Autoinmune hepatitis and odour of a fish food proteins

Dear Sir:

Recently we presented a case of 15-year-old boy with classic (type 1) autoimmune hepatitis presumably caused by a long-term exposure to the strong odour of food fed to a large number of tropical fish which the boy kept in tanks in his bedroom¹.

Since then we found several publications being in concert with our reasoning presented in this paper^2-9. All these reports confirm that tropical fishes are not suitable pets for allergic person² because some ingredients of pet-fish food are known triggers of type I and type III allergy which may induce "aquarium" allergy. For example, bronchial asthma may be caused by polyvalent sensitization to various components in fish food, such as dried daphnia^3-5. Pet-fish food lung - a new form of extrinsic allergic alveolitis have also been reported⁶. In this female patient, bronchioloalveolar lavage yielded a highly active lymphocytic alveolitis with a CD4⁺/CD8⁺ ratio of 0.8, and serum precipitins directed against two commercially available pet-fish food were detected by counter-immunoelectrophoresis⁶. Allergic reactions associated with inhalation of fish odours or fumes are IgE-mediated⁷, and IgE antibodies induced by aeroallergens recognize structurally similar components in certain foods even from taxonomically unrelated plants⁸. Recently, it was suggested that there are likely to be organ-specific disease susceptibility genes, which together with general atopy genes target the allergic response to specific mucosal tissue⁹.

All these literature data may support our suggestion that odour of fish food proteins may be responsible for triggering autoimmune hepatitis in our patient exposed for several months to sharp odour of fish food proteins.

Joseph Prandota, MD, PhD

Professor of Pediatrics & Clinical Pharmacology

Department of Public Health, University Medical School

23 Worcella St., 50-445 Wroclaw, Poland

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