Allergy information for: Shrimp, white shrimp (Litopenaeus setiferus)

  • Name: Shrimp, white shrimp
  • Scientific Name: Litopenaeus setiferus
  • Occurrence: Eaten as cooked shrimp or prawn, sometimes in batter as scampi, and also cooked in mixed seafood dishes such as paella and often in more general dishes such as Chinese special fried rice.
  • Allergy Information:

    Shrimp along with crayfish, crabs and lobsters are crustaceans. Food allergy to crustaceans is relatively common, symptoms ranging from mild oral allergy to severe symptoms such as anaphylaxis. Cooking does not remove the allergen. Crustacea are the third most important cause of food induced anaphylaxis after peanuts and tree nuts (cashews, almonds, pecans, walnuts, etc.). Thus crustacea and products thereof are listed in annex IIIa of the EU directive on labelling of foods and must be labelled when used as ingredients in pre-packaged food.

    Most allergy to crustacea seems to involve a muscles protein called tropomyosin, which is very similar in a wide range of crustacean foods. As a result someone with allergy to tropomyosin from one kind of crustacean is likely to react to others. Thus individuals with allergy to one kind of crustacean are usually advised to avoid all types of crustacean foods.

    In addition, some individuals with allergies to insects such as cockroach or moths can suffer food allergy to crustacean foods. Whilst most individuals with allergy to shrimps (crustacea) can tolerate molluscs, individuals with allergy to both types of shellfish have been reported. However, individuals allergic to finfish (such as cod or salmon) do not generally have allergies to shellfish.
  • Other Information:

    Crustacea and products thereof are listed in annex IIIa of the EU directive on labelling of foods. Crustacea include shrimps, crabs, crayfish, and lobsters.

  • Taxonomic Information:

    Litopenaeus setiferus NEWT 64468, ITIS 551680

    Publications on food allergy report data from several species of shrimp, sometimes simply remarking "fresh shrimp were purchased locally" without reporting species. Apart from the gammarus shrimps (ITIS 93773), which have only been reported as occupational allergens, all the shrimp species reported as allergenic are decapodes. The order decapoda contains shrimps, prawns, crawfish, lobsters and crabs. These are believed to have evolved from a Devonian shrimp-like ancestor and the penaeoid shrimps are not more closely related to shrimps such as pandalus than to crabs or lobsters.

    The main shrimp species used in publications on food allergy are:

    1. Metapenaeus ensis (NEWT 32278, ITIS 95814) has the English names greasyback shrimp, offshore greasyback shrimp or sand shrimp.

    2. Farfantepenaeus aztecus (NEWT 6690, ITIS 551570) was called Penaeus aztecus and has the English names brown shrimp, gulf shrimp, golden shrimp, northern brown shrimp, red shrimp or redtail shrimp.

    3. Penaeus monodon (NEWT 6703, ITIS 95638) has the English names tiger prawn, giant tiger prawn or black tiger shrimp.

    4. Fenneropenaeus indicus (NEWT 29960, ITIS 95626) was called Penaeus indicus and has the English names Indian prawn, Indian white prawn, tugela prawn or white prawn.

    5. Fenneropenaeus chinensis (ITIS 551578) was called Cancer chinensis, Penaeus chinensis or Penaeus orientalis and has the English name fleshy prawn. NEWT gives two species, Fenneropenaeus chinensis (NEWT 139456) or Fenneropenaeus orientalis (NEWT 70917).

    6. Parapenaeus fissurus (ITIS 95743) was called Penaeus fissurus and has the English name Neptune rose shrimp. This species and the rose shrimp Parapenaeus fissuroides (NEWT 228860, ITIS 551689) are closely related and sometimes treated as synonyms(http://www.fa.gov.tw/tfb10/e/f3/a52b.htm).

    7. Litopenaeus setiferus (NEWT 64468, ITIS 551680) was called Penaeus setiferus or Cancer setiferus (in some articles Penaeus setifecus) and has the English names white shrimp or northern white shrimp.

    8. Pandalus borealis (NEWT 6703, ITIS 96967) has been sometimes called Pandalus borelis or Pandalus boralis. This is a true rather than a penaeoid shrimp. The English names are northern shrimp, northern red shrimp, pink shrimp, coldwater shrimp or deepwater prawn. As this species is used in the Parmacia Diagnostics (Uppsala, Sweeden) ImmunoCAP system, it is often implied when the species is not named.

    A mixture of Penaeus monodon, Penaeus semisulcatus (ITIS 95644, NEWT 64467, green tiger prawn) and Metapenaeus affinis (ITIS 95784, NEWT 228858, jinga shrimp) is used in extracts from Torii Yakuhin (Kobe, Japan).

    9. Crangon crangon (ITIS 97118) is called the common shrimp and also the brown shrimp or better the European brown shrimp. It is a true shrimp carrying its eggs on its legs.

