BACKGROUND: Food allergy and seafood (fish, mollusk, and crustacean) consumption have increased considerably over the past 40 years. Seafood allergy is now a leading cause of anaphylaxis in both the United States and Australia. However, there is only limited published data describing the clinical presentation and management of seafood allergy. OBJECTIVES: To describe the characteristics of a large cohort of children with seafood allergy. METHODS: Using a retrospective chart review, we collected data on all children presenting to our Tertiary Allergy Service with an allergic reaction to seafood between 2006 and 2009. RESULTS: 167 children had a history of definite clinical reaction to seafood and/or positive food challenge (103 male, 62%). 94% had evidence of co-existent atopic disease. Prawn/shrimp was the most common seafood implicated. One-fifth presented with a history of anaphylaxis to seafood. Over 50% of crustacean-allergic children could tolerate non-crustacean fish. Sensitization to other fish species was very common in fish-allergic children, with one third reporting clinical reactions to at least two species; 16% developed symptoms to fish vapours. In children with allergy to tuna and/or salmon, at least 21% were able to tolerate the fish in a tinned form. CONCLUSIONS: Seafood is a relatively common and important cause of food allergy in Australian children, presenting with a high rate of anaphylaxis.
BACKGROUND:Food allergy and seafood (fish, mollusk, and crustacean) consumption have increased considerably over the past 40 years. Seafood allergy is now a leading cause of anaphylaxis in both the United States and Australia. However, there is only limited published data describing the clinical presentation and management of seafood allergy. OBJECTIVES: To describe the characteristics of a large cohort of children with seafood allergy. METHODS: Using a retrospective chart review, we collected data on all children presenting to our Tertiary Allergy Service with an allergic reaction to seafood between 2006 and 2009. RESULTS: 167 children had a history of definite clinical reaction to seafood and/or positive food challenge (103 male, 62%). 94% had evidence of co-existent atopic disease. Prawn/shrimp was the most common seafood implicated. One-fifth presented with a history of anaphylaxis to seafood. Over 50% of crustacean-allergic children could tolerate non-crustacean fish. Sensitization to other fish species was very common in fish-allergic children, with one third reporting clinical reactions to at least two species; 16% developed symptoms to fish vapours. In children with allergy to tuna and/or salmon, at least 21% were able to tolerate the fish in a tinned form. CONCLUSIONS: Seafood is a relatively common and important cause of food allergy in Australian children, presenting with a high rate of anaphylaxis.