Estrada Rodríguez J L, Gozalo Reques F
Unidad de Alergología, Hospital de León, Spain.
Allergol Immunopathol (Madr). 1997 Mar-Apr;25(2):95-7.
It has recently been published patients suffering from urticaria or anaphylaxia induced by nematodes usually parasitizing fishs or cephalopode, in whom, Anisakis simplex (AK) sensitization prevalence was detected up to 37%. We tried out a prospective study to evaluate the presence of AK specific-IgE in an asthmatic population, comparing to other group of patients with urticaria. Complaints related to food ingestion were recorded in both, and dietetic measures were advised. Thirteen patients (13/66; 20%) showed AK specific IgE. Nine of them were asthmatics (p < 0.01), and only 4 suffered from urticaria. Four patients, three of them asthmatics, could link symptoms after fishs, cephalopode or, surprisingly, seafood intake, including epigastralgia, rhinorrhea, conjunctivitis, hives, and dyspnea. Atopia was not a consistent status, only five AK sensitized patients also did to common inhalants (all skin prick-test positive to house dust mites). Asthmatic AK-sensitized patients were older than non AK-sensitized asthmatics (46.23 vs 30.1; p < 0.05). The way of sensitization could be inhalative or through digestive mucosa parasitization by live larvae. Possibility that an AK allergen can play a role in adult asthma, should be considered specially in countries with high fish or seafood diet content.
最近有文献报道,由通常寄生于鱼类或头足类动物的线虫引起荨麻疹或过敏反应的患者中,简单异尖线虫(AK)致敏率高达37%。我们进行了一项前瞻性研究,以评估哮喘患者中AK特异性IgE的存在情况,并与其他荨麻疹患者组进行比较。记录了两组与食物摄入相关的主诉,并给出了饮食建议。13名患者(13/66;20%)显示有AK特异性IgE。其中9名是哮喘患者(p<0.01),只有4名患有荨麻疹。4名患者,其中3名是哮喘患者,在食用鱼类、头足类动物或令人惊讶的是食用海鲜后出现症状,包括上腹部疼痛、流涕、结膜炎、荨麻疹和呼吸困难。特应性并非一致的情况,只有5名AK致敏患者也对常见吸入物致敏(所有皮肤点刺试验对屋尘螨均呈阳性)。AK致敏的哮喘患者比未致敏的哮喘患者年龄更大(46.23对30.1;p<0.05)。致敏途径可能是吸入性的,也可能是通过活幼虫寄生在消化黏膜上。在鱼类或海鲜饮食含量高的国家,应特别考虑AK变应原在成人哮喘中可能起作用的可能性。