Sole is a food which may result in allergy symptoms in sensitised individuals.

Other species of fish, including flounder and dab, are sometimes incorrectly labelled as sole.

Sole Allergy Test: Allergen Exposure

The common sole, also known as the Dover sole is a species of flatfish which is found in the coastal seas around Europe, and is an important food fish, widely consumed by humans.

Sole are available for sale fresh or frozen, and may be sold as whole fish, dressed fish or fillets. Fresh fish may only be available seasonally, whereas frozen fish are generally available year-round.

Sole is a popular choice in many restaurants, usually prepared by grilling, baking, poaching or pan frying. It is also used in stews, soups and salads. Specific recipes in which sole is a main ingredient include the French dishes sole Véronique (with grapes and vermouth), and sole à la meunière (served with a sauce of browned butter, parsley and lemon juice), as well as sole goujons (fillet strips dipped in egg and flour and deep-fried).

The flesh is white, with a characteristically mild taste. Sole are low in fat, and are a good source of protein, as well as niacin, B vitamins, phosphorus, calcium and selenium.

Sole Allergy Test: Allergen Description

No specific allergens present in sole have been characterised, although a number of proteins have been identified.

Sole Allergy Test: Potential Cross-Reactivity

Species within groups of fish, like Gadiformes (examples: codfish and hake) and Scombroid fishes (examples: mackerel and tuna) seem to share allergenic components. The overlap of allergen specificity between the groups seems to be moderate or even small.

Cross reactivity between sole and other members of the Soleidae family could therefore be expected.

Clinical sensitivity and IgE antibodies against sole have been studied and discussed in relation to sensitivity to other types of fish, including cod.

Immediate allergic reactions may follow ingestion of even minute amounts of fish.

Symptoms can include oral allergy syndrome, generalised urticaria, facial angioedema and anaphylaxis.

Because patients react to both cooked and raw fish, it is assumed the allergens are heat-resistant. However, more recent studies indicate that patients may react differently to processed food and that allergic reactions may be species-specific.

It has been reported that some fish allergic persons can exhibit allergic symptoms due to the steam (airborne allergens) from cooking fish.

Sole Allergy Test: Clinical Experience

Sensitisation to fish allergen is common. Fish, including sole, is a potential cause of food allergy and atopic dermatitis.

Other reactions

Acute anisakiasis as a result of the larvae of the fish parasite Anisakis simplex may occur following ingestion of undercooked or raw sole. The larvae are present in the muscles and visceral organs of the fish.

Symptoms can include abdominal pain, nausea, vomiting, abdominal distention, diarrhea, blood and mucus in stool, and mild fever. Allergic reactions with rash and itching, and infrequently, anaphylaxis, can also occur.

Fish allergy is sometimes confused with a reaction to histamine in spoiled fish.