INTRODUCTION: Fish allergies are common food allergies, and in Thailand, the prevalence of fish allergies in children ranges from 0.29% to 1.1%. Common fish allergens include parvalbumin, enolase, and aldolase. METHOD: This cross-sectional study included children with immunoglobulin E (IgE)-mediated fish allergies. The diagnosis was based on clinical history with a positive skin prick test (SPT) and/or specific IgE (sIgE). Serum IgE binding profiles to allergens in fish extracts were analyzed. RESULT: Eleven children, with a median age of 3 years, were recruited
the median age of onset was 1.25 years. Cutaneous symptoms were the most frequent clinical manifestation (63.6%). Tilapia and catfish were the most common triggers. All participants showed positive SPT and/or sIgE results for fish species. The immunoblot analysis revealed IgE binding to 40-50 kDa protein in all participants, while only seven participants (63.6%) showed IgE binding to the 11 kDa protein. CONCLUSION: Tilapia and catfish are the most common triggers of fish allergies in Thai children. The 40-50 kDa proteins were identified as a major fish allergen in tested cohort.