Year 2008 / Volume 100 / Number 3
Original
Use of anamnesis and immunological techniques in the diagnosis of anisakidosis in patients with acute abdomen

pp. 146-152

del Rey-Moreno, A. / Valero-López, A. / Gómez-Pozo, B. / Mayorga-Mayorga, C. / Hernández-Quero, J. / Garrido-Torres-Puchol, M. L. / Torres-Jaén, M. J. / Lozano-Maldonado, J.

Abstract
Introduction: Anisakis simplex can be a cause of digestive symptoms. Our aim was to evaluate the epidemiological antecedents and immunological data available for a differentiation between patients with anisakidosis and those with other acute abdominal problems.

Patients and methods: this is a prospective cohort study involving 134 patients with acute abdominal problems: 52 patients were diagnosed with anisakidosis by means of surgical and pathological findings and/or specific IgE seroconversion against Anisakis simplex (group A), and in 82 patients anisakidosis had been ruled out (group NA: non-anisakidosis). We evaluated the antecedent of raw fish ingestion, the skin prick test, and IgE immunoblotting as diagnostic tools.

Results: patients in groups A and NA differ in terms of prior raw fish ingestion (p < 0.0001) and positive SPT (p < 0.0001), with their respective negative predictive values (NPV) being 98.39% (95%CI: 90.17-99.92) and 95.56% (95%CI: 83.64-99.23). Regarding immunoblotting, in 86.2% of patients in group A a band of 60 kDa was detected, which was also detected in 19.2% of patients in group NA.

Conclusions: a negative answer to the question about raw or undercooked fish ingestion has very high sensitivity and NPV (98.39%), and is thus reasonably reliable to rule out anisakidosis. The absence of cutaneous sensitization to crude A. simplex extract gives a high probability (95.56%) that the illness is absent. The presence of a band of about 60 kDa in immunoblotting would be useful for diagnosis.
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del Rey-Moreno, A. / Valero-López, A. / Gómez-Pozo, B. / Mayorga-Mayorga, C. / Hernández-Quero, J. / Garrido-Torres-Puchol, M. L. / Torres-Jaén, M. J. / Lozano-Maldonado, J.. Use of anamnesis and immunological techniques in the diagnosis of anisakidosis in patients with acute abdomen. 146-152


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