    Note that several names such as "Atlantic shrimp" or "brown shrimp" are used for more than one species.

    Some articles mention the 19th century division of the crustacea into natantia (swimmers such as shrimps) and reptania (walkers such as crabs). The monophylly and subdivision of reptania has been discussed (Ahyong & O'Meally, 2004 [1653]; Dixon et al, 2003 [1654]; Morrison et al, 2002 [1652]) but natantia has found fewer defenders http://tolweb.org/tree?group=Decapoda.
  • Last modified: 18 October 2006

Reviews (0)

    References (3)

    • Morrison CL, Harvey AW, Lavery S, Tieu K, Huang Y, Cunningham CW.
      Mitochondrial gene rearrangements confirm the parallel evolution of the crab-like form.
      Proc Biol Sci. 269(1489):345-350.\r\n. 2002
      PUBMEDID: 11886621
    • Ahyong, ST; O'Meally, D.
      Phylogeny of the Decapoda reptantia: Resolution using three molecular loci and morphology
      RAFFLES BULLETIN OF ZOOLOGY, 52 (2): 673-693\r\n. 2004
      PUBMEDID:
    • Dixon, CJ; Ahyong, ST; Schram, FR.
      A new hypothesis of decapod phylogeny
      CRUSTACEANA, 76: (8) 935-975\r\n. 2003
      PUBMEDID:

    Clinical History

    • Number of Studies:6-10
    • Number of Patients:>50
    • Symptoms:

      Clinical histories do not normally include the species of crustacean. Thus the symptoms below are for all types of shrimp.

      Hoffman et al. (1981) [1600] report symptoms from 11 patients as 3/11 eczema flair, 2/11 urticaria, 1/11 angioedema, 1/11 angioedema and urticaria, 1/11 rash, 1/11 eosinophilic granuloma and 2/11 anaphylaxis.

      To avoid double counting of patients, we quote the summary of Besler et al. (2001) [1598] of the symptoms reported by the New Orleans group in 4 articles, noting that laryngeal symptoms, oral allergy and swelling of lips were counted as gastrointestinal symptoms and that wheeze was the main respiratory symptom. White shrimps and brown shrimps were consumed in the area.

      1. Waring et al. (1985) [1613] reported symptoms from 14 patients as 14% fainting, 57% angioedema, 86% urticaria, 43% gastrointestinal and 29% respiratory symptoms.

      2. Daul et al. 1987 [1574] reported symptoms from 33 patients as 21% anaphylaxis, 6% pruritus, 85% urticaria/angioedema, 40% gastrointestinal and 27% respiratory symptoms.

      3. Daul et al. 1988 [1573] reported symptoms from 9 patients as 33% angioedema, 100% pruritus, 11% urticaria , 44% gastrointestinal and 44% respiratory symptoms.

      4. Morgan et al. 1989 [1571] reported symptoms from 36 patients as 72% angioedema, 75% pruritus, 56% urticaria , 42% gastrointestinal and 39% respiratory symptoms.

      Steensma (2003) [1541] reports a case of anaphylaxis (lip angioedema, throat swelling, diffuse flushing, urticaria, abdominal cramps, nausea, wheezing, severe dyspnea, and hypotension with noninvasive blood pressure level of 80/50 mm Hg) following a kiss from someone who had eaten shrimps. Colas des Francs et al (1991) [1615] also report anaphylaxis at low dose.

      There are several reports of shrimp in articles surveying food induced anaphylaxis such as Strickler et al (1986) [522] or Moneret-Vautrin et al. (2003) [1016].

      Harada et al. (2000) [1593] surveyed the Japanese literature and reported that shrimp and wheat are the two most common allergens involved in food dependent exercise induced anaphylaxis, FDEIA, in Japan. Tokunaga et al. (1995) [1596] and Watanabe et al. (1990) [1597] report individual cases of FDEIA to shrimp and Harada et al. (2001) [767] report a case where both aspirin and exercise were required to cause FDEIA after eating shrimp. The first report of FDEIA with crustacea may have been Maulitz et al. (1979) [1705]. Mathelier-Fusade et al. (2002) [880] and McNeil & Strauss (1988) [1614] also reported cases of FDEIA with shrimp.

      Asthma is often the most important symptom of occupational allergy to shrimps. Asero et al. (2002) [1546] describe a case of allergy to aerosols from cooking shrimps with severe asthma and rhinoconjunctivitis associated with eyelid angioedema in a patient who could tolerate eating shrimps.

