Tuna/Yellow fin

 
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Code: f40
Latin name: Thunnus albacares
Source material: Fish muscle
Family: Scombridae
Anaphylaxis after ingestion of tuna has been reported

Allergen Exposure

Meat from tuna.
Tuna is sold fresh, canned or frozen.
Japanese sashimi/sushi includes raw tuna.

Potential Cross-Reactivity

Species within groups of fish, like Gadiformes (examples: codfish and hake) and Scombroid fishes (examples: mackerel and tuna) seem to share allergenic components. The overlap of allergen specificity between the groups seems to be moderate and small.

Clinical Experience

IgE-mediated reactions
Anaphylaxis after ingestion of tuna has been reported.
It has been suggested that canned tuna is not as allergenic as cooked and raw tuna.
 
Other reactions
In Scombroid fish (examples: tuna, mackerel) histamine is rapidly formed upon storage.
 
Review
Tuna is an oceanic fish of great commercial value. The family includes bonitos and mackerel. It thrives in warmer seas where different species vary considerably in size and appearance, but T. albacares is most prevalent in the Pacific. Tagging studies have shown that individual tunas have crossed every major ocean of the world. Bluefin tunas can weigh up to 700 kg. Tuna has been hunted since ancient times but the overzealous fishing during this century has resulted in over-fishing in the Atlantic and Pacific Oceans. About 50% if not more of the global tuna harvest is canned or frozen for the US market. According to US regulations, more than 20 related species may be labelled "tuna" (1). Japanese sashimi/sushi is a popular dish including raw tuna.
 
In an Italian study of cod-sensitive children, 55% also showed sensitivity to tuna. Tuna was, however, a poor inhibitor of codfish-specific IgE antibody binding (2). These investigators concluded that while cod allergy might be a reliable index of fish allergy, cod-positive children may be able to tolerate other species, which should be tested before including in the diet. Anaphylaxis after ingestion of tuna has been reported (3). Bernhisel-Broadbent et al. (1) found that canned tuna lost definable protein bands when compared to raw and cooked tuna extracts, suggesting that canned tuna is not as potent an allergen. Raw tuna, which is consumed in Japan as sushi or sashimi, has the most allergenic potential (1).
 
Improperly handled tuna and related fish contain high levels of histamine produced through bacterial action, which can trigger similar symptoms to those of food allergy (scombroid poisoning) (4, 5).

References

  1. Bernhisel-Broadbent, J; Strause, D; Sampson, HA. Fish hypersensitivity. II: Clinical relevance of altered fish allergenicity caused by various preparation methods. J Allergy Clin Immunol; 1992; 90: 622-629.
  2. de Martino, M; Novembre, E; Galli, L; de Marco, A; Botarelli, P; Marano, E; Vierucci, A. Allergy to different fish species in cod-allergic children: In vivo and in vitro studies. J Allergy Clin Immunol; 1990; 86: 909-914.
  3. Frick, OL; Barker, S. Allergenicity among different food fish species studied by western blotting. J Allergy Clin Immunol; 1989; 83: 295.
  4. Sánchez-Guerrero, IM; Vidal, JB; Escudero, AI. Scombroid fish poisoning: A potentially life-threatening allergic-like reaction. J Allergy Clin Immunol; 1997; 100:433-434.
  5. Wu, ML; Yang, CC; Yang, GY; Ger, J; Deng JF. Scombroid fish poisoning: an overlooked marine food poisoning. Vet Human Toxicol; 1997; 39: 236-241.

 

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.