Shrimp-Induced Anaphylaxis

Abstract

Shrimp and other crustaceans and molluscs are one of the most frequent causes of food allergy and anaphylaxis at all ages. Molecular biology has paved the way to a better understanding of the allergen profile of invertebrates that is much more complex than thought only one decade ago. While tropomyosin has been traditionally considered as the dominating major allergen in crustaceans and other invertebrates, recent research demonstrated that IgE to this allergen can be detected in about 50% of shrimp-allergic patients only. Many of these allergens are conserved ones and, hence, potentially cross-reacting across different invertebrates, including house dust mites. Patients not sensitized to tropomyosin frequently experience anaphylactic reactions, suggesting that also the so-called minor allergens may have an extreme clinical relevance. This review focuses on the clinical features of shrimp allergy and highlights the recent findings on shrimp allergens. The use of epinephrine, which remains a cornerstone of the treatment of anaphylaxis, is reviewed as well.