    Skin Prick Test

    • Number of Studies:1-5
    • Food/Type of allergen:Daul et al. (1987) [1574], Daul et al. (1988) [1573], Morgan et al. (1989) [1570] and Morgan et al. 1989 [1571] made a water soluble shrimp extract by boiling white shrimps (Litopenaeus setiferus) in deionized water for 15 minutes. Shrimp meat was removed from the shell, degutted and homogenized in PBS, pH 7.2 in a blender. The slurry was shaken overnight at 4°C and centrifuged at 27,500g. The supernatant was concentrated with an Amicon YM5 (cutoff >5000 Da), centrifuged at 105,000g and dialysed against PBS. Extracts were sterile filtered with a 0.45 µm membrane and were tested and found negative for hepatis B surface antigen. Morgan et al. 1989 [1571] also used a similar extract of brown shrimp, Farfantepenaeus aztecus. 
    • Protocol: (controls, definition of positive etc)Daul et al. (1988) [1573] used increasing concentrations of allergen (1µg/ml to 10 mg/ml) to find a positive response defined as a mean wheal diameter 3 mm greater than that from the PBS/glycerol (50% v/v) control.
    • Number of Patients:Daul et al. (1987) [1574] tested 33 patients with a history of shrimp allergy and 29 controls.

      Daul et al. (1988) [1573] tested 30 patients.

      Morgan et al. (1989) [1570] tested 60 patients of whom 36 had a history of shrimp allergy.

      Morgan et al. (1989) [1571] tested 30 shrimp allergic patients with both white and brown shrimp extracts.

    • Summary of Results:Daul et al. (1987) [1574] reported that 28/33 shrimp-sensitive subjects had positive skin prick tests to shrimp extract, whereas skin tests were negative in 27/29 control subjects.

      Daul et al. (1988) [1573] reported 23/30 positive SPT results and 7/30 negative. The oral challenges on these patients associated all but a single open challenge result with the positive SPTs. 

      Morgan et al. (1989) [1570] reported that there was a higher incidence of SPT reactivity to shrimp extract in patients who reported pulmonary symptoms compared to patients without pulmonary symptoms (86% vs. 55%).

      Morgan et al. (1989) [1571] found that 6/30 were negative to both white and brown shrimp extracts, 23/30 were positive for both extracts and a single patient was positive only for brown shrimp.

    IgE assay (by RAST, CAP etc)

    • Number of Studies:0
    • Food/Type of allergen:

      Lehrer et al. (1990) [1607] made a water soluble shrimp extract by boiling white shrimps (Litopenaeus setiferus) in deionized water for 15 minutes. Shrimp meat was removed from the shell, degutted and homogenized in PBS, pH 7.2 for 3 min. in a blender. The slurry was shaken overnight at 4°C and centrifuged at 44,000g. The supernatant was concentrated with an Amicon YM2 (cutoff >1000 Da), dialysed with a 3.5 kDa cutoff against PBS and centrifuged at 78,000g. The supernatant was then aliquoted and stored at -20°C. The water from the initial boiling was also concentrated with a YM2, dialysed against water, centrifuged, freeze dried and stored at -20°C.

      Daul et al. (1987) [1574], Daul et al. (1988) [1573], Morgan et al. (1989) [1570] and Morgan et al. 1989 [1571] used the extract of boiled white shrimp described for SPT. Morgan et al. 1989 [1571] also used a similar extract of brown shrimp, Farfantepenaeus aztecus. 

    • IgE protocol:

      Daul et al. (1987) [1574] and Daul et al. (1988) [1573] used RAST for IgE and ELISA for IgG, IgA and IgM.

      Morgan et al. 1989 [1571] and Lehrer et al. (1990) [1607] used RAST and RAST inhibition.

    • Number of Patients:

      Daul et al. (1988) [1573] tested sera from 30 patients who were also subjected to oral challenge.

      Morgan et al. 1989 [1571] tested sera from 31 shrimp allergic patients and 13 atopic shrimp tolerant controls.

      Lehrer et al. (1990) [1607] tested sera from 14 shrimp allergic patients and 6 atopic shrimp tolerant controls.

    • Summary of Results:

      Daul et al. (1988) [1573] reported a good correlation between shrimp RAST and both SPT reactions and response to oral challenge. The combination of a positive SPT to shrimp and >11% bound in shrimp RAST had a 87% positive predictive value. Np correlation of IgG, IgA or IgM levels with challenge responses was observed.

      Morgan et al. 1989 [1571] reported that 16/31 patients had positive RAST to both brown and white shrimp, one was only positive to white shrimp and 2 only to brown shrimp extract. None of the sera from SPT negative patients gave a positive RAST. RAST Inhibition studies of 7 sera with high RASTs showed that 2 showed qualitatively different allergens between white and brown shrimp.

      Lehrer et al. (1990) [1607] report significant specific anti-shrimp meat and shrimp water IgE from all 14 sera from allergic patients with low binding from control sera.  Shrimp meat and shrimp water extacts could inhibit each other to at least 50%. 

      Daul et al. (1990) [1568] reported that specific anti-shrimp IgE was maintained in the 7 DBPCFC positive patients tested over at least 24 months.

