We report the case of a 25-year-old female who experienced two immediate episodes of labial, lingual and larynx angiodema after eating fried mantis shrimp (Squilla empusa), a crustacean belonging to the Squillidae family, and a third episode after eating shellfish pudding. Prick by prick tests to mantis shrimp and to other crustacean were positive. Serum specific IgE showed higher values than 0.35 kU/L to extracts from mantis shrimp shell, prawn, large prawn and crab. Serum specific IgE against large prawn tropomyosin were below 0.35 kU/L. Sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE) immunoblotting results with raw mantis shrimp shell revealed IgE-binding bands of 46 kDa and 25 kDa, in non reducing and reducing conditions, respectively. Cross-reactivity studies using the enzyme allergo sorbent test (EAST)-inhibition and Immunoblotting-inhibition methods showed the existence of significant cross-reactivity between the IgE-binding proteins present in mantis shrimp and those from prawn, large prawn and small crab.
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