[Anisakiasis gastrointestinal manifestations: description of 42 cases]. / Manifestaciones digestivas de la anisakiasis: descripción de 42 casos.

BASIS: Anisakiasis is an emerging parasitosis in our environment, although still scarcely known, mainly its gastrointestinal manifestations. PATIENTS AND METHODS: In this paper 42 cases of anisakiasis with gastrointestinal symptoms (with or without cutaneous allergic manifestations) are described; all cases were studied in our hospital between 1995 and May 2004. RESULTS: Thirty seven cases showed a gastric or gastroallergic form (6 confirmed with gastroscopy) and 5 suffered intestinal symptoms. In those in which endoscopy was not carried out, the diagnosis was done after clinical and biological findings. All patients were sensitized in the presence of Anisakis simplex. The 69% (29 cases) described raw anchovies ingestion or anchovies seasoned in vinegar ingestion some hours before the beginning of the clinical picture. The 59% showed allergic symptoms (gastroallergic anisakiasis); no patient with intestinal affectation showed allergic symptoms. Nausea (67%), vomiting (51%), and epigastralgia (50%) were the dominant symptoms in the group with gastric or gastroallergic anisakiasis without endoscopic confirmation; on the other hand, pain in right ileac fossa was the dominant symptom in the intestinal form. Fever was seen in two of the later patients (40%), but in no patient with gastric or gastroallergic anisakiasis. CONCLUSIONS: Gastrointestinal symptomatology after ingestion of fish suspiciously prepared should suggest anisakiasis, regardless if clinical picture includes allergic manifestations. In our study, pain in right ileac fossa, fever, and absence of allergic manifestations were typical of intestinal form.

Manifestaciones digestivas de la anisakiasis: descripción de 42 casos / Anisakiasis gastrointestinal manifestations: description of 42 cases

Fundamento. La anisakiasis es una parasitosis emergente en nuestro medio, aunque todavía escasamente conocida, principalmente en sus manifestaciones digestivas. Pacientes y métodos. Se describen 42 casos de anisakiasis con afectación digestiva (con o sin manifestaciones alérgicas cutáneas) estudiados en nuestro hospital entre 1995 y mayo de 2004. Resultados. Treinta y siete casos mostraban una forma gástrica o gastroalérgica (6 confirmados mediante gastroscopia) y 5 manifestaciones intestinales. En aquellos en que no se realizó endoscopia el diagnóstico se efectuó tras los hallazgos clínicos y biológicos. Todos los pacientes estaban sensibilizados frente a Anisakis simplex. El 69% (29 casos) referían ingesta unas horas antes de anchoas en vinagre o crudas. El 59% presentó clínica alérgica asociada (anisakiasis gastroalérgica), no presentando esta clínica ninguno de los casos con afectación intestinal. Las náuseas (67%), vómitos (51%) y epigastralgia (50%) fueron los síntomas dominantes en el grupo con anisakiasis gástrica o gastroalérgica sin confirmación endoscópica, mientras que el dolor en fosa ilíaca derecha lo fue en la forma intestinal. Dos de estos pacientes (40%) presentaron fiebre, aunque ninguno de los casos con anisakiasis gástrica o gastroalérgica. Conclusiones. La aparición de sintomatología digestiva después de la ingesta de pescado preparado de forma sospechosa debe hacer pensar en una posible anisakiasis, independientemente de que se asocien o no manifestaciones alérgicas. La presencia de dolor en fosa ilíaca derecha, fiebre y la ausencia de manifestaciones alérgicas fueron característicos de las formas intestinales

Basis. Anisakiasis is an emerging parasitosis in our environment, although still scarcely known, mainly its gastrointestinal manifestations. Patients and methods. In this paper 42 cases of anisakiasis with gastrointestinal symptoms (with or without cutaneous allergic manifestations) are described; all cases were studied in our hospital between 1995 and May 2004. Results. Thirty seven cases showed a gastric or gastroallergic form (6 confirmed with gastroscopy) and 5 suffered intestinal symptoms. In those in which endoscopy was not carried out, the diagnosis was done after clinical and biological findings. All patients were sensitized in the presence of Anisakis simplex. The 69% (29 cases) described raw anchovies ingestion or anchovies seasoned in vinegar ingestion some hours before the beginning of the clinical picture. The 59% showed allergic symptoms (gastroallergic anisakiasis); no patient with intestinal affectation showed allergic symptoms. Nausea (67%), vomiting (51%), and epigastralgia (50%) were the dominant symptoms in the group with gastric or gastroallergic anisakiasis without endoscopic confirmation; on the other hand, pain in right ileac fossa was the dominant symptom in the intestinal form. Fever was seen in two of the later patients (40%), but in no patient with gastric or gastroallergic anisakiasis. Conclusions. Gastrointestinal symptomatology after ingestion of fish suspiciously prepared should suggest anisakiasis, regardless if clinical picture includes allergic manifestations. In our study, pain in right ileac fossa, fever, and absence of allergic manifestations were typical of intestinal form

[Good's syndrome and chronic diarrhea]. / Síndrome de Good y diarrea crónica.

Good's syndrome is an infrequent disorder associated with humoral immunodeficiency and thymoma. Patients usually present severe or chronic infections. The most frequent are sinopulmonary infections sometimes associated with bronchiectasias. Another complication is chronic diarrhea, frequently associated with malabsorption, which can be due to a mucosal lesion, infection with gastrointestinal pathogens, or bacterial overgrowth. We describe a patient with Good's syndrome and chronic diarrhea due to bacterial overgrowth.