Reacción alérgica a la protamina / Allergic reaction of protamine

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Anaphylactic shock to oysters and white fish with generalized urticaria to prawns and white fish.

Because seafood consumption is moderate-to-high in Spain, allergic reactions to seafood such as fish, crustacea and mollusc are fairly frequent. The clinical features of these reactions depend on the implicated species and whether the reaction is provoked by ingestion, handling or vapor inhalation. Because different species have common antigenic structures, cross-sensitization is frequent, especially between crustaceans and molluscs. Contamination of fish by nematodes (Anisakis) may produce severe reactions. We report the case of a female patient with no personal or family history of allergy who experienced two episodes of anaphylactic shock: the first occurred immediately after eating oysters and the second after ingestion of white fish. The patient also developed generalized urticaria provoked by crustacean (prawns) and white fish. The results of skin prick tests were negative for fish, shellfish, crustacean and oysters while in vitro tests were positive for oyster, prawns, Anisakis, Ascaris and Echinococcus, although stool samples and gastric endoscopy were negative.

Anaphylactic shock to oysters and white fish with generalized urticaria to prawns and white fish

Because seafood consumption is moderate-to-high in Spain, allergic reactions to seafood such as fish, crustacea and mollusc are fairly frequent. The clinical features of these reactions depend on the implicated species and whether the reaction is provoked by ingestion, handling or vapor inhalation. Because different species have common antigenic structures, cross-sensitization is frequent, especially between crustaceans and molluscs. Contamination of fish by nematodes (Anisakis) may produce severe reactions. We report the case of a female patient with no personal or family history of allergy who experienced two episodes of anaphylactic shock: the first occurred immediately after eating oysters and the second after ingestion of white fish. The patient also developed generalized urticaria provoked by crustacean (prawns) and white fish. The results of skin prick tests were negative for fish, shellfish, crustacean and oysters while in vitro tests were positive for oyster, prawns, Anisakis, Ascaris and Echinococcus, although stool samples and gastric endoscopy were negative (AU)

Como el consumo de alimentos procedentes del mar en España es de moderado a elevado, las reacciones alérgicas a pescados, crustáceos y moluscos son bastante frecuentes. Las características clínicas de dichas reacciones dependen de las especies implicadas y de si la reacción está provocada por ingestión, manipulación o inhalación de vapores. Como distintas especies tienen estructuras antigénicas comunes, la sensibilización cruzada es frecuente, especialmente entre los crustáceos y los moluscos. La contaminación del pescado por nematodos (Anisakis) puede producir reacciones graves. Describimos el caso de una mujer sin antecedentes personales ni familiares de alergia que experimentó dos episodios de shock anafilático: el primero se produjo inmediatamente después de tomar ostras y el segundo, después de comer pescado blanco. La paciente también sufrió una urticaria generalizada provocada por crustáceos (gambas) y pescado blanco. Los resultados de las pruebas de punción cutánea fueron negativas para pescado, mariscos, crustáceos y ostras, mientras que las pruebas in vitro fueron positivas para ostras, gambas, Anisakis, Ascaris y Echinococcus, si bien las muestras de heces y la endoscopia gástrica resultaron negativas (AU)

Rhinoconjunctivitis and asthma provoked by Asticot maggots.

Asticot maggots are used as bait by anglers fishing the rivers, reservoirs and coastal waters of Spain. We report the case of a male patient, a keen angler, who used this bait on weekends and suffered allergic reactions that affected his conjunctiva and respiratory system for years. Other baits (earthworms, Eisemia foetida) did not elicit this reaction. In order to confirm the allergic reaction, we used maggots in vivo in the Prick Test, obtaining a positive reaction in 15 to 30 minutes. The patient also had an allergic reaction to house dust mites in prick test. To a lesser extent, he also was sensitive to certain grass pollens (Lollium perenne) and seafood (prawns and squid).