Shigehira Yuki, Inomata Naoko, Nakagawara Ryoko, Okawa Tomoko, Sawaki Haruna, Nakamura Kazuko, Kobayashi Yukihiro, Shiomi Kazuo, Ikezawa Zenro
Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine.
Arerugi. 2010 Jan;59(1):55-60.
A 75-year-old man ingested salted fish guts made of Sagittated calamari which he caught in the daytime, with alcohol and then dozed. Five hours later, he woke up due to itching over his entire body and noticed generalized urticaria and a swollen tongue, which was too large for him to close his mouth. Serum total IgE was 456 IU/ml and ImmunoCAP was positive for anisakis, but negative for squid, shrimp, and ascaris. A skin prick test (SPT) was positive for anisakis extract (10 mg/ml) and house dust mites, but negative for squid and shrimp. He was diagnosed with IgE-mediated allergy due to Anisakis simplex after the ingestion of salted fish guts made of Sagittated calamari, which had been parasitized by Anisakis simplex. Furthermore, we performed SPT with six extracts of purified or recombinant allergens (Ani s 1, 3, 4, 5, 6, and 8) to identify the causative allergens in this case. Only Ani s 3 (tropomyosin) was positive, indicating that Ani s 3 was the causative allergen in this case. Third stage larvae of the nematode Anisakis simplex often parasitize not only marine fish but also invertebrates, including squid. It is necessary to consider Anisakis simplex allergy for urticarial reactions that develop after the ingestion of squid.
一名75岁男性食用了他白天钓到的剑尖枪乌贼制成的咸鱼肠，还喝了酒，然后便打起盹来。5小时后，他因全身瘙痒醒来，发现全身出现荨麻疹，舌头肿胀，以至于嘴巴都合不上。血清总IgE为456 IU/ml，免疫化学发光法检测显示对异尖线虫呈阳性，但对鱿鱼、虾和蛔虫呈阴性。皮肤点刺试验（SPT）对异尖线虫提取物（10 mg/ml）和屋尘螨呈阳性，但对鱿鱼和虾呈阴性。该患者在食用了被异尖线虫寄生的剑尖枪乌贼制成的咸鱼肠后，被诊断为异尖线虫引起的IgE介导的过敏反应。此外，我们用六种纯化或重组过敏原提取物（Ani s 1、3、4、5、6和8）进行了SPT，以确定该病例中的致病过敏原。只有Ani s 3（原肌球蛋白）呈阳性，表明Ani s 3是该病例中的致病过敏原。线虫异尖线虫的第三期幼虫不仅经常寄生于海鱼，还寄生于包括鱿鱼在内的无脊椎动物。食用鱿鱼后出现的荨麻疹反应有必要考虑异尖线虫过敏。
