suspected codfish allergy.
• To determine the clinical utility of these diagnostic methods in identifying true codfish allergy.

Main Methods:

• Conducted skin prick tests, RAST, and histamine release tests on 10 codfish-allergic patients and 27 controls.
• Performed titrated, oral, double-blind, placebo-controlled food challenges (DBPCFC) with codfish on the 10 patients.
• Compared test results with DBPCFC outcomes and patient-reported symptoms.

Main Results:

• Oral food challenges confirmed codfish allergy in 7 out of 10 patients, with reproducible symptoms.
• Oropharyngeal itching and swelling were consistently the initial symptoms.
• Skin prick tests and RAST demonstrated high sensitivity (7/7) in identifying DBPCFC-positive subjects.
• All tested methods showed high specificities, ranging from 90-97%.

Conclusions:

• Skin prick tests and RAST are sensitive tools for detecting codfish allergy.
• Despite high sensitivity, these tests do not eliminate the need for oral food challenges.
• DBPCFC remains the gold standard for confirming codfish allergy and understanding symptom profiles.