A 30-year-old man exhibited systemic edema, dyspnea and wheal immediately after eating raw fish and cuttlefish served on an abalone shell. He had history of anaphylaxis after eating abalone and beef 4 years ago and had avoided shellfish including abalone since then. He also had past history of bronchial asthma and anaphylaxis due to shrimp. CAP-FEIA was performed to determine the allergen and was positive for scallop and oyster. Refined extracts made from abalone are not commercially available in Japan. Therefore, we purchased several kinds of shellfish, which are commonly consumed by Japanese, and used them, as is, for skin testing. Prick-by-prick tests were conduced using these shellfish, and yielded positive results for abalone and effluent from washing the abalone shell. Consequently, he was diagnosed with anaphylaxis caused by abalone extracts attached to the surface of raw fish. In our case, prick-by-prick test with shellfish was useful for the diagnosis of type I food allergy. If there are no commercial reagents of suspected food allergens for skin testing or challenge-test is not available, prick-by-prick tests might be performed for the diagnosis of food allergy.
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