    Immunoblotting

    • Immunoblotting separation:Lehrer et al. (1990) [1607] separated shrimp allergens by isoelectric focusing in thin 5% polyacrylamide gels (LKB PAG plates, Bromma, Sweeden) with a pH range 4.0 to 6.5.  
    • Immunoblotting detection method:

      Lehrer et al. (1990) [1607] cut the gel and fixed half in 11.5% trichloracetic acid and 3.5% sulfosalicylic acid, before staining with Coomassie brilliant blue in 20% methanol and 8% acetic acid. The other half of the gel was blotted by passive transfer onto a 0.2µm pore nitrocellulose membrane. This was blocked for 1 hour with 0.05M phosphate buffer, pH 7.5, with 1% (w/v) bovine serum albumin and 0.4% (v/v) Tween 20. The strips were incubated with human sera, washed with phosphate/Tween buffer and incubated overnight in 125I-labelled equine anti-human IgE diluted with blocking buffer. After washing, IgE binding was revealed by autoradiography at -70°C for 48 hours.

    • Immunoblotting results:Lehrer et al. (1990) [1607] reported that 86% of the 14 sera reacted with allergens with pIs from 5.5 to 6.0. The 12 individual sera showed from 3 to 7 bands in this region. 8 0f these sera reacted to proteins focusing between pH 4.5 and 5.0 (57.5%) and 9 (64.3%) reacted to proteins focusing between pH 5.0 and 5.5. Only 4/12 sera bound proteins focusing below pH 4.5. 2/14 sera did not show any binding in the blot.

    Oral provocation

    • Number of Studies:1-5
    • Food used and oral provocation vehicle:

      A water soluble shrimp extract was made by boiling white shrimps (Litopenaeus setiferus) in deionized water for 15 minutes. Shrimp meat was removed from the shell, degutted and ground in 0.1M PBS, pH 7.2. The slurry was stirred overnight at 4°C and centrifuged at 27,500g. The supernatant was concentrated with an Amicon YM5 (cutoff 5 kDa) and centrifuged at 105,000g. The supernatant was then dialysed against PBS, aliquoted and stored at -20°C. The extract was disguised in a grape flavoured vanilla ice-cream milkshake. Increasing doses of 1, 4 and 16 shrimp equivalents were given at 1hr. intervals. The open challenge was 16 shrimps (approx. 64 g.) (Daul et al. 1988 [1573]).

      Several articles report oral challenge to "shrimp" in studies of allergy to a range of allergenic foods without giving details of the shrimp species or the food preparations (Rance et al. (2005) [1647]; Osterballe et al (2005) [1764]; Rance & Dutau, 1997[481]; Stricker et al, 1986 [522]; Atkins et al, 1985 [1704]).

    • Blind:Double blind challenge followed by open challenge if negative (Daul et al. 1988 [1573]).
    • Number of Patients:

      30 patients were challenged by Daul et al. (1988) [1573] with clinical histories of oropharyngeal pruritus (90%), urticaria (61%), angioedema (52%), wheezing (42%), gastero-intestinal symptoms (35%) and anaphylaxis (10%).

      Atkins et al. (1985) [1704] reported 4 positive challenges with shrimp.

      Stricker et al. (1986) [522] reported a single positive challenge with shrimp.

      Rance & Dutau (1997) [481] reported 4 positive challenges with shrimp.

      The study of Rance et al. (2005) [1647] found 4 positive challenges with shrimp (Rance pers. comm.)

      Osterballe et al (2005) [1764] reported 3 positive challenges with shrimp.  

    • Dose response:Not reported.
    • Symptoms:

      Daul et al. (1988) [1573] reported that 9/30 patients gave a positive challenge with objective symptoms. 6 of these reacted to the blind challenge and 3 to the open challenge. All reactions occurred within 1hr. and all but 2 (persistant vomiting and wheezing) resolved without treatment. 12 reacted only with subjective symptoms of oropharyngeal pruritus. All DBPCFC positive patients also complained of subjective symptoms at lower doses. 9 patients did not respond to the challenge.

    IgE cross-reactivity and Polysensitisation

    There is strong IgE cross-reactivity between all the crustacea. The most important allergen in these species is tropomyosin and DeWitt et al. (2004) [1536] reported that recombinant Pen a 1 bound 94% of the IgE from the 6 crustacea specific sera. As tropomyosin is strongly conserved in sequence with more than 99% identity amongst penaeoid shrimps and 92% identity between more distantly related crustacea such as a penaeoid shrimp (Farfantepenaeus aztecus) and a crab (Charybdis feriatus), allergy to crustacea is generally treated as a single allergy.

    Lehrer et al. (1985) [1706] used crossed immunoelectrophoresis to show that of the 7 allergens detected from white shrimp, 5 cross-reacted with crayfish, 3 with lobster and 1 with crab extract. Two precipitins appear to be common crustacea allergens and were present in shrimp, crayfish, lobster and crab.

