Angioedema, rhinitis and asthma provoked by fishing bait (Eisenia foetida).

The Eisenia foetida is an earthworm that is used as fishing bait in river fishing. We report a case of facial angioedema, rhinitis and asthma in an amateur fisherman who used this worm (Eisenia foetida) as fishing bait when fishing in rivers. However, the manifestations of dermo-respiratory hypersensitivity did not arise when he used other fishing bait (Tenibrio molitor and Marphysa sanguinea) in open-sea fishing. "In vivo" and "in vitro" tests using a battery of the usual neumoallergens and food (fish) were negative. Consequently, extracts of Eisenia foetida, Tenibrio molitor and Marphysa sanguinea were prepared. Skin tests, nasal challenge, histamine release curve and levels of specific IgE were positive when using an extract of Eisenia foetida. These parameters, however, were negative for beetle larvae (Tenibrio molitor) and marine worm (Marphysa sanguinea). The allergo-immunological study was also negative for the group of healthy and atopic controls when using these three extracts of fishing bait. The rarity of the allergen responsible for this dermo-respiratory picture stresses the need to include, on occasions, not only insects but also worms in the battery of the usual neumoallergens.

Evaluation of immune parameters (including specific IgG4) during immunotherapy.

A group of 26 patients with allergic asthma and rhinitis, exclusively sensitized to house dust and mites, underwent immunotherapy with an extract of Dermatophagoides pteronyssinus (Allpyral) for a period of 36 months. Every 6 months we carried out a clinical examination and assessed IgE levels, specific IgE to house dust and mites, histamine release curve to house dust and mites, CD3+ CD4+ CD8+ lymphocyte subpopulations, anti-Dermatophagoides pteronyssinus specific IgG and anti-Dermatophagoides pteronyssinus specific IgG4. The results did not show any significant differences in the IgE levels pre therapy and those monitored every 6 months. However, the anti-Dermatophagoides pteronys-sinus specific IgE generally registered a decrease during hyposensitization when compared with the levels obtained before the therapy. The histamine release curve to house dust and mites registered superior histamine release percentages pre immunotherapy to those obtained after 36 months of treatment. The T subpopulations did not show any statistically significant differences at any of the times they were monitored. The assessment of anti-Dermatophagoides pteronyssinus specific IgG did not yield any significant differences in the levels pre, during or at the end of the hyposensitizing period. The study of the levels of anti-Dermatophagoides pteronyssinus specific IgG4 showed a mean overall increase between 6 and 24 months of immunotherapy. When separately comparing these increases in specific IgG, with the clinical course no relationship was found between the increase in these antibodies and levels of the "in vivo" assessment scale.(ABSTRACT TRUNCATED AT 250 WORDS)