JEADV 2015 JEADV while the patient consumed soft-shelled turtle only once a year, the onset of the IgE-mediated reaction became perceptible gradually due to lengthy and constant exposure to the allergen in her work environment. The patient did not have fish allergy. Based on the fact that there is only a 62% correspondence in the amino acid sequence of b-parvalbumin in Pelodiscus sinensis compared with Salmo salar, we speculated that the antigen-recognition sites were different in the two species.The point of interest in this case resides in the fact that the patient was sensitized to the parvalbumin antigen through exposure to steam emitted by food containing soft-shell turtle. The initial symptoms were shown as contact urticaria on the face and neck. However, we hypothesize that the inhalation of the steam eventually led to the development of an IgE-mediated response via sensitization of the oral and tracheal mucosa to parvalbumin.

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