Background: In our region, Anisakis allergy is responsible for 8% of acute urticarial reactions, 25% of which progress to anaphylactic shock. The poor specificity of skin tests and in vitro specific immunoglobulin (Ig) E means that Anisakis allergy is frequently overdiagnosed.

Objective: We studied the diagnostic value of 2 Anisakis allergens: rAni s 1 and rAni s 3.
Methods: Skin tests, the basophil activation test (BAT), and specifi c IgE determination were performed with rAni s 1 and 3 in 25 patients allergic to Anisakis, 17 atopic controls, and 10 controls with acute urticaria and positive skin test and sIgE results for Anisakis, but no allergy to Anisakis.

Results: For rAni s1, skin tests had a sensitivity and specificity of 100% and specific IgE had a sensitivity and specificity of 100% in the atopic control group and 90% in the urticaria control group. BAT had a sensitivity of 96.8% and a specifi city of 100% in the atopic control group and 66.7% in the urticaria control group. For rAni s 3, only 1 patient had positive specific IgE results to rAni s 3. All other techniques gave negative results in patients and controls

Conclusions: rAni s 1 is the major allergen of Anisakis and the target allergen when diagnosing allergy to Anisakis. rAni s 3 is not relevant when attempting to explain false-positive results.

Key words: Allergy. Anisakis. Diagnosis. rAni s 1. rAni s 3.