在皮肤科就诊的湿疹婴儿中的IgE食物致敏情况。

IgE food sensitization in infants with eczema attending a dermatology department.

作者信息

Hill David J, Heine Ralf G, Hosking Cliff S, Brown Jennifer, Thiele Leone, Allen Katrina J, Su John, Varigos George, Carlin John B

机构信息

Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

J Pediatr. 2007 Oct;151(4):359-63. doi: 10.1016/j.jpeds.2007.04.070. Epub 2007 Aug 6.

DOI:10.1016/j.jpeds.2007.04.070

PMID:17889069

Abstract

OBJECTIVES

Because community-based studies, which report IgE food sensitization (IgE-FS) in more than 80% of infants with moderate atopic eczema, may be influenced by referral bias, we assessed the prevalence of IgE-FS in a cohort of infants with moderate atopic eczema attending a dermatology department clinic.

STUDY DESIGN

Consecutive infants (n = 51, 39 males; median age, 34 weeks; range, 20 to 51 weeks) with moderate atopic eczema referred to a university-affiliated dermatology department were studied prospectively. Clinical history and eczema severity were documented. IgE-FS was assessed by the skin prick test (SPT; n = 51) and food-specific serum IgE antibodies (CAP-FEIA test; n = 41). IgE-FS was diagnosed if the SPT or CAP-FEIA level exceeded the >95% predictive reference cutoff for positive food challenges.

RESULTS

Based on SPT, 44 of 51 infants (86%; 95% confidence interval [CI] = 74% to 94%) had IgE-FS (cow's milk, 16%; egg, 73%; peanut, 51%). Using age-specific 95%-predictive cutoff values, CAP-FEIA identified 34 of 41 infants (83%; 95% CI = 68% to 93%) with IgE-FS (cow's milk, 23%; egg, 80%). Forty-six (90%) infants had IgE-FS to at least 1 food item by either SPT or CAP-FEIA.

CONCLUSIONS

Atopic eczema was found to be closely associated with IgE-FS in infants attending a dermatology department.

摘要

目的

由于社区研究中报告称，超过80%的中度特应性湿疹婴儿存在IgE介导的食物过敏（IgE-FS），这类研究可能受到转诊偏倚的影响，因此我们评估了在皮肤科门诊就诊的中度特应性湿疹婴儿队列中IgE-FS的患病率。

研究设计

对连续转诊至某大学附属医院皮肤科的中度特应性湿疹婴儿（n = 51，男39例；中位年龄34周；范围20至51周）进行前瞻性研究。记录临床病史和湿疹严重程度。通过皮肤点刺试验（SPT；n = 51）和食物特异性血清IgE抗体（CAP-FEIA试验；n = 41）评估IgE-FS。如果SPT或CAP-FEIA水平超过食物激发试验阳性的>95%预测参考临界值，则诊断为IgE-FS。

结果

基于SPT，51例婴儿中有44例（86%；95%置信区间[CI]=74%至94%）存在IgE-FS（牛奶，16%；鸡蛋，73%；花生，51%）。使用年龄特异性的95%预测临界值，CAP-FEIA确定了在41例婴儿中有34例（83%；95% CI = 68%至93%）存在IgE-FS（牛奶，23%；鸡蛋，80%）。通过SPT或CAP-FEIA，46例（90%）婴儿对至少1种食物存在IgE-FS。