    Chiou et al. (2003) [1689] studied cross-reactivity of 67 sera IgE with 36 Pharmacia allergens. There was a significant correlation of reactivity between F23 from crab, Cancer pagus, and F24 from shrimp, Pandalus borealis. 27 sera bound F23 and 28 bound F24 and 20 sera bound both allergens. Inhibition studies on 15 sera showed that 3 showed an inhibition of >50% between shrimp and cockroach reactive sera, 11 showed a inhibition of >50% between shrimp and crab reactive sera, and 4 showed a inhibition of >50% between crab and cockroach reactive sera.

    As mentioned above, Morgan et al. (1989) [1571] report that 1/16 subjects reacted only to white shrimp (Litopenaeus setiferus) extracts and 2/16 subjects to brown shrimp (Farfantepenaeus aztecus) extract alone. Greater differences might be predicted for less closely related crustacea.

    Crustacea are eaten after cooking so that the resistance of the allergenicity of tropomyosins to heat may cause these to be more dominant. Similarly, the use of extracts from boiled shrimp may favour the identification of the highly conserved tropomyosins. It is possible that less heat stable allergens are more species specific and that reaction to allergens such as arginine kinase (Yu et al. 2003 [1542]) is dependent on both cooking conditions and species.

    There is also IgE cross-reactivity between crustacea and insects, gastropods, bivalves and cephalopods (Lehrer & McCants, 1985 [1575]; van Ree et al, 1996 [1609]; Leung et al, 1999 [1557]; Goetz & Whisman, 2000 [1594]). This is believed to be due to allergenic tropomyosins. Fernandez et al. (2003) [1539] demonstrated IgE binding and SPT reactivity to shrimp in subjects sensitised by insect and mite allergens without prior exposure to shrimp.

    In contrast to the observed cross-reactivity in IgE binding between arthropods and mollusks, clinical cross-reactivity is less common and some but not all crustacea allergics can tolerate mollusks (Leung et al, 1996 [1557]; Ishiwara et al., 1998 [1584]; Ishiwara et al., 1998 [1582]).

    Other Clinical information

    Although many articles described allergy to white shrimp in the period 1985-1990, subsequent research has characterized molecular allergens from other shrimps, including the greasyback shrimp, Metapenaeus ensis and the brown shrimp, Farfantepenaeus aztecus. As the allergens are likely to be similar, data on other shrimps is relevant to this entry. As the species is often unspecified, data on "shrimps" is often repeated in several entries.

    Rance et al. (2005) [1647] reported that 13 of 183 food allergic children were allergic to shrimp, showing that shrimp was responsible for 5.3% of food allergies in their population (7th most common). As 2716 questionaires had been returned from children at a number of schools, this implied a prevalence of 0.48%. Osterballe et al (2005) [1764] reported that 3 adults and no children were allergic to shrimp by DBPCFC from their population of 898 children and 936 adults. Thus the adult prevalence of allergy to shrimp was 0.3%.

    Morgan et al. (1989) [1570] reported SPT results with other foods for 36 patients with a history of shrimp allergy. The atopic patients with pulminary symptoms were also more likely to show other sensitizations.

    Morgan et al. (1990) [1567] determined the levels of different classes of IgG antibodies to white shrimp extract in the sera of 31 DBPCFC positive patients. IgG1, IgG2 and IgG4 antibodies levels were higher in shrimp allergic individuals than in controls (significantly for IgG2 and IgG4). However, the IgG levels did not give useful diagnostic information. 

    Sheah-Min & Choon-Kook (2001) [1547] similarly measured levels of IgE, IgG and IgG4 to shrimp and crab (using Bencard allergens) in allergic patients. The levels of these antibodies did not correspond with each other. High IgE or IgG4 levels were significantly associated with allergy. IgE levels were most predictive of allergy but were not a reliable test for allergy.

    Crustacea have been frequently reported as occupational allergens. Several species in addition to those mentioned in articles on food allergy have been reported as occupational allergens including snow crabs (Cartier et al, 1986 [1591]; Cartier et al, 2004 [1610]), Nephrops norvegicus or scampi (Griffin et al, 2001 [1611]) and gammarus shrimps (Fontan et al. 2005 [1765]; Baur et al. 2000 [1550]). Occupational allergy probably involves aerosols (Bang et al. 2005 [1767]; Goetz & Whisman, 2000 [1594]; Desjardins et al 1995 [1561]) and both the stability of tropomyosins in boiling water (Lehrer et al. 1990 [1607]) and their cross-reactivity may be significant. Other allergens such as the 97 kDa allergen of scampi are also stable as aerosols (Griffin et al, 2001 [1611]). However, contact determatis has also been reported (Aasmoe et al, 2005 [1766]; Scharer et al, 2002 [1612]).

