FISH ALLERGY IN CHILDREN

Fish allergy is a relevant clinical problem in fish eating and/or proc essing communities but, because of the technologic advances of the pre served food industry, it may now be said to be a worldwide problem. Am ong 558 consecutive children referred for atopic diseases, 25 (4.48%) subjects skin test- and RAST- positive to cod were recorded and we ext rapolated that about 4-5/1000 children have allergy to cod in our area s. As a group, children with cod allergy seem to manifest a higher ato pic condition and more severe clinical manifestations. IgE level z-sco re (mean +/- SD) was significantly (P <.001) higher in 68 cod-positive children (14.27 +/- 3.87) than in 533 children positive to other inha lant and/or food allergens (8.12 +/- 4.06). In spite of a smaller medi an age (59 months), cod-positive children had a higher frequency of as thma (41/68 = 60.2%) than children with other allergies, and age at th e onset of asthma was significantly (P < .001) younger in the former ( 32 months) than in the latter (41 months) subjects. In addition, urtic aria-angioedema was more frequently recorded in cod-allergic children (23/68 = 33.8%) than in patients with allergy to inhalants (26/410 = 6 .3%; P <.01), inhalants and foods different from cod (11/74 = 14.8%; P <.01), or foods different from cod (6/49 = 12.2%; P < .01). The male female ratio in cod-allergic children (3.53) was significantly higher than that observed in children with allergy to inhalants (1.78; P = .0 37) or foods (0.68; P < .0001). The odds ratio (95% confidence limits) of developing allergy to cod in boys as compared with girls was 2.36 (1.25-4.50). Our previous studies showed that cod testing is a useful approach to fish allergy since 85% of cod-allergic children (versus 10 % of children with other food allergies) were positive to one or more of 17 different fish species tested. On the other hand, our findings a lso suggested that most cod-allergic children can tolerate some fish s pecies. We carried our RAST inhibition experiments showing high-degree cross-reactions among fish species belonging to the actinopterygii su bclass but not between osteichtyes and chondrichthyes class fish speci es. These findings may have clinical relevance in managing cod-allergi c children.