Golden David B K
Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Curr Opin Allergy Clin Immunol. 2006 Aug;6(4):289-93. doi: 10.1097/01.all.0000235904.87676.40.
Some aspects of insect sting allergy are unique in children. This review will identify and update the published data that exist pertaining specifically to insect allergy in children.
Children have a different pattern of insect sting allergy than adults. Honeybee allergy is more common in children. Severe systemic reactions are less common than in adults but the risk of recurrence can persist for decades. Systemic reactions are limited to mild 'cutaneous' reactions in over 60% of children (but only 15% of adults). Children with mild systemic reactions rarely get worse. Children with moderate or severe systemic reactions still had a 30% chance of a similar reaction even 20 years later. The long-term immune tolerance induced by venom immunotherapy is greater in children than adults. Children who had received venom immunotherapy for 3-5 years were still immune 10-20 years later.
Children with insect sting allergy are tested and treated in much the same way as adults. Children with mild systemic reactions do not require testing or immunotherapy. Children with moderate to severe systemic reactions are at risk for decades and should receive venom immunotherapy, which gives very long-lasting protection.
昆虫叮咬过敏的某些方面在儿童中具有独特性。本综述将识别并更新已发表的专门针对儿童昆虫过敏的数据。
儿童的昆虫叮咬过敏模式与成人不同。蜜蜂过敏在儿童中更为常见。严重的全身反应比成人少见，但复发风险可能持续数十年。超过60%的儿童全身反应仅限于轻度“皮肤”反应（而成人仅为15%）。轻度全身反应的儿童很少会病情加重。即使在20年后，中度或重度全身反应的儿童仍有30%的几率出现类似反应。毒液免疫疗法诱导的长期免疫耐受在儿童中比成人更强。接受毒液免疫疗法3至5年的儿童在10至20年后仍具有免疫力。
昆虫叮咬过敏的儿童的检测和治疗方式与成人大致相同。轻度全身反应的儿童无需检测或免疫治疗。中度至重度全身反应的儿童数十年都有风险，应接受毒液免疫疗法，该疗法能提供非常持久的保护。
