Food allergy to Paracentrotus lividus (sea urchin roe)

Sea urchins are increasingly used as culinary products in Japanese and Korean cuisine throughout the world.

To investigate a possible IgE-mediated allergy in a patient who experienced an anaphylactic reaction after eating sea urchin roe and mussels.

A 40-year-old man experienced generalized pruritus and urticaria, shortness of breath, and wheezing 10 minutes after eating steamed mussels and boiled sea urchin roe. Investigations included skin prick tests, serum specific IgE determinations, oral challenge tests, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting.

Results of skin prick tests with common aeroallergens were negative. Positive prick test responses were obtained with boiled and raw sea urchin extracts, boiled and raw sea urchins themselves, and boiled sea urchin water. Results of an oral challenge test with steamed mussels were negative. Five minutes after the oral mucosa contacted the boiled sea urchin extract, lip pruritus was present. Specific IgE concentrations to boiled sea urchin water and boiled and raw sea urchins surpassed the criterion for a positive result (1.1, 0.6, and 0.4 kU/L, respectively). In boiled sea urchin extract, a 118-kDa band appeared as the unique relevant IgE-binding antigen.

In this patient with IgE-mediated food allergy to sea urchin roe, a 118-kDa protein seemed to be the antigen responsible for the reaction.