Cross-reactivity and masqueraders in seafood reactions

Area of Science:

• Food Science
• Clinical Medicine
• Toxicology

Background:

• Adverse seafood reactions are common, but often misdiagnosed as IgE-mediated seafood allergy.
• Existing literature lacks a recent, comprehensive overview of confounding factors in seafood reactions.

Purpose of the Study:

• To provide an updated summary of conditions that can be mistaken for seafood allergy.
• To help clinicians accurately evaluate and manage patients with reported adverse seafood reactions.

Main Methods:

• Literature review of seafood hypersensitivity, cross-reactivity, and various seafood-related conditions.
• Analysis of confounding variables including seafood intoxications, non-allergic reactions, and complex presentations.
• Synthesis of information on ciguatera fish poisoning and Anisakis reactions.

Main Results:

• Seafood reactions are frequently misattributed to allergy due to confounding variables.
• Conditions like scombroid intoxication, ciguatera fish poisoning, and Anisakis reactions can mimic true allergy.
• Cross-reactivity and other non-IgE mediated reactions complicate diagnosis.

Conclusions:

• Accurate diagnosis of adverse seafood reactions requires understanding numerous confounders.
• Distinguishing true seafood allergy from mimics like intoxications and other reactions is essential for proper patient management.
• This review aids clinicians in identifying and managing complex seafood-related presentations.