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[蚂蚁毒液:瑞士过敏反应的罕见原因]

[Ant venoms: a rare cause of allergic reactions in Switzerland].

作者信息

Seebach J D, Bucher C, Anliker M, Schmid-Grendelmeier P, Wüthrich B

机构信息

Departement für Innere Medizin, Medizinische Klinik A, Universitätsspital, Rämistrasse 100, C HOER 31 CH-8091 Zürich.

出版信息

Schweiz Med Wochenschr. 2000 Nov 25;130(47):1805-13.

Abstract

In Switzerland, unlike other countries, allergic reactions to ants are a rare phenomenon when compared to the well known allergies to bee and wasp venom. In this report we present a series of case reports and a review of the different types of allergy to ants. Due to increased travel and heterogeneity of the population, we have observed several patients with sensitisation or allergy to the venom of imported fire ants (Solenopsis), a species of ant found in the Americas. Furthermore, allergic reactions to bites of the mound-building wood ant (Formica rufa), whose habitat is Central and Northern Europe, have been documented. Whereas reactions to fire ants can be life-threatening, reactions to mound-building wood ants have led to marked local reactions and in 2 cases to dyspnoea and wheezing. These reactions could be due either to primary sensitisation to ant venom or cross-reactivity in the presence of an allergy to wasp venom. Evaluation of patients presenting with a potential ant venom allergy includes a detailed personal history, skin testing and determination of specific IgE. However, to date only extracts from fire ants are commercially available for diagnostic tests. In the light of our observations we assume cross-reactivity between the venoms of fire ants and mound-building wood ants, and it therefore seems appropriate to use fire ant diagnostics in determining sensitisation to mound-building wood ants. In patients with severe fire ant-venom allergy we recommend desensitisation by immunotherapy, whereas in patients presenting with minor allergic reactions, e.g. after bites by mound-building wood ants, we provide the patients with emergency medication. Since current knowledge of ant allergies in Europe is limited, further studies are warranted.

摘要

在瑞士,与其他国家不同,相较于广为人知的对蜜蜂和黄蜂毒液的过敏,对蚂蚁的过敏反应是一种罕见现象。在本报告中,我们呈现了一系列病例报告,并对不同类型的蚂蚁过敏进行了综述。由于旅行增加和人口的异质性,我们观察到了几位对进口火蚁(红火蚁属)毒液敏感或过敏的患者,火蚁是一种在美洲发现的蚂蚁种类。此外,对筑巢木蚁(红褐林蚁)叮咬的过敏反应也有记录,其栖息地在中欧和北欧。虽然对火蚁的反应可能危及生命,但对筑巢木蚁的反应导致了明显的局部反应,有2例出现了呼吸困难和喘息。这些反应可能是由于对蚂蚁毒液的原发性致敏,或者是在对黄蜂毒液过敏的情况下发生的交叉反应。对可能存在蚂蚁毒液过敏的患者进行评估包括详细的个人病史、皮肤试验和特异性IgE的测定。然而,迄今为止,只有火蚁提取物可用于商业诊断测试。根据我们的观察,我们推测火蚁毒液和筑巢木蚁毒液之间存在交叉反应,因此在确定对筑巢木蚁的致敏情况时使用火蚁诊断似乎是合适的。对于严重的火蚁毒液过敏患者,我们建议通过免疫疗法进行脱敏,而对于出现轻微过敏反应的患者,例如在被筑巢木蚁叮咬后,我们为患者提供急救药物。由于目前欧洲对蚂蚁过敏的了解有限,有必要进行进一步的研究。

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