{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:36:02Z","timestamp":1780634162647,"version":"3.54.1"},"reference-count":104,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Fish is one of the \u201cbig nine\u201d foods triggering allergic reactions. For this reason, fish allergens must be accurately specified on food labels. Fish allergy affects less than 1% of the world population, but a higher prevalence is observed in pediatric cohorts, up to 7%. Parvalbumin is the main fish allergen found in the muscles. In childhood, sensitization to fish allergens occurs most frequently through the ingestion of fish, rarely transcutaneously or by inhalation. Fish allergy symptoms usually appear within two hours of the allergen contact. The diagnosis begins with the collection of the history. If it is suggestive of fish allergy, prick tests or the measurement of serum-specific IgE should be performed to confirm the suspicion. The oral food challenge is the gold standard for the diagnosis. It is not recommended in case of a severe allergic reaction. It is important to make a differential diagnosis with anisakiasis or scombroid poisoning, which have overlapping clinical features but differ in pathogenesis. Traditionally, managing fish allergy involves avoiding the triggering species (sometimes all bony fish species) and requires an action plan for accidental exposures. The present review will analyze IgE- and non-IgE-mediated fish allergy in children from epidemiology, pathogenesis to clinical features. Moreover, clinical management will be addressed with a particular focus on potential nutritional deficiencies.<\/jats:p>","DOI":"10.3390\/medicina59091651","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T21:34:12Z","timestamp":1694554452000},"page":"1651","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["IgE-Mediated and Non-IgE-Mediated Fish Allergy in Pediatric Age: A Holistic Approach\u2014A Consensus by Diagnostic Commission of the Italian Society of Pediatric Allergy and Immunology"],"prefix":"10.3390","volume":"59","author":[{"given":"Carla","family":"Mastrorilli","sequence":"first","affiliation":[{"name":"Admission and Emergency Pediatric Medicine and Surgery Unit, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-0568","authenticated-orcid":false,"given":"Stefania","family":"Arasi","sequence":"additional","affiliation":[{"name":"Area of Translational Research in Pediatric Specialities, Allergy Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5598-2740","authenticated-orcid":false,"given":"Simona","family":"Barni","sequence":"additional","affiliation":[{"name":"Allergic Unit, Department of Pediatric, Meyer Children\u2019s Hospital, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Caimmi","sequence":"additional","affiliation":[{"name":"Allergy Unit, CHU de Montpellier, Universit\u00e9 de Montpellier, 34295 Montpellier, France"},{"name":"IDESP, UMR A11, Universit\u00e9 de Montpellier, 34093 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2968-033X","authenticated-orcid":false,"given":"Fernanda","family":"Chiera","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5209-9733","authenticated-orcid":false,"given":"Pasquale","family":"Comberiati","sequence":"additional","affiliation":[{"name":"Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-1206","authenticated-orcid":false,"given":"Giulio","family":"Dinardo","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, 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University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Paravati","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Pelosi","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Santa Barbara Hospital, 09016 Iglesias, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-5957","authenticated-orcid":false,"given":"Michele","family":"Miraglia Del Giudice","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Pediatrics 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