Codreanu F, Moneret-Vautrin D A, Morisset M, Guénard L, Rancé F, Kanny G, Lemerdy Ph
Médecine Interne, Immunologie Clinique et Allergologie, Hôpital Central 29, Nancy.
Eur Ann Allergy Clin Immunol. 2006 Feb;38(2):52-4.
Prick-tests to foods are usually carried out as the first step in the diagnosis of food allergy. Severe anaphylaxis accounts for 4.9 % of allergies in children and occurs more frequently in adults, raising the possibility of systemic reactions to prick-tests in highly sensitized people. Several studies published in the literature have used commercial extracts. As for airborne allergens, concentrations causing a skin reaction of 15 mm do not present a risk of systemic reactions. Prick-tests to native foods--prick-in-prick tests--have been less extensively studied. The CICBAA1 data, from 1,138 food allergic patients of all ages, cover 34,905 prick-in-prick tests to foods. The wheal of these prick-tests has been regulary registered. The risk of systemic reactions can be evaluated at 0.008 %. There were no severe reactions and anti-histamine and corticosteroid therapy were sufficient. These results are similar to those of the large study in 2000 carried out by Devenney in neonates (0.005%). A review of the literature reveals only a few severe reactions in adults. The authors draw attention to the necessary precautions: temporary contra-indication for skin prick-tests in children and adults with grade 3 or 4 asthma, with particular attention to such foods as all kinds of nuts, fish, etc.
食物点刺试验通常是诊断食物过敏的第一步。严重过敏反应占儿童过敏的4.9%，在成人中更常见，这增加了高度敏感人群对点刺试验产生全身反应的可能性。文献中发表的几项研究使用了商业提取物。至于空气传播的过敏原，引起15毫米皮肤反应的浓度不会产生全身反应的风险。对天然食物的点刺试验——皮内点刺试验——研究较少。来自1138名各年龄段食物过敏患者的CICBAA1数据涵盖了34905次食物皮内点刺试验。这些点刺试验的风团已被定期记录。全身反应的风险可评估为0.008%。没有严重反应，抗组胺药和皮质类固醇治疗就足够了。这些结果与2000年Devenney在新生儿中进行的大型研究结果（0.005%）相似。文献综述显示成人中只有少数严重反应。作者提请注意必要的预防措施：3级或4级哮喘的儿童和成人进行皮肤点刺试验时应暂时禁忌，尤其要注意各种坚果、鱼类等食物。
