(1) Background:
Tropomyosin is a major cause of
shellfish allergy and
anaphylaxis triggered by food. It acts as a pan-
allergen, inducing cross-reactivity in insects, dust mites, crustaceans, and mollusks. Our study investigates
anaphylaxis in children with
asthma or atopic diseases after consuming
tropomyosin-containing food. (2) Methods: We analyzed the molecular sensitization profiles of pediatric patients at the University of Campania 'Luigi Vanvitelli' from 2017 to 2021, with conditions such as
allergic rhinitis,
asthma,
atopic dermatitis,
urticaria, and
food allergies. (3) Results: Out of a total of 253 patients aged 1 to 18 years (167 males, 86 females), 21 patients (8.3%) experienced
anaphylaxis after shrimp ingestion. All 21 (100%) were sensitized to various tropomyosins: Pen m 1 (100%), Der p 10 (90.5%), Ani s 3 (81%), and Bla g 7 (76.2%). Clinical symptoms included allergic
asthma (76.2%),
atopic dermatitis (61.9%),
urticaria (38.1%), and
allergic rhinitis (38.1%). (4) Conclusions: Crustaceans and mollusks are major
allergens in Italy and Europe, requiring mandatory declaration on food labels. Italian pediatric patients demonstrated significant
anaphylaxis after consuming shrimp, often accompanied by multiple atopic disorders such as
asthma,
rhinitis, and
atopic dermatitis. Considering the cross-reactivity of
tropomyosin among various invertebrates and the emergence of 'novel foods' containing insect flours in Europe, there is ongoing debate about introducing precautionary labeling for these products.