Shellfish Allergy Management

Introduction to Shellfish Allergy

• Patients with shellfish-induced angioedema should strictly avoid all shellfish from their specific group (crustaceans or mollusks) and consider avoiding all shellfish due to the high risk of cross-reactivity between species, as recommended by the American Academy of Allergy, Asthma, and Immunology 1

Diagnosis and Testing

• Patients with a history of severe shellfish allergy should consider testing for other related shellfish and possibly for fish before consumption, according to the American College of Allergy, Asthma, and Immunology 1
• Patients with shellfish allergy can generally consume fish and shellfish without issues if they have alpha-gal syndrome (allergy to mammalian meat), as stated by the American Gastroenterological Association 2

Avoidance and Prevention

• Patients should strictly avoid their identified allergen, read food labels carefully, and inform restaurants about their allergy, as advised by the Food Allergy Research & Education organization 1
• Avoiding restaurants that prepare shellfish and checking food labels for potential shellfish contamination is crucial, as recommended by the American Academy of Allergy, Asthma, and Immunology 1

Treatment and Emergency Planning

• Patients with a history of severe reactions should carry an epinephrine auto-injector and have a plan for emergency treatment, including antihistamines and corticosteroids, according to the American Academy of Allergy, Asthma, and Immunology 1

Relationship with Other Allergies

• There is no relationship between shellfish allergy and allergy to iodinated contrast media, as stated by the American Heart Association 3
• Iodine is not the mediator of allergic reactions to shellfish, and no special premedication is required for contrast studies in patients with shellfish allergy, according to the American College of Radiology 3