Anaphylaxis caused by ingestion of jellyfish

Although anaphylaxis caused by foods is well known, an immediate allergic reaction due to jellyfish ingestion has never been reported. We report a 32-year-old Japanese female, who developed anaphylaxis after eating salt-preserved jellyfish. The patient was a surfer and had frequently been stung by jellyfish. Thirty minutes after eating salted jellyfish, she showed wheals and oral stinging sensation and 60 minutes later when she was dancing the hula, she showed an asthma-like attack, hypotension, nausea, vomiting and abdominal pain. Prick-to-prick test for the salted jellyfish produced a positive reaction as strong as that induced by histamine. Immunoblot analysis revealed that IgE antibodies in the patient serum reacted with an approximately 200 kDa protein in extracts from tentacle and umbrella of living jellyfish and in extract from the salted jellyfish, as well as a 25 kDa protein only in extracts from living jellyfish. This patient is considered to be the first reported case of anaphylaxis caused by intake of jellyfish. It is speculated that the patient was first sensitized through the skin by jellyfish stings and then jellyfish intake induced generalized attack of anaphylaxis. The 200 kDa unknown jellyfish protein may be the causative allergen.