Hansen T K, Bindslev-Jensen C
Food Allergy Unit, National University Hospital, Copenhagen, Denmark.
Allergy. 1992 Dec;47(6):610-7. doi: 10.1111/j.1398-9995.1992.tb02383.x.
Ten adult patients with a medical history of immediate allergic reactions following ingestion of minute amounts of codfish were examined together with 27 control subjects (8 nonatopics, 7 pollen allergics, and 12 suffering from atopic dermatitis) all regularly ingesting codfish without experiencing reactions. All 37 subjects were evaluated by skin prick test, RAST, and histamine release test in order to determine the value of these commonly used diagnostic tests. The results were compared to titrated, oral, double-blind, placebo-controlled food challenges (DBPCFCs) with fresh codfish undertaken in the 10 patients, whereas all control subjects were classified as challenge-negative according to their questionnaires. Totally, 7 of 10 medical histories were confirmed by DBPCFC, and in these most of the reported symptoms proved reproducible. Oropharyngeal itching and swelling occurred as the first symptom, always preceding the onset of any accompanying symptom. For identification of DBPCFC-positive subjects, skin prick test and RAST proved to be the most sensitive tests (7/7), and all tests showed specificities of 90-97%. The skin prick test still seems reliable but does not, however, exclude the need for DBPCFC.
对10名有摄入微量鳕鱼后立即出现过敏反应病史的成年患者，以及27名对照受试者（8名非特应性个体、7名花粉过敏者和12名患有特应性皮炎者）进行了检查，所有对照受试者均经常食用鳕鱼且未出现反应。对所有37名受试者进行了皮肤点刺试验、放射变应原吸附试验（RAST）和组胺释放试验，以确定这些常用诊断试验的价值。将结果与10名患者进行的新鲜鳕鱼滴定口服双盲安慰剂对照食物激发试验（DBPCFC）进行比较，而所有对照受试者根据问卷被分类为激发试验阴性。总体而言，10份病史中有7份经DBPCFC证实，在这些病例中，大多数报告的症状被证明是可重现的。口咽瘙痒和肿胀是首发症状，总是先于任何伴随症状出现。对于识别DBPCFC阳性受试者，皮肤点刺试验和RAST被证明是最敏感的试验（7/7），所有试验的特异性均为90% - 97%。皮肤点刺试验似乎仍然可靠，但这并不排除进行DBPCFC的必要性。
