Suzuki Shintaro, Nakamura Yoichi, Nishioka Kiyoshi, Adachi Mitsuru
Department of Allergology, Medical Center for Allergic and Immune Disease, Yokohama City Minato Red Cross Hospital, Japan.
Arerugi. 2007 Jun;56(6):593-7.
A 30-year-old man exhibited systemic edema, dyspnea and wheal immediately after eating raw fish and cuttlefish served on an abalone shell. He had history of anaphylaxis after eating abalone and beef 4 years ago and had avoided shellfish including abalone since then. He also had past history of bronchial asthma and anaphylaxis due to shrimp. CAP-FEIA was performed to determine the allergen and was positive for scallop and oyster. Refined extracts made from abalone are not commercially available in Japan. Therefore, we purchased several kinds of shellfish, which are commonly consumed by Japanese, and used them, as is, for skin testing. Prick-by-prick tests were conduced using these shellfish, and yielded positive results for abalone and effluent from washing the abalone shell. Consequently, he was diagnosed with anaphylaxis caused by abalone extracts attached to the surface of raw fish. In our case, prick-by-prick test with shellfish was useful for the diagnosis of type I food allergy. If there are no commercial reagents of suspected food allergens for skin testing or challenge-test is not available, prick-by-prick tests might be performed for the diagnosis of food allergy.
一名30岁男性在食用盛放在鲍鱼壳上的生鱼和墨鱼后,立即出现全身水肿、呼吸困难和荨麻疹。他4年前曾有食用鲍鱼和牛肉后发生过敏反应的病史,此后一直避免食用包括鲍鱼在内的贝类。他还有支气管哮喘病史,曾因虾发生过敏反应。进行了CAP - FEIA检测以确定过敏原,结果显示扇贝和牡蛎呈阳性。在日本,市面上没有由鲍鱼制成的精制提取物。因此,我们购买了几种日本人常食用的贝类,直接用于皮肤试验。使用这些贝类进行点刺试验,结果显示鲍鱼和清洗鲍鱼壳的废水呈阳性。因此,他被诊断为由附着在生鱼表面的鲍鱼提取物引起的过敏反应。在我们的病例中,贝类点刺试验对I型食物过敏的诊断很有用。如果没有用于皮肤试验的可疑食物过敏原的商业试剂,或者无法进行激发试验,那么可以进行点刺试验来诊断食物过敏。