Ma Songhui, Sicherer Scott H, Nowak-Wegrzyn Anna
Mount Sinai School of Medicine, Department of Pediatrics, Division of Allergy and Immunology, New York, NY 10029, USA.
J Allergy Clin Immunol. 2003 Oct;112(4):784-8. doi: 10.1016/s0091-6749(03)02008-6.
There is no consensus on the diagnosis and therapy of oral allergy syndrome (OAS; also known as pollen-food allergy syndrome), a disorder caused by IgE antibody-mediated reactions to homologous proteins in pollens and fruits and vegetables.
We sought to determine how practicing allergists define and treat OAS.
A questionnaire was mailed to 226 randomly selected US allergists from the American Academy of Allergy, Asthma and Immunology directory.
One hundred twenty-two (54%) returned surveys were analyzed. Median estimates of the prevalence of OAS among the patients with pollen allergy were 5% among children and 8% among adults. Twenty percent of allergists reported that some patients progressed to systemic symptoms. Fifty-three percent of allergists recommended complete avoidance of causal foods to all patients, whereas 9% did not advocate any restrictions. Thirty percent never prescribed epinephrine for OAS, 3% always did, and the remainder did so on the basis of symptoms. When presented with clinical cases, 20% diagnosed systemic reactions to peach as OAS, 13% believed peanut could cause OAS, and 25% did not prescribe epinephrine for peanut allergy manifested by oral symptoms.
Allergists' estimates of the prevalence of OAS in patients with pollen allergy (5%-8%) are lower than the prevalence reported (approximately 50%) in the published studies of these patients, perhaps reflecting a low index of suspicion, underdiagnosis, or both. The wide range of responses regarding diagnosis and management indicates the need for a better definition for the disorder and standard therapeutic guidelines. Discrepancies might be related to the term OAS, and therefore use of the more specific term "pollen-food allergy syndrome" is suggested.
口腔过敏综合征（OAS；也称为花粉 - 食物过敏综合征）是一种由IgE抗体介导的、针对花粉与水果和蔬菜中同源蛋白的反应所引起的疾病，目前对于其诊断和治疗尚无共识。
我们试图确定执业过敏症专科医生如何定义和治疗OAS。
从美国过敏、哮喘与免疫学会名录中随机抽取226名美国过敏症专科医生，并向他们邮寄了一份调查问卷。
对122份（54%）回复的调查问卷进行了分析。花粉过敏患者中OAS患病率的中位数估计为：儿童5%，成人8%。20%的过敏症专科医生报告称，一些患者会发展为全身症状。53%的过敏症专科医生建议所有患者完全避免食用致病食物，而9%的医生不主张任何限制。30%的过敏症专科医生从未为OAS患者开具肾上腺素，3%的医生总是开具，其余医生则根据症状开具。在面对临床病例时，20%的医生将对桃子的全身反应诊断为OAS，13%的医生认为花生可导致OAS，25%的医生未为有口腔症状的花生过敏患者开具肾上腺素。
过敏症专科医生对花粉过敏患者中OAS患病率的估计（5% - 8%）低于已发表研究中报道的患病率（约50%），这可能反映出怀疑指数较低、诊断不足或两者皆有。关于诊断和管理的广泛不同反应表明，需要对该疾病进行更好的定义以及制定标准治疗指南。差异可能与OAS这个术语有关，因此建议使用更具体的术语“花粉 - 食物过敏综合征”。
