摘要
目的对小麦依赖-运动诱发的严重过敏反应(wheat-dependant exercise-induced anaphylaxis,WDEIA)的临床特点进行分析和总结。方法对2004年3月至2007年12月在北京协和医院诊断为WDEIA15例患者的临床表现和发病特点进行总结,检测小麦、面筋、玉米、燕麦、大麦、荞麦、鸡蛋、牛奶等食物的特异性IgE水平,在部分病例进行小麦水溶蛋白、醇溶蛋白皮肤点刺试验;同时进行常见吸入变应原皮内试验和血清特异性IgE检查。结果运动后发生严重过敏反应患者15例,所有患者发病前0.5～6h均进食小麦类食物,确诊前平均发生低血压休克3.2次。15例患者中13例(86.7%)血清小麦IgE(f4)阳性,15例(100%)面筋IgE(f79)阳性。对其中5例患者进行小麦皮肤点刺试验,结果均为阳性。确诊前患者对WDEIA认知度较低,确诊后所有患者遵医嘱严格避免运动前进食小麦类食物,均未再发生严重过敏反应。结论WDEIA是一种诊断困难,在临床上被低估的严重过敏性疾病,但结合病史特点、血清IgE检测和皮肤点刺试验,仍可以被临床医生所认识。
Objective To analyze and summarize clinical features of wheat-dependant exercise-induced anaphylaxis （WDEIA）. Methods Clinical manifestations of the 15 cases of WDEIA diagnosed from Mar 2004 to Dec 2007 in our hospital were analyzed and summarized. Specific IgE level of wheat, gluten and other common food allergens such as corn, oat, barley, buckwheat, egg, milk, etc. was detected. Skin prick test of wheat and gliadin was performed in part of the patients. Skin test and serum IgE test to common airborne allergens were performed as well. Results Fifteen patients manifested anaphylaxis on exertion half to six hours after intake of wheat were concluded. They experienced anaphylaxis 3.2 times on average before diagnosis. 86.7% （13/15） patients had positive wheat IgE and all of them （15/15） had positive IgE to gluten. Skin prick test of wheat and gliadin was performed in five patients with positive results. Although the patients’ recognition of the etiology was fairly poor, after diagnosis none of these patients was attacked by further anaphylaxis episode on avoidance of wheat intake before exercises. Conclusion WDEIA is a disease difficult to diagnose and clinically underestimated.
出处
《中华临床免疫和变态反应杂志》
2010年第1期26-32,F0003,共8页
Chinese Journal of Allergy & Clinical Immunology
基金
卫生部行业基金科研项目(200802001)
