Division of Pediatric Allergy, Koc University Hospital, 34010 Istanbul, Turkey
Marzio Masini
Department of Pediatrics, Sapienza University of Rome, 00185 Rome, Italy
Francesca Mori
Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy
Simona Barni
Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy
Giulia Liccioli
Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy
Lucrezia Sarti
Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy
Lorenzo Lodi
Department of Health Sciences, Division of Immunology, Section of Pediatrics, University of Florence and Meyer Children’s Hospital, 50139 Florence, Italy
Mattia Giovannini
Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy
George du Toit
Pediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London SE5 9NU, UK
Andreas Ludwig Lopata
Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
Maria Andreina Marques-Mejias
Pediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London SE5 9NU, UK
Fish allergy constitutes a severe problem worldwide. Its prevalence has been calculated as high as 7% in paediatric populations, and in many cases, it persists into adulthood with life-threatening signs and symptoms. The following review focuses on the epidemiology of Immunoglobulin E (IgE)-mediated fish allergy, its pathogenesis, clinical manifestations, and a thorough approach to diagnosis and management in the paediatric population. The traditional approach for managing fish allergy is avoidance and rescue medication for accidental exposures. Food avoidance poses many obstacles and is not easily maintained. In the specific case of fish, food is also not the only source of allergens; aerosolisation of fish proteins when cooking is a common source of highly allergenic parvalbumin, and elimination diets cannot prevent these contacts. Novel management approaches based on immunomodulation are a promising strategy for the future of these patients.
