Shellfish Allergy – Symptoms, Diagnosis, and Treatment

Shellfish allergy is the most common self-reported food allergy among U.S. adults, affecting about 3% of adults and 1% of children. It differs from a fin fish allergy and often involves crustaceans (like shrimp, crab, lobster) or mollusks (like clams, oysters, mussels).

Causes

Shellfish allergies result from the immune system mistakenly attacking certain proteins in shellfish, triggering an allergic reaction.

Symptoms

Reactions usually occur within 60 minutes of eating shellfish and may include:

• Mouth/throat itching

• Lip swelling

• Hives or skin redness
  Severe cases can cause anaphylaxis, with symptoms such as:

• Breathing difficulty

• Vomiting or diarrhea

• Low blood pressure, dizziness, or fainting
  Immediate treatment with epinephrine (e.g., EpiPen) is essential in such cases.

Diagnosis

Diagnosis involves:

• Allergy history review

• Skin prick or blood tests (though not always conclusive)

• Oral food challenge under medical supervision to confirm the allergy

Long-Term Outlook

Most people do not outgrow shellfish allergies. Those suspecting improvement should consult an allergist and avoid shellfish unless confirmed safe.

Treatment & Management

• Avoidance of shellfish is key

• Keep epinephrine accessible

• Immunotherapy may reduce sensitivity but doesn’t cure the allergy

• Treatment for accidental exposure includes antihistamines, epinephrine, and breathing treatments if needed

Corticosteroids are not proven effective for immediate allergy treatment. Secondary therapies like oral immunotherapy or biologics (e.g., Omalizumab) may help reduce reaction severity over time.

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