What is shellfish allergy?

They are crustaceans: prawns and shrimps , prawns , prawns , crabs, lobsters , cicadas, lobsters , mantis shrimp , crabs , spider crabs, crabs , moeche of all kinds, etc. Crustaceans are invertebrate organisms of the underwater type, both sea and fresh or brackish water. These are invertebrate animals which, together with molluscs and fish, form the set of ” fishery products “. Crustaceans are considered valuable and very tasty foods

; despite having a high cost, thanks to their palatability, they are among the most traded fish foods in the world.
From a nutritional point of view, crustaceans are classified in the I fundamental group of foods . They have a moderate energy intake , contain high biological value proteins , B vitamins and mineral macro -elements ( 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 nourishing , crustaceans have a very high allergenic power ; that’s why, like shellfish, they should be excluded from children’s diets and replaced with hypoallergenic fish such as cod .

What is shellfish allergy?

By allergy we mean an immune-mediated adverse reaction (release of certain immunoglobulins) against one or more well-defined peptide sequences. In the case of food allergies , the symptoms (more or less severe) appear after the ingestion of 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 allergy is one of the most common, frequent and widespread all over 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 fish and shellfish allergy. Those who suffer from allergic reactions to molluscs can, in theory, easily eat fish “properly so called” (those with bones, so to speak, such as sea bream , anchovies , tuna , etc.), cuttlefish , octopus , squid , squid , baby octopus , snails sea ​​and land , mussels , clams , cockles , cockles , oysters , scallops ,canestrelli , sea truffles , razor clams , etc. On the other hand, before expanding their food choices to these solutions, the shellfish allergy should consult an allergist and follow a very specific diagnostic procedure.
Note : even if statistically the shellfish allergy is more often definitive, it is not known for sure. This depends a lot on the case and there are no known methods to identify the residence time.

Symptoms

What are the symptoms of shellfish allergy?

The most frequent symptoms of shellfish allergy are:

• He retched
• Stomach cramps
• Indigestion
• Diarrhea
• Urticariaspread throughout the body
• Breathing difficulty
• Wheezing
• Cough
• Hoarseness and swallowingproblems
• Swollen tongue 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 containing them or containing their derivatives; it is always necessary to check food labelscarefully . It is advisable to pay close attention to products such as surimi , fried snacks
   3. Foods that have come into contact with you; it is essential, especially in meals consumed outside the home, to communicate effectively with the kitchen staff.

In the previous paragraph we specified that shellfish allergy is a form of adverse reaction different from fish and shellfish allergy. However, especially in collective catering, cases of cross-contamination caused by the mixture of the various products are not rare. To give a trivial example, if the “mixed fried ” menu is offered , in all probability the various ingredients are already mixed together. By ordering a “fried without shrimp”, the chances are very high that the kitchen operator will simply remove the shrimp from the preparation. Or, the oil itself used for cooking may be rich in residues from previously cooked shrimp. Either way, a very sensitive allergiche would certainly undergo a more or less severe symptomatic reaction.

2. ONLY for mild allergic forms, some symptoms can be kept at bay with the use of antihistaminesand corticosteroids
3. 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 ) at hand . It is also essential to ensure that these drugs:
   1. They are injected promptly, when the first symptoms appear; remember that a severe 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 if the first is broken or if the reaction is very serious.
4. Furthermore, if the allergic to shellfish is a child, in the absence of parents, it is essential that the adults present at meals (for example school teachers, babysitters, etc.) are informed and trained.

Note : It is important for the allergist to provide a prescription that specifies the emergency treatment with the type of medication 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 travel to the hospital unconscious and, being unable to communicate with health professionals, this slows the diagnosis.
• Symptoms can be subjective and very different among 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 episodes of the same person
• As we have said, in some cases allergy symptoms can appear even just by eating suitable foods, which however have come into contact with crustaceans
• Not too frequently, there are cases of allergic reaction after inhaling the fumes / vapors of cooking crustaceans.

When a food allergy is suspected, it is important to consult an allergist, who can diagnose, prescribe specific tests and advise patients on how to manage any symptoms of an accidental ingestion.
The diagnostic process of the allergist 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 start”, “what 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 immunoglobulin E (IgE). Prick tests
(skin – prik) are conducted on an outpatient basis and provide results within 15-30 minutes. They are performed by placing a drop of a liquid containing the allergen on the patient’s forearm or back and punching the skinwith a small sterile probe (allowing the liquid to 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. The results are generally available in one or two weeks and are reported with a numerical value to be contextualized in a specific range.
Recall that there are cases in which allergies are positive on the skin test but do not trigger symptoms with food ingestion of the food in question. Furthermore, it should be noted that the quantity of IgE measured with the blood test is not necessarily proportional to the severity of the symptoms.
Should both of these diagnostic tools offer unclear results, for a definitive diagnosis, the allergist may choose to conduct a food test in which (under close medical supervision) the patient is fed increasing amounts of the potentially allergenic food .