Anisakis simplex induces not only anisakiasis: report on 28 cases of allergy caused by this nematode.
Anisakis simplex induces not only anisakiasis: report on 28 cases of allergy caused by this nematode.
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单纯异尖线虫不仅诱发异尖线虫病：28例由该线虫引起的过敏病例报告。
DOI：
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发表时间：
1996
影响因子：
7.2
通讯作者：
Javier Pons Díez
中科院分区：
文献类型：
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作者：
L. F. Corres;M. Audicana;M. Pozo;D. Muñoz;E. Fernández;J. A. Navarro;M. García;Javier Pons Díez
简单异尖线虫，寄生于几种海鱼和头足类。正如最近证实的那样，这种寄生虫不仅会引起异尖线虫病，还会引起过敏反应。我们报告了28名对单纯性异尖线虫过敏的患者，这些患者是在摄取寄生鱼类后发展起来的。每个病例都是通过提示性回忆、单纯性黄曲霉提取物皮肤点刺试验、血清特异性IgE检测(CAP系统)和组胺释放试验确诊。28例患者临床表现均为荨麻疹/血管水肿，1例出现呼吸骤停。矛盾的是，患者报告在过敏发作期间和之后对摄入相同种类的鱼有耐受性。皮肤点刺试验阳性，所有病例均检出特异性IgE，1例典型病例组胺释放阳性，均显示1型对单纯性弧菌过敏。在所有情况下，相同测试的阴性反应都排除了对鱼自身蛋白质的敏感度。还被证明，涉事的过敏原/S可能对烹饪和冷冻有抵抗力。因此，过敏反应可能是由感染引起的，或者更常见的是，仅仅是暴露在过敏原中。结果证实，单纯性弧菌可发生IgE介导的过敏反应，其临床严重程度在接受检查的患者中明显。医生必须考虑到，食用寄生鱼可能会引起严重反应，即使同种鱼随后被耐受。在以鱼为主食的国家，这种类型的反应可能会出现更高的频率。
Anisakis simplex R., parasitizes several sea-fish and cephalopods. This parasite induces not only anisakiasis but also anaphylactic reactions, as has recently been confirmed. We present 28 patients with immediate hypersensitivity to Anisakis simplex, developed after parasitized fish ingestion. Each case was diagnosed by suggestive anamnesis, skin prick tests with an A. simplex extract, specific IgE detection in serum (CAP System), and histamine release test. The clinical manifestations were urticaria/angioedema in all 28 patients and respiratory arrest in one. Paradoxically, the patients reported tolerance to ingestion of the same kind of fish between and after the allergic episodes. Type 1 hypersensitivity to A. simplex was demonstrated by a positive skin-prick test reaction, specific IgE detection in all cases and positive histamine release in a representative case. Sensitization to the proteins of the fish themselves was ruled out by negative reactions of the same tests in all cases. It was also proven that the allergen/s involved may be resistant to cooking and deep freezing. Hence, anaphylactic reactions may result either from infection or, more frequently, from mere exposure to the allergen. The results confirm that A. simplex can develop IgE-mediated anaphylactic reactions, the clinical severity of which was pronounced in the patients examined. Physicians must take into account that the consumption of parasitized fish may cause severe reactions, even if fish of the same kind is subsequently tolerated. A higher frequency of reactions of this type can be expected in countries where fish is a staple diet.