[Use of anamnesis and immunological techniques in the diagnosis of anisakidosis in patients with acute abdomen].
BACKGROUND
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.


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.
del Rey-Moreno
A
A
Servicio de Cirugía, Hospital de Antequera, C/Poeta Muñoz Rojas s/n, Antequera, Málaga. arturodelreymoreno@gmail.com
Valero-López
A
A
Gómez-Pozo
B
B
Mayorga-Mayorga
C
C
Hernández-Quero
J
J
Garrido-Torres-Puchol
M L
ML
Torres-Jaén
M J
MJ
Lozano-Maldonado
J
J
D000006:Abdomen, Acute / Q000469:parasitology*; D000328:Adult; D017129:Anisakiasis / Q000175:diagnosis* / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies