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Anisakis simplex-sensitized patients: should fish be excluded from their diet?

Gracia-Bara, Maria T; Matheu, Victor LU ; Zubeldia, José Manuel; Rubio, Maria; Ordoqui, Elena; Lopez-Saez, Maria Pilar; Sierra, Zita; Tornero, Pilar and Baeza, Maria Luisa (2001) In Annals of Allergy, Asthma & Immunology 86(6). p.679-685
Abstract
BACKGROUND: Anisakis simplex (A.s.) allergy is an emerging disease. The third-stage larvae of this nematode are a source of hidden allergens in fish. There are no clear guidelines concerning dietary restrictions for patients with serum-specific IgE to this parasite. OBJECTIVE: To follow up the clinical data and immunological parameters of patients sensitized to A.s. during 6 to 23 months. METHODS: The clinical symptoms and serologic status of 17 patients with specific IgE and positive skin prick test results to A.s. were studied prospectively. Six of these had anaphylaxis (ANA) attributed to A.s. and 11 patients experienced concomitant chronic urticaria (CU). All patients were advised not to eat fish for 6 months. RESULTS: Four patients... (More)
BACKGROUND: Anisakis simplex (A.s.) allergy is an emerging disease. The third-stage larvae of this nematode are a source of hidden allergens in fish. There are no clear guidelines concerning dietary restrictions for patients with serum-specific IgE to this parasite. OBJECTIVE: To follow up the clinical data and immunological parameters of patients sensitized to A.s. during 6 to 23 months. METHODS: The clinical symptoms and serologic status of 17 patients with specific IgE and positive skin prick test results to A.s. were studied prospectively. Six of these had anaphylaxis (ANA) attributed to A.s. and 11 patients experienced concomitant chronic urticaria (CU). All patients were advised not to eat fish for 6 months. RESULTS: Four patients from the ANA group excluded fish, and ANA did not recur. Two other patients with ANA refused to exclude fish; one remained free of symptoms and the other experienced several urticarial episodes. During this 6-month period total IgE levels decreased in all six ANA patients; specific IgE for A.s. decreased in four patients and increased in two. Two patients from the CU group did not exclude fish, and symptoms persisted in these two patients. Clinical improvement was observed in 78% of the patients with CU who excluded fish. Total and specific IgE levels decreased in all the patients with CU. CONCLUSIONS: Because ANA symptoms are very severe, patients should always be advised to exclude fish until specific food allergens are identified. However, in patients with CU and specific IgE to A.s., only the clinical response to fish ingestion will determine the need for strict fish avoidance. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Allergy, Asthma & Immunology
volume
86
issue
6
pages
679 - 685
publisher
American College of Allergy, Asthma & Immunology
external identifiers
  • pmid:11428742
  • scopus:0034978939
ISSN
1081-1206
language
English
LU publication?
yes
id
2fe0661b-08ac-43f3-9db1-3d63b0b70ce2 (old id 1119984)
date added to LUP
2008-06-30 08:52:18
date last changed
2018-05-29 10:58:35
@article{2fe0661b-08ac-43f3-9db1-3d63b0b70ce2,
  abstract     = {BACKGROUND: Anisakis simplex (A.s.) allergy is an emerging disease. The third-stage larvae of this nematode are a source of hidden allergens in fish. There are no clear guidelines concerning dietary restrictions for patients with serum-specific IgE to this parasite. OBJECTIVE: To follow up the clinical data and immunological parameters of patients sensitized to A.s. during 6 to 23 months. METHODS: The clinical symptoms and serologic status of 17 patients with specific IgE and positive skin prick test results to A.s. were studied prospectively. Six of these had anaphylaxis (ANA) attributed to A.s. and 11 patients experienced concomitant chronic urticaria (CU). All patients were advised not to eat fish for 6 months. RESULTS: Four patients from the ANA group excluded fish, and ANA did not recur. Two other patients with ANA refused to exclude fish; one remained free of symptoms and the other experienced several urticarial episodes. During this 6-month period total IgE levels decreased in all six ANA patients; specific IgE for A.s. decreased in four patients and increased in two. Two patients from the CU group did not exclude fish, and symptoms persisted in these two patients. Clinical improvement was observed in 78% of the patients with CU who excluded fish. Total and specific IgE levels decreased in all the patients with CU. CONCLUSIONS: Because ANA symptoms are very severe, patients should always be advised to exclude fish until specific food allergens are identified. However, in patients with CU and specific IgE to A.s., only the clinical response to fish ingestion will determine the need for strict fish avoidance.},
  author       = {Gracia-Bara, Maria T and Matheu, Victor and Zubeldia, José Manuel and Rubio, Maria and Ordoqui, Elena and Lopez-Saez, Maria Pilar and Sierra, Zita and Tornero, Pilar and Baeza, Maria Luisa},
  issn         = {1081-1206},
  language     = {eng},
  number       = {6},
  pages        = {679--685},
  publisher    = {American College of Allergy, Asthma & Immunology},
  series       = {Annals of Allergy, Asthma & Immunology},
  title        = {Anisakis simplex-sensitized patients: should fish be excluded from their diet?},
  volume       = {86},
  year         = {2001},
}