Anaphylaxis provoked by ingestion of marshmallows containing fish gelatin

Most gelatins are of bovine and porcine origin. Because the use of bovine gelatin has caused concern in the context of the bovine spongiform encephalopathy crisis, gelatin from pig skin has become the most widely used gelatin. [...]no allergic reaction was provoked by means of oral challenge with 5 g of tuna gelatin in 3 sensitized patients7 and with a cumulative dose of 3.6 g of codfish gelatin in 3 patients with positive skin prick test responses to fish gelatin, except 1 mild subjective reaction at a cumulative dose of 7.61 g of fish gelatin.8In vitro studies did not show IgE cross-reactivity between bovine and fish gelatins.7 The clinical case of a patient who experienced a severe anaphylactic reaction on ingestion of marshmallows containing fish gelatin prompted us to analyze in detail the IgE profile of this patient.