Advertisement

International Journal of Clinical Pharmacy

, Volume 36, Issue 6, pp 1126–1129 | Cite as

Flushing and pruritus secondary to prescription fish oil ingestion in a patient with allergy to fish

  • Amanda Howard-ThompsonEmail author
  • Anna Dutton
  • Robert Hoover
  • Jennifer Goodfred
Case Report

Abstract

Background A brand of fish oil capsules contains omega-3 fatty acids obtained from several fish sources. Although the manufacturer calls for caution in patients with fish hypersensitivity, insufficient data is available to make a definitive recommendation regarding its use in this population. Case presentation A patient with documented seafood allergy presented to the emergency department 4 days after the initiation of prescription brand name fish oil capsules complaining of chest tightness, shortness of breath, tingling of upper extremities, flushing, and pruritus that was minimally relieved by excessive nonprescription diphenhydramine administration. During subsequent follow-up, the patient reported that all symptoms had resolved within 5 days of discontinuing the medication and 3 days of disposing of her pillbox and all medications that had come in contact with the fish oil capsules. Conclusion Due to the patient’s allergic history, timing of onset/offset of the reaction, laboratory evidence, and the use of the Naranjo probability scale, prescription fish oil capsules were deemed the probable cause of this patient’s pruritus and flushing of the face and trunk. Practitioners and patients should always ensure they have an updated list of allergies within the patient’s medical record that includes medications as well as foods and food additives.

Keywords

Allergic reaction Allergy Fish oil Hypersensitivity Omega-3-acid ethyl esters Omega-3 fatty acids 

Notes

Funding

There is no funding for the writing or publishing of this manuscript.

Conflicts of interest

The authors have no conflicts of interest to disclose.

References

  1. 1.
    Husain Z, Schwartz RA. Food allergy update: more than a peanut of a problem. Int J Dermatol. 2013;52:286–94.PubMedCrossRefGoogle Scholar
  2. 2.
    Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of seafood allergy in the United States determined by a random telephone survey. J Allergy Clin Immunol. 2004;114:159–65.PubMedCrossRefGoogle Scholar
  3. 3.
    Product Information: LOVAZA(R) oral capsules, omega 3 acid ethyl esters oral capsules. Research Triangle Park: GlaxoSmithKline (per FDA); 2013. Google Scholar
  4. 4.
    Lopata AL, Lehrer SB. New Insights into seafood allergy. Curr Opin Allergy Clin Immunol. 2009;9:270–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Kmet A, Unger J, Jahangir K, Kolber MR. Fish-oil capsule ingestion: a case of recurrent anaphylaxis. Can Fam Physician. 2012;58:e379–81.PubMedCentralPubMedGoogle Scholar
  6. 6.
    Knopp RH. Evaluating niacin in its various forms. Am J Cardiol. 2000;86:51L–6L.PubMedCrossRefGoogle Scholar
  7. 7.
    Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–45.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Amanda Howard-Thompson
    • 1
    Email author
  • Anna Dutton
    • 2
  • Robert Hoover
    • 3
  • Jennifer Goodfred
    • 3
  1. 1.Department of Clinical Pharmacy and Family MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Department of PharmacyRegional One HealthMemphisUSA
  3. 3.Department of Family MedicineUniversity of Tennessee Health Science CenterMemphisUSA

Personalised recommendations