1/43. Asymptomatic gastroduodenal anisakiasis as the cause of anaphylaxis. A great number of parasites have been reported in fish, but only a few of them are capable of infecting human beings. anisakiasis or anisakidosis is caused by sea nematodes of the genus anisakis, with the main implicated species being anisakis simplex. infection with anisakis causes a wide spectrum of clinical manifestations, ranging from symptoms related to the upper and occasionally lower digestive tract to allergic manifestations, mainly urticaria and anaphylaxis. We report a case of asymptomatic gastroduodenal anisakiasis presenting as severe anaphylaxis. ( info) |
| A case of acute intestinal anisakiasis has been reported; a nematode larva being found in the submucosa of the ileum of a woman in Jaen (spain). The source of infection was the ingestion of raw Engraulis encrasicholus. On the basis of its morphology, the worm has been identified as a fourth-stage larva of anisakis simplex. In spain, this is the ninth report of human anisakiasis and also probably the first case of anisakiasis caused by a fourth-stage larva of A. simplex. ( info) |
3/43. Eosinophilic gastritis due to anisakis: a case report. BACKGROUND: the parasite anisakis simplex is a helminth included in the nematode class. When man eats raw or rare fish and cephalopods infested by anisakis larvae, he can acquire the parasitic disease (anisakidosis). The parasite can also originate manifestations of immediate IgE mediated hypersensitivity in patients with sensitisation to it. methods AND RESULTS: we present the case of a 14 year old boy diagnosed of eosinophilic gastritis after endoscopic examination and biopsy associated to recurrent abdominal pain. After allergologic study, a type I hypersensitivity mechanism against anisakis simplex is confirmed by means of prick test, antigen specific IgE determination and antigen specific histamine release test. Sensitisation against fish proteins is ruled out as well as parasitic infestation. CONCLUSIONS: in this case report we demonstrate a type I hypersensitivity mechanism against anisakis simplex in a patient diagnosed of eosinophilic gastritis. This can be suspected in cases of gastritis or non filiated enteritis with a torpid evolution following the conventional treatment and especially if the onset of the symptoms is related with the intake of fish. The therapeutic success was reached when fish and shellfish were taken out of the diet. After two years without seafood ingestion our patient is asymptomatic and the allergologic study has been normalised. ( info) |
4/43. Gastrointestinal infection due to anisakis simplex in southern italy. The authors present four cases of infection due to anisakis in an area where people are prone to infectious diseases transmitted by raw fish, but in which the presence of this parasite has never been reported. Three of four cases were discovered accidently during surgical procedures for co-existing abdominal pathologies. Raw fish was apparently not involved in all patients. Characteristics of the patients are discussed. ( info) |
5/43. What does anisakis simplex parasitism in gastro-allergic anisakiasis teach us about interpreting specific and total IgE values? BACKGROUND: gastro-allergic anisakiasis is a mostly transitory clinical entity caused by anisakis simplex (A. simplex) and can be suspected by history and confirmed by fiberoptic gastroscopy and specific IgE. OBJECTIVE: we report a case of gastro-allergic anisakiasis, in which the parasite induces a high specific and total IgE response, and want to follow the specific and total IgE values by a serologic follow up over 10 months. methods: an analysis of total IgE and specific IgE against. A. simplex was performed within 24 hours, after 1, 4, 6 and 10 months. At month 4 and month 10 specific IgE against ascaris lumbricoides and echinococcus granulosus was determined in order to value cross-reactivity. RESULTS: there is an important raise in specific IgE against anisakis simplex (up to 903 kU/l) after 6 months and total IgE (up to 15,258 kU/l) after one month. Cross-reactive specific IgE against ascaris lumbricoides and echinococcus granulosus can be detected. CONCLUSIONS: we consider a raise of total and specific IgE as a typical feature of helminth infestation and learn that specific and total IgE values are highly variable in the months following the allergic and parasite-specific reaction. The amount of specific IgE against other cross reactive parasites depends directly on the total IgE values. ( info) |
