Jewish cuisine is a collection of cookery traditions linked by Jewish dietary laws and holiday traditions. Certain foods, notably pork and shellfish, are forbidden.A question from Twitter:
@kidneynotes A puzzle: an Orthodox Jewish patient with an allergy to shellfish.
Answer:
Patients with seafood allergy are frequently reported to also have allergic reactions to mites and insects. This cross-reactivity is probably due to the high amino acid homology of these invertebrate tropomyosins and may have significant clinical implications.
A recent study demonstrated sensitization to shrimp tropomyosin in orthodox Jews who are prohibited by religious dietary laws from eating shellfish; however, as they were never exposed to crustacean allergens, this sensitization to tropomyosin is probably due to a noncrustacean source, such as house dust mites (HDM), cockroaches or both, via inhalation.
Seafood hypersensitivity in mite sensitized individuals: is tropomyosin the only responsible allergen?
Tropomyosin does not seem to be the main allergen involved in mite-seafood sensitization in mite sensitized individuals. However, high levels of sIgE to tropomyosin seem to be related to severity of symptoms. http://goo.gl/Wj9xW
References:
Immunoglobulin E antibody reactivity to the major shrimp allergen, tropomyosin, in unexposed Orthodox Jews. Fernandes J, Reshef A, Patton L, Ayuso R, Reese G, Lehrer SB. Clin Exp Allergy. 2003 Jul;33(7):956-61.
New Insights Into Seafood Allergy. Andreas L. Lopata; Samuel B. Lehrer. From Current Opinion in Allergy and Clinical Immunology.
Exposure to cockroach is linked to high shrimp IgE with questionable clinical reactivity - food challenge is needed for diagnosis (JACI, 2011).
A 20-year-old man with a known dust mite-related allergic rhinitis develops rash, dyspnea, bradycardia, dizziness 30 minuts after eating oysters. What is the cause?
(A) Shigella
(B) Cholera
(C) Scrombroid
(D) Tropomyosin
(E) Parvalbumin
Answer: Tropomyosin. Shrimp Allergy in Italian Adults: Skin reactivity to house dust mite (HDM) was found 70% (Int Arch Allergy Immunol. 2011),
References:
Immunoglobulin E antibody reactivity to the major shrimp allergen, tropomyosin, in unexposed Orthodox Jews. Fernandes J, Reshef A, Patton L, Ayuso R, Reese G, Lehrer SB. Clin Exp Allergy. 2003 Jul;33(7):956-61.
New Insights Into Seafood Allergy. Andreas L. Lopata; Samuel B. Lehrer. From Current Opinion in Allergy and Clinical Immunology.
Exposure to cockroach is linked to high shrimp IgE with questionable clinical reactivity - food challenge is needed for diagnosis (JACI, 2011).
Cross Reactions Among Foods (PDF).
Shellfish allergy is a frequent, long-lasting, life-threatening disorder. As shellfish consumption increases, the number of allergic reactions to shellfish is expected to continue to rise too http://goo.gl/D2PRx