Several plant-foods, taxonomically unrelated, independent of peach involvement, are implicated in LTP syndrome. Local symptoms should be evaluated as a risk marker for anaphylaxis because they are frequently associated with cofactor-dependent anaphylaxis. The association of these symptoms with pollinosis, especially plane tree pollinosis, could be part of this syndrome in our area.

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Background: Shellfish allergy is an important cause of food allergy and anaphylaxis worldwide. Several allergenic proteins have been described in the last few years, but the only diagnostic tool that allows discrimination between allergic and non-allergic sensitized subjects is still the oral food challenge (OFC). Objective: The aim of this study was to evaluate the usefulness of nasal allergen provocation test (NAPT) as a diagnostic tool in the diagnosis of shellfish allergy. Methods: Forty-five subjects with confirmed sensitization to shrimp by a positive skin prick test (SPT) to a commercial shrimp extract were recruited and classified as Sensitized-Allergic or non-Allergic based on current tolerance to shrimp intake, the result of an OFC with a freeze-dried cooked shrimp mixture extract, or recent history of anaphylaxis from shrimp ingestion. These subjects and ten controls without shrimp sensitization were subjected to a NAPT with a freeze-dried cooked shrimp mixture extract. The response was evaluated by means of acoustic rhinometry (AcRh) and visual analogue scale scores (VAS). Results: Significant differences (p=.001) were found between the Sensitized-Allergic group (18/20 positive NAPT, 90%) compared to both Sensitized-non-Allergic (2/18 positive NAPT, 11.1%) and Control (0/10 positive NAPT) groups. NAPT allows differentiation between allergic and non-allergic subjects with a S: 90%, E: 89%, PPV: 90% and NPV: 89%. Conclusions: According to the study results NAPT may be a useful diagnostic tool that allows differentiating sensitized symptomatic subjects from sensitized tolerant. It could be a valuable test to consider when conducting a shrimp allergy study.