Purpose: Fish allergy is rare in children, and there have been few studies on childhood fish allergy. This study aims to investigate the clinical characteristics and laboratory findings of white meat fish (WMF) allergy in Korean children. Methods: In this study, we enrolled 150 children with a history of WMF consumption who underwent serum specific immunoglobulin E to cod (cod-sIgE) at Ajou University Hospital from January 2019 to December 2022. The demographic characteristics, clinical symptoms, history of consuming 6 major Korean WMF (cod, cutlass, yellow croaker, brown sole, olive flounder, and anchovy), and cod-sIgE were investigated. Results: Sixty-five subjects (43.3%) had clinical responses to at least 1 of the 6 WMF (WMF-allergic), and 85 subjects had no allergic reaction to all 6 WMF (WMF-tolerant). The median age of first symptom onset in the WMF-allergic group was 15 months. Major causative WMF were yellow croaker (30.6%), cutlass (28.7%), cod (26.1%), brown sole (20.4%), anchovy (14.7%), and olive flounder (6.5%). Twenty-three of 65 WMF-allergic children (35.4%) had anaphylaxis. The median level of cod-sIgE was 4.61 kUA/L (range, 0.04–100.10 kUA/L) in the WMF-allergic group, and this value was significantly higher (P < 0.001) than that of the WMF-tolerant group (0.04 kUA/L; range, 0.04–3.08 kUA/L). The positive rates ( ≥ class 2, 0.7 kUA/L) of cod-sIgE for the 6 individual WMF ranged from 69% to 90%. Conclusion We propose that WMF allergy can develop in young children, with 35.4% experiencing anaphylaxis. Cod-sIgE is considered a useful tool for diagnosing not only cod allergy but also other WMF allergy in children.

Providing a protocol in the case of multiple food allergies is difficult although the demand of immunotherapy for patients with wheat anaphylaxis is increasing. This case series study aimed to report the wheat oral immunotherapy successfully achieving the maintenance dose along with immunological changes in children with multiple food anaphylaxis. In oral food immunotherapy, personalized therapeutic protocol, which sets the initial dose using the oral food provocation test and increase the dose considering the patients’ needs and compliance, for each patient is essential.

Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.

Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.

Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.

Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.