    Shellfish can act as hidden allergens in fishcake made from finfish and Faeste et al. (2003) [1616] report a case of anaphylaxis with detection of IgE against shrimp tropomyosin and also detection of (invertebrate) tropomyosin in the fish cake.

    Apparent allergy to shellfish can arise from allergy to parasitic worms (Gonzalez-Galan et al. 2002 [1388]).

    Reviews (4)

    • Lehrer SB, Ayuso R, Reese G.
      Seafood allergy and allergens: a review.
      Mar Biotechnol (NY). 5(4):339-348.. 2003
      PUBMEDID: 14719162
    • Lehrer SB, Ayuso R, Reese G.
      Current understanding of food allergens
      Ann N Y Acad Sci. 964:69-85.. 2002
      PUBMEDID: 12023195
    • Besler M, Daul CB, Leung PSC.
      Allergen Data Collection: Shrimps (Natantia)
      Internet Symposium on Food Allergens 3(1): 37-53. 2001
      PUBMEDID:
    • Chu KH, Tang CY, Wu A, Leung PS.
      Seafood allergy: lessons from clinical symptoms, immunological mechanisms and molecular biology.
      Adv Biochem Eng Biotechnol. 97:205-235.. 2005
      PUBMEDID: 16261809

    References (48)

    • Daul CB, Morgan JE, Hughes J, Lehrer SB.
      Provocation-challenge studies in shrimp-sensitive individuals.
      J Allergy Clin Immunol. 81(6):1180-1186.. 1988
      PUBMEDID: 3379230
    • Morgan JE, O'Neil CE, Daul CB, Lehrer SB.
      Species-specific shrimp allergens: RAST and RAST-inhibition studies.
      J Allergy Clin Immunol. 83(6):1112-1117. 1989
      PUBMEDID: 2732411
    • Stricker WE, Anorve-Lopez E, Reed CE,
      Food skin testing in patients with idiopathic anaphylaxis.
      J Allergy Clin Immunol 77: 516-519.. 1986
      PUBMEDID: 3950255
    • Rance F, & Dutau G
      Labial food challenge in children with food allergy.
      Pediat Allergy Immunol 8: 41-4.. 1997
      PUBMEDID: 9260218
    • Lehrer SB, Ibanez MD, McCants ML, Daul CB, Morgan JE.
      Characterization of water-soluble shrimp allergens released during boiling.
      J Allergy Clin Immunol. 85(6):1005-1013.. 1990
      PUBMEDID: 2355151
    • Morgan JE, Daul CB, Lehrer SB.
      The relationships among shrimp-specific IgG subclass antibodies and immediate adverse reactions to shrimp challenge.
      J Allergy Clin Immunol. 86(3 Pt 1):387-392.. 1990
      PUBMEDID: 2212410
    • Daul CB, Morgan JE, Waring NP, McCants ML, Hughes J, Lehrer SB.
      Immunologic evaluation of shrimp-allergic individuals.
      J Allergy Clin Immunol. 80(5):716-722.. 1987
      PUBMEDID: 3680815
    • Morgan JE, Daul CB, Hughes J, McCants M, Lehrer SB.
      Food specific skin-test reactivity in atopic subjects.
      Clin Exp Allergy 19(4):431-435.. 1989
      PUBMEDID: 2758357
    • Waring NP, Daul CB, deShazo RD, McCants ML, Lehrer SB.
      Hypersensitivity reactions to ingested crustacea: clinical evaluation and diagnostic studies in shrimp-sensitive individuals.
      J Allergy Clin Immunol. 76(3):440-445.. 1985
      PUBMEDID: 4031316
    • Sheah-Min Y, Choon-Kook S.
      The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients.
      Asian Pac J Allergy Immunol. 19(1):7-10.. 2001
      PUBMEDID: 11495303
    • Atkins FM, Steinberg SS, Metcalfe DD.
      Evaluation of immediate adverse reactions to foods in adult patients. II. A detailed analysis of reaction patterns during oral food challenge.
      J Allergy Clin Immunol. 75(3):356-363.. 1985
      PUBMEDID: 3973310
    • Maulitz RM, Pratt DS, Schocket AL.
      Exercise-induced anaphylactic reaction to shellfish.
      J Allergy Clin Immunol. 63(6):433-434.. 1979
      PUBMEDID: 447945
    • Daul CB, Morgan JE, Lehrer SB.
      The natural history of shrimp hypersensitivity.
      J Allergy Clin Immunol. 86(1):88-93.. 1990
      PUBMEDID: 2370391
    • Lehrer SB, McCants ML.
      Reactivity of IgE antibodies with crustacea and oyster allergens: evidence for common antigenic structures.
