What does Anisakis simplex parasitism in gastro-allergic anisakiasis teach us about interpreting specific and total IgE values?

BACKGROUND

gastro-allergic Anisakiasis is a mostly transitory clinical entity caused by Anisakis simplex (A. simplex) and can be suspected by history and confirmed by fiberoptic gastroscopy and specific IgE.

OBJECTIVE

we report a case of gastro-allergic Anisakiasis, in which the parasite induces a high specific and total IgE response, and want to follow the specific and total IgE values by a serologic follow up over 10 months.

METHODS

an analysis of total IgE and specific IgE against. A. simplex was performed within 24 hours, after 1, 4, 6 and 10 months. At month 4 and month 10 specific IgE against Ascaris lumbricoides and Echinococcus granulosus was determined in order to value cross-reactivity.

RESULTS

there is an important raise in specific IgE against Anisakis simplex (up to 903 kU/l) after 6 months and total IgE (up to 15,258 kU/l) after one month. Cross-reactive specific IgE against Ascaris lumbricoides and Echinococcus granulosus can be detected.

CONCLUSIONS

we consider a raise of total and specific IgE as a typical feature of helminth infestation and learn that specific and total IgE values are highly variable in the months following the allergic and parasite-specific reaction. The amount of specific IgE against other cross reactive parasites depends directly on the total IgE values.