Occupational asthma induced by fish exposure.

Occupational asthma triggered by inhaling fish-derived aerosols is estimated to affect 2-8% of exposed individuals. This primarily affects workers in the fish processing industry. Fishmongers, rarely experience this issue, as recent research found no significant difference in asthma rates compared to a control group. We report the case of a fishmonger who presented with a 1-year history of rhinoconjunctivitis and asthma. The patient attributed these symptoms to his occupational exposure within the fish market environment, which worsened in the cold storage warehouse. Symptoms improved during holidays. Diagnosis involved skin-prick tests, sIgE (ImmunoCAP-specific IgE) measurements, and bronchial challenge tests, confirming occupational asthma from fish bioaerosol exposure. Parvalbumins, common fish proteins, share structural similarities, leading to cross-reactivity in fish allergy sufferers. In this case, sensitivity to rGad c1 (cod parvalbumin) was identified as the primary trigger for the patient's asthma, and responsible for sensitizations observed across various tested fish species.

Involvement of hidden allergens in food allergic reactions.

BACKGROUND: Hidden allergens in foods can induce allergic reactions. Currently it is not possible to estimate the exact prevalence of these reactions but they are clearly a growing problem. OBJECTIVE: The purpose of this study was to provide an overview of the role of hidden allergens (their importance, the types of food involved, and the severity of reactions) in allergic reactions in our geographical area. METHODS: A retrospective study was carried out in an adult population. Over a five year period, a total of 530 food reactions were reviewed. RESULTS: One hundred nineteen reactions (22.4%) were considered to be due to hidden allergens. Thirty-two percent of these were anaphylactic reactions. The most common hidden allergen was the Anisakis simplex larvae present in fish and shellfish. Fish allergens hidden in other foods caused reactions in 35% of fish-allergic patients. Twenty-two per cent of allergic reactions caused by eggs were due to egg allergens hidden in foods. All but one of the reactions caused by hidden legume allergens occurred in soy-allergic patients. Reactions caused by hidden fruits and hidden nuts were very uncommon. CONCLUSION: Hidden allergens were the cause of a quarter of all food allergic reactions, mainly as a result of contamination and carelessness on the part of the patient. A simplex was the hidden allergen most frequently involved. Fruits and nuts were not frequent hidden allergens in our area. Reactions due to other uncommon foods such as soy, mustard, flavourings, and honey were multiple and usually went unnoticed. Only if the sources of hidden allergens are determined will it be possible to avoid such substances and thus guarantee the safety of the allergic patient.

Allergy to eggs from duck and goose without sensitization to hen egg proteins.

BACKGROUND: Eggs are among the foods most frequently causing allergy. Hen eggs are the most important. Those of other birds are of lesser significance. OBJECTIVE: We report an unusual case of food allergy after consumption of eggs from duck and goose in an adult patient without hen egg allergy. METHODS: Skin prick tests were performed with fresh white and yolk from eggs of duck and goose and egg white, egg yolk, ovalbumin, and ovomucoid from hen egg. Specific serum IgE was measured to hen egg proteins. SDS-PAGE and IgE immunoblotting were carried out with egg white extracts from hen, duck, and goose. RESULTS: Skin tests were positive to egg whites from duck and goose. The skin tests and specific serum IgE were negative to hen egg proteins. Immunoblotting demonstrated the presence of specific IgE to a proteic band of molecular weight around 45 kd. CONCLUSIONS: We report a patient with an IgE-mediated allergy to egg white from duck and goose without hen egg allergy. Ovalbumin seems to be the responsible protein. The antigenic determinant of this protein seems to be specific of order Anseriforme and it is not present in the ovalbumin of order Galliforme.