Halvorsen Ragnhild
Voksentoppen, Rikshospitalet, 0027 Oslo.
Tidsskr Nor Laegeforen. 2004 Nov 18;124(22):2909-10.
Food allergy is common in small children. Sensitisation to wheat is frequent, reactions to ingested wheat more seldom and mostly associated with atopic eczema and exercise-induced anaphylaxis.
Eleven children with severe reactions after ingestion of small amounts of wheat were referred to us for further diagnostic procedures. Skin prick tests, total and specific IgE as well as oral provocation test were performed.
All but two children had strongly positive skin prick tests results to wheat. The same two children had specific IgE to Immunocap f4 (a-amylase) < 10 kUa/L while the nine other children had specific IgE to f4 > 29 kUa/L. All children had general reactions when provoked orally with small amounts of wheat with the need for administration of adrenalin and in most cases oral steroids.
It is important to identify children at risk for general reactions to wheat, as cereals are staple foods in our community. Identification of the proteins involved in serious reactions is essential.
食物过敏在幼儿中很常见。对小麦致敏很频繁，摄入小麦后的反应则较少见，且大多与特应性湿疹和运动诱发的过敏反应有关。
11名摄入少量小麦后出现严重反应的儿童被转介给我们进行进一步诊断程序。进行了皮肤点刺试验、总IgE和特异性IgE检测以及口服激发试验。
除两名儿童外，所有儿童对小麦的皮肤点刺试验结果均为强阳性。同样这两名儿童针对免疫捕获f4（α-淀粉酶）的特异性IgE<10 kUa/L，而其他九名儿童针对f4的特异性IgE>29 kUa/L。所有儿童在口服少量小麦激发时均出现全身反应，需要使用肾上腺素，且在大多数情况下还需要口服类固醇。
识别有小麦全身反应风险的儿童很重要，因为谷物是我们社区的主食。确定严重反应中涉及的蛋白质至关重要。
