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Anisakis simplex-sensitized patients: should fish be excluded from their diet?
M T Gracia-Bara1, V Matheu, J M Zubeldia
1Sección de Alergia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Summary
Patients with Anisakis simplex (A.s.) allergy should avoid fish, especially those with severe anaphylaxis (ANA). For chronic urticaria (CU), individual clinical response to fish guides dietary needs.
Area of Science:
- Allergy and Immunology
- Parasitology
- Clinical Medicine
Background:
- Anisakis simplex (A.s.) allergy is an emerging health concern, with its larvae acting as hidden allergens in fish.
- Current dietary guidelines for patients with serum-specific IgE to A.s. are unclear.
- This study addresses the clinical and immunological follow-up of patients sensitized to A.s.
Purpose of the Study:
- To prospectively evaluate the clinical outcomes and immunological markers in patients sensitized to Anisakis simplex (A.s.).
- To assess the impact of fish exclusion on symptom recurrence in patients with A.s.-related anaphylaxis (ANA) and chronic urticaria (CU).
Main Methods:
- Prospective study of 17 patients with specific IgE and positive skin prick tests to A.s.
- Patients were divided into two groups: six with ANA and eleven with concomitant CU.
- All participants were advised to exclude fish from their diet for six months.
Main Results:
- In the ANA group, four patients who excluded fish remained symptom-free; two who did not had recurrent symptoms.
- In the CU group, 78% of patients who excluded fish showed clinical improvement.
- Total and specific IgE levels decreased in most patients across both groups who adhered to dietary changes.
Conclusions:
- Strict fish avoidance is recommended for patients experiencing severe anaphylaxis due to A.s. until specific allergens are identified.
- For patients with A.s.-specific IgE and chronic urticaria, the decision for strict fish avoidance should be guided by their individual clinical response to fish consumption.