Shrimp Sensitization and Allergy Among Patients With Edible Insect Allergy

This study aims to determine the prevalence of shrimp sensitization and clinical shrimp allergy among patients aged ≥7 years with confirmed allergy to edible insects, including silkworm, bamboo worm, and palm weevil. Participants undergo skin prick testing, specific IgE testing, ALEX2, immunoblot analysis, and risk-based oral food challenges to assess clinical cross-reactivity between edible insects and white shrimp and to help avoid unnecessary shrimp restriction.

Inclusion Criteria: * Patients aged 7 years or older with a history of allergy to one or more of the following edible insects: silkworm, bamboo worm, or palm weevil. * Patients with a history of an acute allergic reaction to silkworm, bamboo worm, or sago palm weevil who meet at least one of the following criteria: 1. Development of clinical symptoms consistent with an acute allergic reaction within 2 hours after ingestion of the implicated edible insect, with evidence of sensitization confirmed by a positive skin prick test (SPT) to that edible insect; or 2. A positive oral food challenge (OFC) to the edible insect previously associated with allergic symptoms (silkworm, bamboo worm, or sago palm weevil). Exclusion Criteria: * Scombroidosis (histamine fish poisoning). * Currently receiving allergen immunotherapy. * Unable to comply with the study follow-up schedule. * Uncontrolled or severe asthma. * Cardiovascular disease. * Current use of beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs). * Developmental delay or intellectual disability.