Specific allergy to Penaeus monodon (seawater shrimp) or Macrobrachium rosenbergii (freshwater shrimp) in shrimp-allergic children

• Published in: Clinical and experimental allergy Vol. 38; no. 6; pp. 1038 - 1047
• Main Authors: Jirapongsananuruk, O., Sripramong, C., Pacharn, P., Udompunturak, S., Chinratanapisit, S., Piboonpocanun, S., Visitsunthorn, N., Vichyanond, P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2008; Blackwell
• Subjects: Administration, Oral; Adolescent; Allergens - adverse effects; Allergic diseases; Animals; Biological and medical sciences; Child; Child, Preschool; Cooking; Digestive allergic diseases; Female; food allergy; food challenge; Food Hypersensitivity - diagnosis; Food Hypersensitivity - epidemiology; Food Hypersensitivity - etiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; Logistic Models; Macrobrachium rosenbergii; Male; Medical sciences; Palaemonidae; Penaeidae; Penaeus monodon; predictive probability; Predictive Value of Tests; prick-to-prick test; Respiratory Hypersensitivity - epidemiology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sensitivity and Specificity; Shellfish - adverse effects; shrimp allergy; shrimp extract; skin prick test; Skin Tests - methods; Statistics, Nonparametric; Food allergy; shrimp extract; shrimp allergy; Extract; Penaeus monodon; Macrura; Crustacea; Immunology; Decapoda; Child; Shrimp; Food; Seawater; Skin test; Human; Immunopathology; prick-to-prick test; Exploration; Macrobrachium rosenbergii; predictive probability; food challenge; Arthropoda; Digestive diseases; skin prick test; Invertebrata
• ISSN: 0954-7894; 1365-2222; 1365-2222
• DOI: 10.1111/j.1365-2222.2008.02979.x

Summary Background Allergy to specific shrimp species has not been studied systematically by oral challenges. A comparison of allergy to different shrimp species, especially seawater or freshwater varieties treatment, would be useful in testing shrimp‐allergic subjects. Objective The aim of the study was to identify cases of specific allergy to seawater shrimp, Penaeus monodon (Pm), or freshwater shrimp, Macrobrachium rosenbergii (Mr), among shrimp‐allergic children. Comparisons of skin tests using commercial and crude shrimp extracts plus the prick‐to‐prick (PTP) method were investigated. Methods Sixty‐eight children with a history of shrimp allergy and skin tests positive to shrimp were orally challenged to both shrimp species. Reactivity to skin prick tests using extracts of Pm (PmSPT), Mr (MrSPT), commercial shrimp (ComSPT), and PTP tests (PmPTP, MrPTP) was compared. Results Food challenges identified specific allergy to Pm and Mr in 17.65% and 23.53% of the subjects, respectively. Positive and negative challenges to both shrimp species were found in 47.06% and 11.76% of the subjects, respectively. Correlations between the mean weal diameter (MWD) from ComSPT–PmSPT, ComSPT–PmPTP, ComSPT–MrPTP, PmSPT–PmPTP and MrSPT–MrPTP, but not ComSPT–MrSPT, were observed. The MWD from PmSPT and PmPTP were significantly larger in patients with positive than negative challenges to P. monodon (P<0.05). There was a trend that MWD from MrSPT were larger in patients with positive than negative challenges to M. rosenbergii (P=0.058). In the Pm allergy group, PmSPT with an MWD of 30 mm provided 80% predictive probability for positive challenges. PmPTP and ComSPT with an MWD of 22.5 and 20 mm provided 95% predictive probability, respectively. In the Mr allergy group, MrSPT with an MWD of 30 mm provided 95% predictive probability. Conclusion Specific allergy to Pm or Mr was confirmed by food challenges. SPT using crude extracts and the PTP test are useful tools for screening shrimp sensitization before a food challenge. The predictive probability of SPT is helpful where a food challenge is not feasible.