Assessing diagnostic tests for shrimp allergy in children: A multicenter trial

Yuri Takaoka, MD, PhD; Yuki Tsurinaga, MD; Yukiko Hiraguchi, MD, PhD; Masaaki Hamada, MD, PhD; Atsuko Nakano, MD; Tomoko Kawakami, MD; Ikuo Okafuji, MD, PhD; Nayu Iwakoshi, MD; Masaaki Doi, MD, PhD; Keita Otsuka, MD; Yukiko Sugimoto, MD; Norihito Iba, MD; Junko Kumon, MD; Rumi Ueno, MD; Tamana Nakano, MD; Tomohiro Yamaguchi, MD; Yohei Fuksawa, MD; Amane Shigekawa, MD; Yukinori Yoshida, MD, PhD; Makoto Kameda, MD

Journal of Allergy and Clinical Immunology: Global (Aug 2025)

Assessing diagnostic tests for shrimp allergy in children: A multicenter trial

Yuri Takaoka, MD, PhD,
Yuki Tsurinaga, MD,
Yukiko Hiraguchi, MD, PhD,
Masaaki Hamada, MD, PhD,
Atsuko Nakano, MD,
Tomoko Kawakami, MD,
Ikuo Okafuji, MD, PhD,
Nayu Iwakoshi, MD,
Masaaki Doi, MD, PhD,
Keita Otsuka, MD,
Yukiko Sugimoto, MD,
Norihito Iba, MD,
Junko Kumon, MD,
Rumi Ueno, MD,
Tamana Nakano, MD,
Tomohiro Yamaguchi, MD,
Yohei Fuksawa, MD,
Amane Shigekawa, MD,
Yukinori Yoshida, MD, PhD,
Makoto Kameda, MD

Affiliations

Yuri Takaoka, MD, PhD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan; Corresponding author: Yuri Takaoka, MD, PhD, Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, 3-7-1, Habikino, Osaka 583-8588, Japan.
Yuki Tsurinaga, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Yukiko Hiraguchi, MD, PhD: Department of Pediatrics, Osaka Saiseikai Nakatsu Hospital, Shibata, Kita, Osaka, Japan
Masaaki Hamada, MD, PhD: Department of Pediatrics, Yao Municipal Hospital, Ryuge, Yao, Osaka, Japan
Atsuko Nakano, MD: Department of Pediatrics, Kokuho Chuo Hospital, Daimonjimiyako, Tawaramoto, Shiki, Nara, Japan
Tomoko Kawakami, MD: Department of Pediatrics, Sumitomo Hospital, Nakanoshima, Kita, Osaka, Japan
Ikuo Okafuji, MD, PhD: Department of Pediatrics, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Minatoshima, Chuo, Kobe, Hyogo, Japan
Nayu Iwakoshi, MD: Department of Pediatrics, Higashiosaka City Medical Center, Nishiiwata, Higashiosaka, Osaka, Japan
Masaaki Doi, MD, PhD: Department of Pediatrics, Higashiosaka City Medical Center, Nishiiwata, Higashiosaka, Osaka, Japan
Keita Otsuka, MD: Department of Pediatrics, Nara City Hospital, Higashikidera, Nara, Japan
Yukiko Sugimoto, MD: Department of Pediatrics, Hoshigaoka Medical Center, Hoshigaoka, Hirakata, Osaka, Japan
Norihito Iba, MD: Minnanokodomo Allergy Clinic, Tomoda, Wakayama, Japan
Junko Kumon, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Rumi Ueno, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Tamana Nakano, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Tomohiro Yamaguchi, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Yohei Fuksawa, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Amane Shigekawa, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Yukinori Yoshida, MD, PhD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
Makoto Kameda, MD: Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan

Journal volume & issue: Vol. 4, no. 3
p. 100471

Abstract

Read online

Background: Clinical research on pediatric shrimp allergy is limited. Objective: We sought to evaluate the diagnostic accuracy and safety of testing methods for shrimp allergy. Methods: An oral food challenge (OFC) for shrimp was conducted on Japanese children with suspected shrimp allergy. Before the OFC, shrimp-, tropomyosin-, house dust mite–, and cockroach-specific IgE levels were measured, along with skin prick tests (SPTs). OFC results using epinephrine as a safety indicator determined persistent, mild, or tolerant shrimp allergy. Results: Sixty-six children (median age, 6 years) underwent the OFC. All patients demonstrated house dust mite–specific IgE level exceeding 0.35 IUA/mL. Sixteen were diagnosed with persistent shrimp allergy, defined by Anaphylaxis Scoring Aichi scores greater than or equal to 10 or scores of 5 with urticaria. A 15-year-old required epinephrine for anaphylaxis. Eight children with negative results (scores ≤ 9) reported mild symptoms after repeated home ingestion following the OFC. Median SPT wheal diameters in persistent, mild allergic, and tolerant groups were similarly elevated (8.5 vs 9.5 vs 8.0 mm; P = .99). Patients with persistent shrimp allergy had higher median shrimp- and tropomyosin-specific IgE level than those classified as mild or tolerant (shrimp: 73.5 vs 30.0 vs 9.4 IUA/mL; P = .01; tropomyosin: 68.0 vs 41.9 vs 11.5 IUA/mL; P = .16). Receiver-operating characteristic analysis determined optimal IgE cutoff values as 58.2 IUA/mL for shrimp-specific IgE and 33.5 IUA/mL for tropomyosin-specific IgE. Conclusions: SPT showed limited symptom correlation, whereas shrimp-specific IgE demonstrated greater diagnostic value than tropomyosin-specific IgE. No IgE cutoff accurately predicts a successfully passed OFC.

Published in Journal of Allergy and Clinical Immunology: Global

ISSN: 2772-8293 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/journal-of-allergy-and-clinical-immunology-global

About the journal

Abstract

Keywords