Sea urchin roe (uni) anaphylaxis.

BACKGROUND

Sea urchin roe, a Japanese and Korean delicacy served with sushi, has not been previously described as a food allergen.

OBJECTIVE

To determine the specific cause of anaphylaxis that occurred while eating a sushi meal consisting of crackling shrimp, California roll with snow crab and sea urchin roe (uni), cooked eel (unagi) with fish sauce, rice, and saki mayo.

METHODS

Allergy percutaneous skin testing, serum IgE testing via the Pharmacia ImmunoCAP system, and fresh eel and sea urchin roe food testing were performed.

RESULTS

Allergy evaluation included negative skin testing to shrimp, lobster, crab, oyster, clam, scallop, tuna, salmon, and cod. Pharmacia ImmunoCAP testing did not detect any specific IgE to oyster, crab, shrimp, blue mussel, lobster, clam, scallop, or eel (allergen specific IgE <0.35 KU/L). Fresh sea urchin roe skin prick testing yielded a 16-mm wheal and a 25-mm flare (histamine positive control: 7-mm wheal and 10-mm flare). Results of fresh eel skin prick testing were similar to those of the saline negative control.

CONCLUSIONS

This case represents the first reported episode of sea urchin roe anaphylaxis. Consideration and investigation of novel food allergens may decipher causes of unexplained, food-related anaphylaxis.