Ozdemir Oner, Arrey-Mensah Annie, Sorensen Ricardo U
Department of Pediatrics, Division of Allergy/Immunology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Pediatr Transplant. 2006 May;10(3):380-3. doi: 10.1111/j.1399-3046.2005.00474.x.
Angioedema and chronic diarrhea in patients taking immunosuppressants are not always because of side effects and could be a new onset of food allergy. Our aim is to discuss the pathogenesis and treatment of the post-transplant development of food allergies. The first patient was receiving tacrolimus subsequent to heart transplantation and developed angioedema after consumption of dairy products at 12 months after transplantation. He was found to be allergic to multiple foods by both RAST and ImmunoCAP tests. The second patient with argininosuccinic aciduria, post-liver transplant, also received tacrolimus and developed chronic non-mucoid/bloody diarrhea at seven months following transplantation. ImmunoCAP test was positive only for egg white and peanuts. Biopsy showed eosinophilic infiltration of the mucosa from the stomach to the rectum. Elimination diets in both patients resolved the symptoms. These cases suggest a direct relationship between tacrolimus and development of food allergy.
服用免疫抑制剂的患者出现血管性水肿和慢性腹泻并不总是由副作用引起，可能是新发的食物过敏。我们的目的是探讨移植后食物过敏发生发展的发病机制及治疗方法。首例患者在心脏移植后接受他克莫司治疗，移植后12个月食用乳制品后出现血管性水肿。通过放射性变应原吸附试验（RAST）和免疫捕获法（ImmunoCAP）检测发现他对多种食物过敏。第二例患者为肝移植后患有精氨酸琥珀酸尿症，也接受他克莫司治疗，移植后7个月出现慢性非黏液性/血性腹泻。免疫捕获法检测仅对蛋清和花生呈阳性。活检显示从胃到直肠黏膜有嗜酸性粒细胞浸润。两名患者通过饮食回避均缓解了症状。这些病例表明他克莫司与食物过敏的发生发展有直接关系。