      J Allergy Clin Immunol. 80(2):133-139.. 1987
      PUBMEDID: 2440933
    • Lehrer SB, McCants ML, Salvaggio JE.
      Identification of crustacea allergens by crossed radioimmunoelectrophoresis.
      Int Arch Allergy Appl Immunol. 77(1-2):192-194.. 1985
      PUBMEDID: 4008073
    • Cartier A, Malo JL, Ghezzo H, McCants M, Lehrer SB.
      IgE sensitization in snow crab-processing workers.
      J Allergy Clin Immunol. 78(2):344-348. . 1986
      PUBMEDID: 3734286
    • Tokunaga H, Kokubu F, Okamoto M, Miyamoto M, Hanyuuda M, Adachi M.
      [A case of food-dependent exercise-induced anaphylaxis induced by shrimp]
      Arerugi 44(11):1297-1304.. 1995
      PUBMEDID: 8857109
    • Griffin P, Allan L, Gibson M, Elms J, Wiley K, Curran AD.
      Measurement of personal exposure to aerosols of Nephrops norvegicus (scampi) using a monoclonal-based assay.
      Clin Exp Allergy 31(6):928-933.. 2001
      PUBMEDID: 11422159
    • Scharer L, Hafner J, Wuthrich B, Bucher C.
      Occupational protein contact dermatitis from shrimps. A new presentation of the crustacean-mite syndrome.
      Contact Dermatitis. 46(3):181-182.. 2002
      PUBMEDID: 12000333
    • Asero R, Mistrello G, Roncarolo D, Amato S.
      A case of allergy to airborne, heat-labile shrimp allergens.
      J Allergy Clin Immunol. 109(2):371-372.. 2002
      PUBMEDID: 11842314
    • Gonzalez Galan I, Garcia Menaya JM, Jimenez Ferrera G, Gonzalez Mateos G.
      Anaphylactic shock to oysters and white fish with generalized urticaria to prawns and white fish.
      Allergol Immunopathol (Madr). 30(5):300-303.. 2002
      PUBMEDID: 12396966
    • Faeste CK, Wiker HG, Lovik M, Egaas E.
      Hidden shellfish allergen in a fish cake.
      Allergy 58(11):1204-1205.. 2003
      PUBMEDID: 14616143
    • Harada S, Horikawa T, Icihashi M.
      [A study of food-dependent exercise-induced anaphylaxis by analyzing the Japanese cases reported in the literature]
      Arerugi. 49(11):1066-1073.. 2000
      PUBMEDID: 11193458
    • Baur X, Huber H, Chen Z.
      Asthma to Gammarus shrimp.
      Allergy 55(1):96-97.. 2000
      PUBMEDID: 10696868
    • Goetz DW, Whisman BA.
      Occupational asthma in a seafood restaurant worker: cross-reactivity of shrimp and scallops.
      Ann Allergy Asthma Immunol. 85(6 Pt 1):461-466.. 2000
      PUBMEDID: 11152166
    • Cartier A, Lehrer SB, Horth-Susin L, Swanson M, Neis B, Howse D, Jong M.
      Prevalence of crab asthma in crab plant workers in Newfoundland and Labrador.
      Int J Circumpolar Health 63 Suppl 2:333-336.. 2004
      PUBMEDID: 15736679
    • Steensma DP.
      The kiss of death: a severe allergic reaction to a shellfish induced by a good-night kiss.
      Mayo Clin Proc. 78(2):221-222.. 2003
      PUBMEDID: 12583533
    • Hoffman DR, Day ED Jr, Miller JS.
      The major heat stable allergen of shrimp.
      Ann Allergy 47(1):17-22.. 1981
      PUBMEDID: 7258736
    • Mathelier-Fusade P, Vermeulen C, Leynadier F.
      [Responsibility of food in exercise-induced anaphylaxis: 7 cases]
      Ann Dermatol Venereol. 129(5 Pt 1):694-697.. 2002
      PUBMEDID: 12124510
    • McNeil D, Strauss RH.
      Exercise-induced anaphylaxis related to food intake.
      Ann Allergy 61(6):440-442.. 1988
      PUBMEDID: 3202335
    • Harada S, Horikawa T, Ashida M, Kamo T, Nishioka E, Ichihashi M.
      Aspirin enhances the induction of type I allergic symptoms when compined with food and exercise in patients with food-dependent exercise-induced anaphylaxis
      British Journal of Dermatology 144: 336-339. 2001
      PUBMEDID: 11531805
    • Watanabe T, Sakamoto Y, Tomonaga H, Inuyama M, Sasayama H, Hara K, Imamura Y, Asai S.
      [A case of food-dependent exercise-induced anaphylaxis]
      Arerugi 39(11):1523-1528.. 1990
      PUBMEDID: 2288498
    • Leung PS, Chow WK, Duffey S, Kwan HS, Gershwin ME, Chu KH.
