Management of Food Allergy to Fish with Oral Immunotherapy: A Pediatric Case Report

Fish allergy represents a persistent allergic disorder that usually does not improve spontaneously. Because neither fully effective therapeutic strategy nor truly curative approaches are currently available for food allergy, we report herein a case of fish allergy in a 11-year-old male patient treated with Oral Immunotherapy (OIT). The patient at the age of 4 years, for the first time, experienced immediate urticaria and angioedema, rhinitis, cough, and dyspnea after ingestion of both salmon and codfish. Skin prick test, specific IgE, and oral food challenge (OFC) were positive for both salmon and codfish. Therefore, positive allergy tests and challenge confirmed allergy to fish. The patient underwent oral administration of increasing doses of the offending food. He was initially treated by OIT using dehydrated codfish. When the dosage of 1 g was achieved and tolerated by the patient, a desensitization regimen was continued through the administration of cooked codfish. At the end of the protocol, the patient achieved desensitization also confirmed by negative OFC with fish. This case suggests that OIT could be used for treatment of food allergy caused by fish with successful results.