Ahn Kang-Mo, Han Young-Shin, Nam Seung-Yeon, Park Hwa-Young, Shin Mee-Yong, Lee Sang-Il
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2003 Aug;18(4):473-7. doi: 10.3346/jkms.2003.18.4.473.
This study was aimed to evaluate the prevalence of soy protein hypersensitivity in cow's milk protein-sensitive children in Korea. A total of 1,363 patients with atopic dermatitis, urticaria, enterocolitis syndrome, bronchial asthma or allergic rhinitis were recruited. First, we estimated the prevalence of sensitization to soy in children sensitized to cow's milk. Specific IgE levels > 0.7 kU/L by CAP assay were considered positive. Next, the prevalence of soy allergy in cow's milk allergy (CMA) patients was investigated. Those children whose parents agreed to participate the open challenge test with soy had a convincing history of allergic reactions elicited by cow's milk and these symptoms were relieved by elimination. All of them had negative soy-specific IgE. Patients with positive soy-specific IgE accounted for 18.3% of 224 children sensitized to cow's milk protein. The prevalence of sensitization to soy decreased with age (36.8% in the first year of life, 16.4% in the second year, and 13.7% in the third year). Of 21 CMA patients, 42.9% (n=9) were determined to have soy allergy (mean age 10.3 months). Our results suggest that soy protein formula should be carefully used as a substitute for cow's milk in CMA patients, especially during infancy.
本研究旨在评估韩国牛奶蛋白敏感儿童中大豆蛋白过敏的患病率。共招募了1363例患有特应性皮炎、荨麻疹、小肠结肠炎综合征、支气管哮喘或过敏性鼻炎的患者。首先,我们估计了牛奶致敏儿童中大豆致敏的患病率。采用CAP检测法,特异性IgE水平>0.7 kU/L被视为阳性。接下来,对牛奶过敏(CMA)患者中大豆过敏的患病率进行了调查。那些父母同意参与大豆开放激发试验的儿童有明确的牛奶引发过敏反应病史,且这些症状通过饮食回避得到缓解。他们所有人的大豆特异性IgE均为阴性。大豆特异性IgE阳性的患者占224例牛奶蛋白致敏儿童的18.3%。大豆致敏率随年龄下降(1岁时为36.8%,2岁时为16.4%,3岁时为13.7%)。在21例CMA患者中,42.9%(n = 9)被确定患有大豆过敏(平均年龄10.3个月)。我们的结果表明,在CMA患者中,尤其是在婴儿期,应谨慎使用大豆蛋白配方奶粉替代牛奶。