Anaphylaxis by inhalation of allergenic proteins from Anisakis simplex

Method We report a 50 year old patient, who works as a cook. A year ago she presented two episodes of anaphylaxis after eating undercooked fresh fish. Thereafter she removed raw fish from her diet. Ten months later after handling fish (eviscerating it), an hour after hand injuring, she presented itching hands and head, epigastric pain, nausea and severe generalized urticaria. Attended the emergency room with adrenaline, corticosteroids, antihistamines, with good response. She manipulates fish daily with gloves because of her profession. Prick test (PT) with allergenic extracts of fish, Anisakis, food (Alk Abelló).Total and specific IgE to Anisakis, white and blue fish (Thermo Fisher). Gastroscopy.