D2.336 - Risk of systemic reactions among school-age children sensitized to fish, crustaceans and molluscs

The prevalence of food allergy and related systemic reactions has increased worldwide in recent decades. Fish and seafood are recognized as important triggers of severe allergic reactions. School-aged children are at particular risk due to increased exposure to allergens outside the home environment and unstable supervision, but epidemiological data on the incidence of systemic reactions remain limited. A better understanding of prevalence patterns in this age group is important for risk assessment and prevention strategies.

The study included 270 children aged 5 to 14 years, sensitized to fish, shellfish and crustacean allergens with various clinical manifestations of food allergy. The sensitization profile was studied using the molecular multiplex test ALEX2 (Macro Array Diagnostics GmbH, Austria). Among the examined children, a group of children with severe systemic reactions to fish and seafood was identified.

During the study of 270 children with food allergy to fish, shellfish, and crustaceans, 38 (14.1%) children experienced severe systemic reactions. The severity of allergic reactions was determined according to the current WAO and EAACI guidelines. Severity criteria were symptoms of anaphylaxis (drop in blood pressure), angioedema, severe dyspnea with decreased oxygen saturation, severe respiratory and hemodynamic compromise, which were accompanied by the administration of one or two doses of adrenaline and hospitalization in the emergency department.

Fish was the cause of a severe allergic reaction in 24 (8.9%) children, mollusks and crustaceans in 11 (4.1%) children, and combined sensitization to fish, crustaceans, and mollusks in 3 (1.1%).

Allergy to fish, shellfish and crustaceans is a common phenomenon. In recent years, the number of cases of severe systemic reactions to these foods has increased significantly. The most common cause of anaphylaxis among school-age children is allergy to fish. This necessitates the need for early diagnosis of food allergy. The capabilities of modern molecular diagnostics allow us to identify dangerous sensitization and recommend adequate elimination. Patient awareness of the danger and the ability to use epinephrine in a timely manner are vital.