Pajno G B, Passalacqua G, La Grutta S, Vita D, Feliciotto R, Parmiani S, Barberio G
II Pediatric Division. University Hospital. Messina. Italy.
Allergol Immunopathol (Madr). 2002 Nov-Dec;30(6):338-41. doi: 10.1016/s0301-0546(02)79149-0.
Food allergy is quite common in children, but it usually trends to improve with ageing. When an individual has specific IgE to a large variety of foods (multifood allergy) the clinical picture may be of remarkable severity and the avoidance of the offending foods may lead to severe dietary impairment. We describe a case of a child with ascertained multifood allergy.
The prick-by-prick testing with fresh foods and serum IgE tests were used to evaluate the patient's sensitivity to food allergens. The clinical effect of sensitizations were evaluated by DBPCFC which was carried out for egg, fish, peanuts, walnut, fig, asparagus, orange, chicory, medlar, peach, strawberry and cherry. Each challenge was performed on a separate day. Medical assistance and resuscitation facilities were available during the whole challenge procedures.
SPT with fresh food gave a 4 mm wheal for fig, asparagus, cherry and walnut; a 5 mm wheal for medlar and orange; a 6 mm wheal for chicory and strawberry; a 7 mm wheal for fish and peanuts; an 8 mm wheal for peach and a 9 mm wheal for egg. The RAST assay confirmed the presence of specific IgE to egg, fish, peanuts, walnut, fig, orange, strawberry, peach, and cherry. The total serum IgE was 730,6 kU/l.The DBPCFC was positive, at various degrees, for all foods tested according to skin sensitizations.
The case herein described is a true multifood allergy, as confirmed by the DBPCFC. Multifood allergy is not common, but when present it can lead to severe dietary limitation.
食物过敏在儿童中相当常见，但通常会随着年龄增长而趋于改善。当个体对多种食物具有特异性IgE（多种食物过敏）时，临床表现可能非常严重，避免食用致敏食物可能导致严重的饮食受限。我们描述了一例确诊为多种食物过敏的儿童病例。
采用新鲜食物点刺试验和血清IgE检测来评估患者对食物过敏原的敏感性。通过对鸡蛋、鱼、花生、核桃、无花果、芦笋、橙子、菊苣、欧楂果、桃子、草莓和樱桃进行双盲安慰剂对照食物激发试验（DBPCFC）来评估致敏的临床效果。每次激发试验在不同日期进行。在整个激发试验过程中都有医疗援助和复苏设备可用。
新鲜食物点刺试验中，无花果、芦笋、樱桃和核桃出现4毫米的风团；欧楂果和橙子出现5毫米的风团；菊苣和草莓出现6毫米的风团；鱼和花生出现7毫米的风团；桃子出现8毫米的风团，鸡蛋出现9毫米的风团。放射变应原吸附试验（RAST）证实存在针对鸡蛋、鱼、花生、核桃、无花果、橙子、草莓、桃子和樱桃的特异性IgE。总血清IgE为730.6 kU/l。根据皮肤致敏情况，双盲安慰剂对照食物激发试验对所有测试食物均呈不同程度的阳性。
如双盲安慰剂对照食物激发试验所证实，本文所述病例为真正的多种食物过敏。多种食物过敏并不常见，但一旦出现可导致严重的饮食限制。
