[植物源性食物引起的口腔过敏综合征：63例患者6年临床回顾]

[Oral allergy syndrome due to plant-derived foods: a clinical review of 63 patients over a period of 6 years].

作者信息

Inomata Naoko, Morita Akiko, Kirino Mio, Yamazaki Haruna, Yamaguchi Jyunko, Yamane Yumiko, Tatewaki Satoko, Hirokado Michiko, Kondo Megumi, Ikezawa Zenro

机构信息

Department of Dermatology, Yokohama City University Hospital, Japan.

出版信息

Arerugi. 2007 Oct;56(10):1276-84.

PMID:17982289

Abstract

BACKGROUND

The clinical features of many patients with oral allergy syndrome (OAS) due to plant-derived foods have rarely been reported in Japan.

OBJECTIVES

We aimed to determine the causative foods of OAS due to plant-derived foods based on clinical features and skin prick tests (SPTs). Furthermore, we aimed to elucidate the association between causative foods and sensitized pollens in patients with OAS due to plant-derived foods.

METHODS

SPTs and specific IgE measurements (CAP-FEIA: CAP) were performed in relation to foods and pollens in 118 patients with positive histories of OAS due to plant-derived foods. Patients with positive histories and with positive skin test responses were identified as having type I allergy to the causative foods.

RESULTS

The mean age of 63 patients with positive histories and positive skin test responses was 29.2 years (range, 2-61 years), and there were twice as many females as male. The most frequent causative foods were found to be apple, peach, kiwi, and melon in 13, 12, 12, and 11 patients, respectively. CAP frequency was shown to be similar to that of SPT regarding apple, whereas it was less than that of SPT regarding melon, peach, and kiwi. A significant correlation between the frequencies of SPT and CAP was found regarding apple (r=0.39, p<0.05) but not peach, kiwi, and melon. Forty-one of 63 patients with OAS (66.1%) had pollinosis and/or allergic rhinitis. In patients with OAS due to apple, the positive ratio of CAP response against alder pollen was higher than that in patients with OAS due to melon. In patients with OAS due to melon, the positive ratio of CAP responses against ragweed pollen, grass pollen, and mugwort pollen was higher than that in patients with OAS due to apple.

CONCLUSION

In this study, positive ratios of SPT and CAP tended to differ according to the causative food, showing a smaller potential for reaction than might be suggested by patient history. Therefore, for the time being it would be more accurate to use a skin test for the diagnosis of OAS due to plant-derived foods.

摘要

背景

在日本，很少有关于植物源性食物引起的口腔过敏综合征（OAS）患者临床特征的报道。

目的

我们旨在根据临床特征和皮肤点刺试验（SPT）确定植物源性食物引起的OAS的致病食物。此外，我们旨在阐明植物源性食物引起的OAS患者中致病食物与致敏花粉之间的关联。

方法

对118例有植物源性食物引起的OAS阳性病史的患者进行了与食物和花粉相关的SPT及特异性IgE检测（CAP-FEIA：CAP）。有阳性病史且皮肤试验反应阳性的患者被确定为对致病食物有I型过敏。

结果

63例有阳性病史且皮肤试验反应阳性的患者的平均年龄为29.2岁（范围2-61岁），女性人数是男性的两倍。最常见的致病食物分别是苹果，有13例；桃子，有12例；猕猴桃，有12例；甜瓜，有11例。苹果的CAP阳性率与SPT相似，而甜瓜、桃子和猕猴桃的CAP阳性率低于SPT。苹果的SPT和CAP阳性率之间存在显著相关性（r=0.39，p<0.05），但桃子、猕猴桃和甜瓜不存在。63例OAS患者中有41例（66.1%）患有花粉症和/或过敏性鼻炎。在苹果引起的OAS患者中，CAP对桤木花粉反应的阳性率高于甜瓜引起的OAS患者。在甜瓜引起的OAS患者中，CAP对豚草花粉、草花粉和艾蒿花粉反应的阳性率高于苹果引起的OAS患者。