REFERATE GENERALE

Alergia la fructele de mare – abordare diagnostică

 Shellfish allergy – diagnostic approach

First published: 31 octombrie 2023

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Aler.7.3.2023.8792

Abstract

Shellfish allergy is one of the most common food allergies, with an estimated prevalence of 3% in the general population. Crustaceans and mollusks are part of this food category, being capable of immunologic hypersensitivity reactions (IgE-mediated, as well as non-IgE-mediated), but also non-immunologic reactions, based on intoxication with certain neurotoxins from contaminated seafood, in which neurological but also gastrointestinal symptoms predominate. The clinical picture in IgE-mediated hypersensitivity reactions can vary in severity, from mild reactions such as oral allergy syndrome to severe reactions such as anaphylaxis. Among the delayed, non-IgE mediated reactions, we can identify food protein-induced enterocolitis syndrome, food protein-induced enteropathy and food protein-induced allergic proctocolitis, which mainly involve gastrointestinal symptoms. Over the past decades, the knowledge gained regarding the characteristics of different allergens has improved the diagnostic approach. Thus, for an accurate diagnosis of seafood-induced allergy, a thorough history, along with skin prick testing and specific IgE dosing are essential, and when these are insufficient, an oral challenge test can disentangle causality.
 

Keywords
shellfish allergy, crustaceans, molluscs, diagnosis, food allergy

Rezumat

Alergia la fructele de mare este una dintre cele mai frecvente alergii alimentare, cu o prevalenţă estimată de 3% în populaţia generală. Crustaceele şi moluştele fac parte din această categorie de alimente, fiind capabile să inducă atât reacţii de hipersensibilitate imunologice (IgE-mediate sau non-IgE-mediate), cât şi reacţii nonimunologice, bazate pe intoxicaţia cu anumite neurotoxine din fructele de mare contaminate, în care predomină simptomele neurologice, dar şi gastrointestinale. Tabloul clinic în reacţiile de hipersensibilitate IgE-mediate poate varia în severitate, de la reacţii uşoare precum sindromul de alergie orală până la reacţii severe, cum ar fi anafilaxia. Printre reacţiile tardive, non-IgE mediate, regăsim sindromul enterocolitei induse de proteinele alimentare, enteropatia indusă de proteinele alimentare şi proctocolita alergică indusă de proteinele alimentare, acestea implicând în special simptome gastrointestinale. În ultimele decenii, cunoştinţele acumulate cu privire la identificarea caracteristicilor diferitelor alergene au condus la îmbunătăţirea abordării diagnostice. Astfel, pentru un diagnostic de precizie al alergiei alimentare induse de fructele de mare, istoricul amănunţit, alături de testarea cutanată prick şi dozarea de IgE specifice sunt esenţiale, iar când acestea nu sunt suficiente, un test de provocare orală poate tranşa cauzalitatea.
 

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