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Severe reactions from roe without concomitant fish allergy.
Soili Mäkinen-Kiljunen1, Raija Kiistala, Elina Varjonen
1Helsinki University Central Hospital, Skin and Allergy Hospital, Helsinki, Finland. soili.makinen-kiljunen@hus.fi
Summary
IgE-mediated allergy to fish roe is possible, even without a fish allergy. This study highlights the need to consider roe allergy in seafood allergy evaluations when fish allergy is absent.
Area of Science:
- Allergy and Immunology
- Food Allergy Research
- Immunoglobulin E (IgE) Mediated Reactions
Background:
- Fish allergy is common, yet allergies to fish roe remain understudied.
- This study addresses the gap in knowledge regarding fish roe allergy.
Observation:
- Two patients presented with symptoms ranging from local reactions to anaphylaxis after consuming fish roe.
- Diagnostic evaluations included skin prick testing (SPT) and serum IgE measurements for specific roe species.
Findings:
- Both patients showed positive SPT results and elevated specific IgE levels to whitefish roe (WFR) and rainbow trout roe (RTR).
- Immunoblotting revealed distinct IgE-binding patterns, indicating potential unique allergens in roe.
- Cross-reactivity between roe species was observed, but allergy to roe occurred independently of fish allergy.
Implications:
- IgE-mediated allergy to fish roe is a distinct clinical entity.
- Clinicians should consider fish roe allergy in patients with suspected seafood allergy who test negative for fish allergy.
- Further research into roe allergens is warranted to improve diagnosis and management.