Case Report

Use of Amiodarone in a Patient With a Shellfish Allergy

Authors: Jennifer W. Beall, PharmD, BCPS, Edward F. Mahan III, MD, Andrea B. Blau, PharmD


A 65-year-old Caucasian male with a shellfish allergy developed atrial fibrillation and hypotension after coronary artery bypass and duodenal ulcer surgery. Following electrical cardioversion, oral amiodarone was continued chronically without an allergic reaction. There is a common misconception that a shellfish allergy correlates to an iodine allergy. There is little documentation of the association between an allergy to shellfish and an allergy to iodine. Food allergies can be subcategorized based on the involvement of IgE. Upon further investigation, it was discovered that shellfish allergies are not due to the iodine component, but rather, to a protein found in the shellfish. Amiodarone can be safely used in patients with shellfish allergies. A shellfish allergy does not necessarily imply an iodine allergy.

Key Points

* There is no documentation that supports the link between a shellfish allergy and an iodine allergy.

* Patients with an allergy to shellfish are actually allergic to tropomyosin, a protein found in shellfish.

* Those patients with allergies to shellfish should be able to safely receive iodine-containing compounds without concern of cross sensitivity.

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