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Shellfish allergy

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What are Crustaceans

They are crustaceans: prawns and prawns , prawns , scampi , crabs, lobsters , cicadas , lobsters , mantis shrimps , crabs , crabs , spider crabs , moeche of all types, etc.
Crustaceans are underwater invertebrate organisms, both marine and fresh or brackish water. These are invertebrate animals which, together with molluscs and fish, form the set of ” fishery products “.
Shellfish are considered valuable and very tasty foods ; despite having a high cost, thanks to their palatability, they are among the most marketed fish foods in the world. From a nutritional point of view, crustaceans are classified in the fundamental group of foods . They have a moderate energy intake , contain proteins of high biological value , B vitamins and mineral macroelements ( calcium, phosphorus , sodium , etc.). They are also rich in astaxanthin ( antioxidant provitamin A ), cholesterol , omega 3 essential fats ( eicosapentaenoic and docosahexaenoic acid ) and important mineral trace elements such as iodine , zinc and selenium . Although nutritious , shellfish have a very high allergenic power ; that’s why, like shellfish, they should be excluded from children’s diets and replaced with hypoallergenic fish like cod .

What is shellfish allergy?

By allergy we mean an immune-mediated adverse reaction (release of certain immunoglobulins) towards one or more very specific peptide sequences. In the case of food allergies , the symptoms (more or less serious) appear after ingesting foods that contain these amino acid sequences; depending on the case, these symptoms can arise almost immediately or after many hours (following the digestion of the food to which you are allergic).
Shellfish allergies are among the most common, frequent and widespread throughout the world. It is also one of the most dangerous and holds the absolute record for hospital admissions. It appears more often in adulthood than in youth.

Shellfish allergy is NOT synonymous with allergy to fish and shellfish. Those who suffer from allergic reactions to molluscs can, in theory, safely eat fish “proper” (those with bones, so to speak, such as sea bream , anchovies , tuna , etc.), cuttlefish , octopus , squid , squid , octopus , snails. sea ​​and land , mussels , clams , cockles , cockles , oysters , scallops , canestrelli , sea truffles , razor clams etc. On the other hand, before broadening one’s food choices to these solutions, those allergic to shellfish should consult an allergist and follow a very specific diagnostic process.
Note : although statistically shellfish allergy is more often definitive, it is not possible to know for sure. This depends very much on the case and no methods are known to identify the residence time.

Symptoms

What are the symptoms of shellfish allergy?

The most frequent symptoms of shellfish allergy are:

  • Vomit
  • Stomach cramps
  • Indigestion
  • Diarrhea
  • Hivesspread throughout the body
  • Breathing difficulty
  • Wheezing
  • Cough
  • Hoarseness and swallowingproblems
  • Swollentongue and/or lips
  • Bradycardia
  • Pallor
  • Dizzinessand/or mental confusion .

Treatment

Management and treatment of shellfish allergy

Below we will briefly summarize the points necessary for the management and treatment of shellfish allergy:

  1. The first fundamental and inalienable rule of any allergy is to avoid the foodsthat trigger the symptomatic reaction; among these we remember:
    1. Crustaceans
    2. Foods that contain them or that contain their derivatives; You should always check food labelscarefully . It is advisable to pay close attention to products such as surimi , fried snacks , etc
    3. Foods that have come into contact with you; it is essential, especially for meals consumed outside the home, to communicate effectively with the kitchen staff.

In the previous paragraph we specified that allergy to crustaceans is a form of adverse reaction different from allergy to fish and molluscs. However, especially in collective catering, cases of cross-contamination caused by the mixing of various products are not uncommon. To give a trivial example, if ” fritto misto” is offered on the restaurant menu , the various ingredients are most likely already mixed together. By ordering a “fried dish without prawns”, there is a very high probability that the kitchen operator will simply eliminate the prawns from the preparation. Or, the oil itself used for cooking could be rich in residues from previously cooked prawns. In both cases, a very sensitive allergy sufferer would certainly experience a more or less serious symptomatic reaction.

  1. ONLY for mild allergic forms, it is possible to keep some symptoms at bay with the use of antihistaminesand corticosteroids
  2. If you suspect the onset of “potentially” serious allergic reactions, especially anaphylaxis (potentially fatal), it is essential to always have self-injectable drugs based on epinephrine ( adrenaline ) on hand. It is also essential to ensure that these drugs:
    1. They are injected promptly, when the first symptoms appear; remember that a serious allergic reactionis much more dangerous than the potential side effects of epinephrine ( anxiety , restlessness , dizziness; rarely tachycardia , hypertension and pulmonary edema )
    2. They have not expired
    3. They are at least in two doses; the second can be fundamental in case the first is broken or if the reaction is very serious.
  3. Furthermore, if the person allergic to shellfish is a child, in the absence of the parents, it is essential that the adults present at meals (for example school teachers, babysitters, etc.) are informed and trained.

Note : It is important that the allergist provides a prescription that specifies the emergency treatment with the type of drugs to be used and the dosage, in relation to the symptoms.

Diagnosis

Is shellfish allergy diagnosable?

For various reasons, the diagnosis of shellfish allergy can also be very complicated:

  • If the shellfish allergy is severe, the person may reach the hospital unconscious and, not being able to communicate with healthcare personnel, this slows down the diagnosis.
  • Symptoms can be subjective and very different between people; let’s not forget that allergic reactions to shellfish can affect the skin, respiratory tract, gastrointestinal tract and/or cardiovascular system
  • Symptoms can change from time to time, between one episode and another in the same person
  • As we have said, in certain cases allergy symptoms can appear even just by eating suitable foods, which however have come into contact with shellfish
  • Not too frequently, cases of allergic reaction are recorded after inhaling the fumes/vapors from cooking shellfish.

When a food allergy is suspected, it is important to consult an allergist, who can make a diagnosis, prescribe specific tests and advise patients on how to manage any symptoms of accidental ingestion.
The allergist’s diagnostic process begins with a detailed investigation of the clinical history and symptoms of the hypothetical shellfish allergy; for example, it will be necessary to report “what was eaten and in what quantity”, “how long it took for symptoms to appear”, “which symptoms appeared” and “how long they lasted”.

Subsequently, the allergist will prescribe a blood test (ImmunoCAP test) and/or perform a skin test himself , to check for the presence of food-specific immunoglobulins E (IgE). Skin prick tests
are conducted on an outpatient basis and provide results within 15 to 30 minutes. They are performed by placing a drop of a liquid containing the allergen on the patient’s forearm or back and puncturing the skin with a small sterile probe (letting the liquid penetrate). These tests, which are not particularly painful but rather annoying, are considered positive when the skin that comes into contact with the allergen turns red and swells (similar to an insect bite ). Blood tests are less sensitive than skin tests and measure the amount of IgE antibodies to specific allergenic foods. Results are generally available in one to two weeks and are reported with a numerical value to be contextualized within a specific range. We remind you that there are cases in which allergies are positive on the skin test but do not trigger symptoms with the ingestion of the food in question. Furthermore, it should be specified that the amount of IgE measured by the blood test is not necessarily proportional to the severity of the symptoms. If both of these diagnostic tools offer unclear results, for a definitive diagnosis, the allergist may choose to conduct a food trial in which (under close medical supervision) the patient is fed increasing amounts of the potentially allergenic food .

 

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