[Use of anamnesis and immunological techniques in the diagnosis of anisakidosis in patients with acute abdomen]. / Utilidad de la anamnesis y de las técnicas inmunológicas en el diagnóstico de la anisakidosis en pacientes con abdomen agudo.

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.

Utilidad de la anamnesis y de las técnicas inmunológicas en el diagnóstico de la anisakidosis en pacientes con abdomen agudo / No disponible

Introducción: Anisakis simplex puede producir síntomas digestivosy alérgicos. En este trabajo se evalúan los antecedentesepidemiológicos y los resultados inmunológicos para diferenciarentre pacientes con anisakidosis y aquellos con otras patologíasdigestivas que cursan con dolor abdominal.Pacientes y método: estudio de cohortes realizado con 134pacientes: 52 fueron diagnosticados de anisakidosis por los hallazgosquirúrgicos y anatomopatológicos y/o seroconversión específicafrente a A. simplex (grupo A) y en 82 pacientes la anisakidosisfue excluida como diagnóstico (grupo NA: no-anisakidosis). Sehan evaluado el antecedente de ingesta de pescado crudo, laprueba cutánea en prick (PC) y el inmunoblot IgE como elementosde diagnóstico.Resultados: los pacientes de los grupos A y NA mostraron resultadosdiferentes respecto a la de ingesta de pescado crudo (p <0,0001) y la PC (p < 0,0001), con valores predictivos negativos(VPN) del 98,39 y 95,56% y positivos (VPP) del 70,83 y 87,50%,respectivamente. En el inmunoblot, se halló una banda de aproximadamente60 kDa en el 86,2 y 19,2% de los pacientes del grupoA y NA, respectivamente (VPP: 62,50%; VPN: 94,03%).Conclusiones: en pacientes con dolor abdominal, la ingesta depescado crudo o poco cocinado tiene elevada sensibilidad y VPN(98,39%) pero menor VPP (70,83%), por lo que nos ayuda principalmentea descartar la anisakidosis. La ausencia de sensibilizacióncutánea al extracto crudo de A. simplex apoya la ausencia de anisakidosiscon una probabilidad alta (95,56%). La presencia de una bandade 60 kDa en el inmunoblot podría ser útil para su diagnóstico

Introduction: Anisakis simplex can be a cause of digestivesymptoms. Our aim was to evaluate the epidemiological antecedentsand immunological data available for a differentiationbetween patients with anisakidosis and those with other acute abdominalproblems.Patients and methods: this is a prospective cohort study involving134 patients with acute abdominal problems: 52 patientswere diagnosed with anisakidosis by means of surgical and pathologicalfindings and/or specific IgE seroconversion againstAnisakis simplex (group A), and in 82 patients anisakidosis hadbeen ruled out (group NA: non-anisakidosis). We evaluated theantecedent of raw fish ingestion, the skin prick test, and IgE immunoblottingas diagnostic tools.Results: patients in groups A and NA differ in terms of priorraw fish ingestion (p < 0.0001) and positive SPT (p < 0.0001),with their respective negative predictive values (NPV) being98.39% (95%CI: 90.17-99.92) and 95.56% (95%CI: 83.64-99.23). Regarding immunoblotting, in 86.2% of patients in groupA a band of 60 kDa was detected, which was also detected in19.2% of patients in group NA.Conclusions: a negative answer to the question about raw orundercooked 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 extractgives 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 (AU)