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Food Allergies/Dorado / dolphin fish allergic reaction

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Question
My daughter aged 16 who has never had any previous allergies ate dorado at a restaurant and developed a serious allregic reaction . She immediately said her mouth felt like it  was burning after the first bite and we thought the spices were just strong ( cajun style) which she often eats , however we eventually landed in the hospital where they administered adrenalin. She is currently recovering from glandular fever , could this have any effect ? I have been informed that retrain game fish caught at the wrong time of the year could have this effect ?  Your opinion is valued. Thank you .

Answer
Single one-off allergy type reactions sometimes just happen for no explanation and never recur. These events could just be due to common viral infections. I once saw about 100 people in a similar geographic area over six months. It spread westwards from earlier cases. But no actual proof of any specific virus.
Glandular fever can do some pretty odd things. I really cannot say if your daughters reaction is actually due to this. It's possible but unlikely.

The most common non-allergic "food allergy" is scombrotoxic. i.e. Fish of the mackerel/tuna family (includes Dorado)contain large amounts of histidine which can be converted into histamine. These toxic products are not only produced, but at the same time the normal metabolism of histamine (which usually happens virtually in seconds) is blocked by other fish breakdown products. This usually causes severe flushing and can produce drops in blood pressure. These products will still occur if the fish is kept at normal refrigerater temperatures overnight. Scombroid fish should always be froze. A friend of mine was given a very fresh fish just out of the water. She had a great dinner that night and put the fish in the fridge. Next morning she ate some for breakfast - Oh Dear, local Dr thought she'd had a heart attack. She can still eat it without effect. But now she keeps her fish frozen.

If she has a fish skin prick test, it is always strongly positive in genuine allergy. A negative skin test essentially excludes the likely occurrence of dangerous allergy.

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David Pearson

Expertise

Any in the field I believe. Only experience of questions that get asked will tell.

Experience

I am a retired medical academic from the UK. I have done major research on Food Allergy and have been a government adviser in the area. 30 years experience running an allergy clinic. And undergraduate and post-graduate teaching.

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Well, apart from the FRCP, I'm no longer active in the area. I'm too busy writing books. And I no longer have the cash to go to international meetings. But was active in many.

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Will 120 scientific papers help? Chapters in books. Patient advisory materials. Magazine articles. TV appearances. Live and recorded. National and international invited lectures, etc. It was my job for 40 years. Do you think I count!

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MD, PhD, Postgraduate Diplomas etc. Fellow of the Royal College of Physicians. etc. But I don't want that put out on the net! Just to let you know!

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irrelevant.

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Too many to count, patients of course and a large number of all sorts of corporate consultancies and considerable work as an expert witness in the Courts. I'm volunteering because your Greek expert has been so helpful, I thought I'd offer something back.

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