Otsubo Saori, Nishiyama Takashi, Okada Naoki, Ando Yukihiro, Yamada Katsumi, Maeda Yuji, Nishimura Yusuke
Departments of Disaster and Emergency Medicine Kobe University Hospital Kobe Hyogo Japan.
Acute Med Surg. 2015 Aug 12;3(2):159-162. doi: 10.1002/ams2.144. eCollection 2016 Apr.
Approximately 4_h after eating mackerel sushi, a 65_year_old man developed generalized itchiness and redness, after which he became unresponsive. He went into a state of ventricular fibrillation but after he was defibrillated twice, his heartbeat returned. The electrocardiogram obtained immediately after hospitalization showed some ST_segment depression, but a subsequent electrocardiogram showed improvement. Coronary CT showed no obvious stenosis or plaque in the coronary artery.
Results of an IgE_RAST test confirmed that the level of allergen_specific IgE for mackerel measured <0.10_UA/mL, while the level for anisakis was 1.91_UA/mL.
As for the mechanism leading to cardiac arrest, it is thought that the histamines and leukotrienes released from cardiac mast cells caused a coronary artery spasm (Kounis syndrome). This anaphylactic shock is considered to be a result of anisakis allergy, but in general cases of anaphylaxis resulting from consumption of blue_skinned fish.
一名65岁男性在食用鲭鱼寿司约4小时后，出现全身瘙痒和发红，随后失去意识。他陷入心室颤动，但在接受两次除颤后，心跳恢复。住院后立即进行的心电图显示有一些ST段压低，但随后的心电图显示有所改善。冠状动脉CT显示冠状动脉无明显狭窄或斑块。
IgE-RAST试验结果证实，鲭鱼过敏原特异性IgE水平测定<0.10 UA/mL，而异尖线虫的水平为1.91 UA/mL。
关于导致心脏骤停的机制，认为心脏肥大细胞释放的组胺和白三烯引起冠状动脉痉挛（库尼斯综合征）。这种过敏性休克被认为是异尖线虫过敏的结果，但一般是食用青皮鱼引起过敏反应的情况。
