IgE-mediated gastroallergic anisakiasis with eosinophilic oesophagitis: a case report

Background Anisakiasis is an emerging zoonosis caused by the fish parasitic nematode Anisakis infecting the gastrointestinal tract. Case presentation We describe a case of a 58-year-old woman diagnosed with gastro-allergic anisakiasis, in which the patient developed an acute food-induced IgE-mediated hypersensitivity reaction as well as concurrent gastro-intestinal manifestations after consumption of raw fish. The patient presented with epigastric pain, anaphylaxis and acute dysphagia caused by eosinophilic oesophagitis. Discussion Anisakis allergy should be considered as causative agent in patients presenting with acute urticarial rash, anaphylaxis and/or abdominal manifestations, especially when symptoms occur after consumption of seafood. Moreover, eosinophilic oesophagitis may be a rare but important complication of Anisakis infection. Endoscopic evaluation with esophageal biopsies should therefore be considered if suggestive symptoms are present. Patients with confirmed gastroallergic anisakiasis are advised to properly freeze or cook fish prior to consumption, although caution is advised, since heat-stable allergen proteins have been described. An adrenaline auto-injector should be prescribed.

Automated summary

This article presents a case of gastro-allergic anisakiasis in a 58-year-old woman who developed acute IgE-mediated hypersensitivity reaction and gastrointestinal symptoms after consuming raw fish. It highlights the importance of considering Anisakis allergy as a potential cause for patients with urticarial rash, anaphylaxis, and abdominal symptoms, particularly after seafood consumption. The article also emphasizes the rare but significant complication of eosinophilic esophagitis in Anisakis infection.