      IgE reactivity against a cross-reactive allergen in crustacea and mollusca: evidence for tropomyosin as the common allergen.
      J Allergy Clin Immunol. 98(5 Pt 1):954-961.. 1996
      PUBMEDID: 8939159
    • Yu CJ, Lin YF, Chiang BL, Chow LP.
      Proteomics and immunological analysis of a novel shrimp allergen, Pen m 2.
      J Immunol. 170(1):445-453.. 2003
      PUBMEDID: 12496430
    • van Ree R, Antonicelli L, Akkerdaas JH, Pajno GB, Barberio G, Corbetta L, Ferro G, Zambito M, Garritani MS, Aalberse RC, Bonifazi F.
      Asthma after consumption of snails in house-dust-mite-allergic patients: a case of IgE cross-reactivity.
      Allergy 51(6):387-393.. 1996
      PUBMEDID: 8837661
    • Ishikawa M; Ishida M; Shimakura K; Nagashima Y; Shiomi K.
      Purification and IgE-binding epitopes of a major allergen in the gastropod Turbo cornutus
      Biosci Biotechnol Biochem. 62(7):1337-1343 . 1998
      PUBMEDID: 9720216
    • Ishikawa M; Ishida M; Shimakura K; Nagashima Y; Shiomi K.
      Tropomyosin, the major oyster Crassostrea gigas allergen and its IgE-binding epitopes
      JOURNAL OF FOOD SCIENCE 63, Iss 1, 44-47 . 1998
      PUBMEDID:
    • DeWitt AM, Mattsson L, Lauer I, Reese G, Lidholm J.
      Recombinant tropomyosin from Penaeus aztecus (rPen a 1) for measurement of specific immunoglobulin E antibodies relevant in food allergy to crustaceans and other invertebrates.
      Mol Nutr Food Res. 48(5):370-379.. 2004
      PUBMEDID: 15672477
    • Chiou YH, Yuo CY, Wang LY, Huang SP.
      Detection of cross-reactivity for atopic immunoglobulin E against multiple allergens.
      Clin Diagn Lab Immunol. 10(2):229-232.. 2003
      PUBMEDID: 12626447
    • Rance F, Grandmottet X, Grandjean H.
      Prevalence and main characteristics of schoolchildren diagnosed with food allergies in France.
      Clin Exp Allergy 35(2):167-172. . 2005
      PUBMEDID: 15725187
    • Osterballe M, Hansen TK, Mortz CG, Host A, Bindslev-Jensen C.
      The prevalence of food hypersensitivity in an unselected population of children and adults.
      Pediatr Allergy Immunol. 16(7):567-573.. 2005
      PUBMEDID: 16238581
    • Fontan M, Anibarro B, Postigo I, Martinez J.
      Allergy to freshwater shrimp (Gammarus).
      J Investig Allergol Clin Immunol. 2005;15(2):150-2.. 2005
      PUBMEDID: 16047717
    • Bang B, Aasmoe L, Aamodt BH, Aardal L, Andorsen GS, Bolle R, Boe R, Van Do T, Evans R, Florvag E, Gram IT, Huser PO, Kramvik E, Lochen ML, Pedersen B, Rasmussen T.
      Exposure and airway effects of seafood industry workers in northern Norway.
      J Occup Environ Med. 2005 May;47(5):482-492.. 2005
      PUBMEDID: 15891527
    • Aasmoe L, Bang B, Andorsen GS, Evans R, Gram IT, Lochen ML.
      Skin symptoms in the seafood-processing industry in north Norway.
      Contact Dermatitis 52(2):102-107.. 2005
      PUBMEDID: 15725289
    • Colas des Francs V, Kopferschmitt-Kubler MC, Kopferschmit J et al.
      Choc anaphylactique après projection oculaire de jus de crevette.
      Rev Fr Allergol 31: 49-51.. 1991
      PUBMEDID:
    • Moneret-Vautrin DA, Kanny G, Morisset M, Rance F, Fardeau MF, Beaudouin E.
      Severe food anaphylaxis: 107 cases registered in 2002 by the Allergy Vigilance Network.
      Allerg Immunol (Paris). 36(2):46-51.. 2004
      PUBMEDID: 15061394
    • Fernandes J, Reshef A, Patton L, Ayuso R, Reese G, Lehrer SB.
      Immunoglobulin E antibody reactivity to the major shrimp allergen, tropomyosin, in unexposed Orthodox Jews.
      Clin Exp Allergy. 33(7):956-961.. 2003
      PUBMEDID: 12859453
    • Desjardins A, Malo JL, L'Archeveque J, Cartier A, McCants M, Lehrer SB.
      Occupational IgE-mediated sensitization and asthma caused by clam and shrimp.
      J Allergy Clin Immunol. 96(5 Pt 1):608-617.. 1995
      PUBMEDID: 7499677