Decruyenaere Philippe, Van de Maele Beatrice, Hulstaert Eva, Van Vlierberghe Hans, Decruyenaere Johan, Lapeere Hilde
Department of Hematology, Ghent University Hospital, Ghent, Belgium.
Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
Acta Clin Belg. 2022 Apr;77(2):396-399. doi: 10.1080/17843286.2020.1822627. Epub 2020 Sep 24.
Anisakiasis is an emerging zoonosis caused by the fish parasitic nematode Anisakis infecting the gastrointestinal tract.
We describe a case of a 58-year-old woman diagnosed with gastro-allergic anisakiasis, in which the patient developed an acute food-induced IgE-mediated hypersensitivity reaction as well as concurrent gastro-intestinal manifestations after consumption of raw fish. The patient presented with epigastric pain, anaphylaxis and acute dysphagia caused by eosinophilic oesophagitis.
Anisakis allergy should be considered as causative agent in patients presenting with acute urticarial rash, anaphylaxis and/or abdominal manifestations, especially when symptoms occur after consumption of seafood. Moreover, eosinophilic oesophagitis may be a rare but important complication of Anisakis infection. Endoscopic evaluation with esophageal biopsies should therefore be considered if suggestive symptoms are present. Patients with confirmed gastroallergic anisakiasis are advised to properly freeze or cook fish prior to consumption, although caution is advised, since heat-stable allergen proteins have been described. An adrenaline auto-injector should be prescribed.
异尖线虫病是一种由感染胃肠道的鱼类寄生线虫异尖线虫引起的新发人畜共患病。
我们描述了一例58岁女性被诊断为胃肠过敏性异尖线虫病的病例，该患者在食用生鱼后出现了急性食物诱导的IgE介导的超敏反应以及并发的胃肠道表现。患者表现为上腹部疼痛、过敏反应以及由嗜酸性食管炎引起的急性吞咽困难。
对于出现急性荨麻疹、过敏反应和/或腹部表现的患者，应考虑异尖线虫过敏为病因，尤其是在食用海鲜后出现症状时。此外，嗜酸性食管炎可能是异尖线虫感染的一种罕见但重要的并发症。因此，如果出现提示性症状，应考虑进行内镜评估并取食管活检。建议确诊为胃肠过敏性异尖线虫病的患者在食用鱼类前进行适当冷冻或烹饪，不过由于已发现有热稳定的过敏原蛋白，所以需谨慎。应开具肾上腺素自动注射器。