6/43. Gastroallergic anisakiasis: findings in 22 patients. BACKGROUND AND AIMS: Ingestion of Anisakidae larvae in raw seafood may cause anisakiasis. However, despite the high level of consumption of seafood in spain, only a few cases of anisakiasis have been reported until now. anisakis simplex can cause allergic reactions in sensitized patients as a result of its parasitism in the gastrointestinal tract. The purpose of this study was to analyse the clinical findings in 22 patients with gastroallergic anisakiasis. methods: patients with allergic and/or gastric symptoms after seafood ingestion were evaluated in the emergency room of the La Paz General University Hospital. skin testing for anisakis simplex and tests on the implicated seafood were performed and amounts of serum-specific immunoglobulin e were assessed. A gastroscopy was performed in those patients with severe allergic or/and persistent gastric symptoms after ingestion of raw or undercooked seafood. RESULTS: Twenty-two patients were diagnosed with gastroallergic anisakiasis in 1 year. Most patients presented to the emergency room of our hospital with allergic symptoms. Gastric symptoms were usually moderate. gastroscopy revealed local mucosal oedema and gastric erosion at the point of fixation. Two or more worms were detected in three patients. The mean time of latency of allergic symptoms was 5 h, while the mean time for gastric symptoms was 3 h. CONCLUSION: anisakis simplex parasitism was the causative agent of allergic and gastric symptoms. Gastroallergic anisakiasis appears to be a relatively common disease, that may have been underdiagnosed. ( info) |
7/43. diagnosis of a case of gastric anisakidosis by PCR-based restriction fragment length polymorphism analysis. A set of genetic markers, based on PCR-RFLPs of three diagnostic restriction enzymes (Hhal, Hinfl and Taql), which proved to be suitable for the identification of the species of the genus anisakis, was used for the first molecular identification of a larva obtained by endoscopy in a case of gastric anisakidosis, in a 51 year old woman from Southern italy. The analysis of the restriction profiles obtained allowed the larva to be identified as anisakis pegreffii, one of the three sibling species of the A. simplex complex. PCR-RFLP proved to be a cost-effective and reliable tool for the exact identification of anisakis larvae recovered from infected humans. ( info) |
8/43. Chronic anisakiasis presenting as a mesenteric mass. Chronic anisakiasis is a rare entity, and its diagnosis is difficult. We report a case of chronic anisakiasis with multiple gastrointestinal manifestations presenting as a palpable mesenteric mass, diagnosed by specific serology and histologic findings. We describe the computed tomographic appearance of this mass and the pathologic correlations. To our knowledge, this is the first time this mesenteric location has been detected by imaging before surgery. ( info) |
9/43. anisakiasis presenting as an obstructive duodenal tumor. A Scandinavian case. A case of chronic anisakiasis presenting as an occluding duodenal tumor is described. Significant falls in anisakis simplex-specific serum IgE and total IgE occurred after resection of the lesion. Histopathologic examination showed a chronic eosinophilic granulomatous infiltrate and a tubular sclerotic structure in the antral submucosa consistent with, but not diagnostic for, an A. simplex larva. ( info) |
10/43. A human case of gastric infection by Pseudoterranova decipiens larva. We report a case of gastric pseudoterranoviasis proven by gastrofiberscopy on Dec. 13, 1994. The 34-year-old male patient, residing in Chungju-shi, was admitted to Konkuk University Hospital complaining of prickling epigastric pain. The symptoms suddenly attacked him two days after eating raw marine fish at Chonan-shi. By the gastrofiberscopic examination, a long white-yellowish nematode was found from the fundus region of stomach. The worm was 34.50 x 0.84 mm in size, and was identified as a 3rd stage larva of Pseudoterranova decipiens judging from the position of the intestinal cecum. This is the 12th confirmed case of human pseudoterranoviasis in korea. ( info) |