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[因对草花粉过敏而出现呼吸困难的病例经快速免疫疗法成功治疗]

[Case of pollinosis to grass pollens who presented with dyspnea successfully treated by rush immunotherapy].

作者信息

Kawada Yasusuke, Takamasu Tetsuya, Inuo Chisato, Aikawa Hiroyuki, Kurihara Kazuyuki

机构信息

Depertment of Allergy, Kanagawa Children's Medical Center.

出版信息

Arerugi. 2007 Nov;56(11):1403-7.

Abstract

We present a 15 years old boy who experienced unusual symptoms for pollen allergy, and successfully treated by rush immunotherapy. The patient started to complain erythema and edema on his face and serous rhinorrhea at 10 years old when going out. He entered baseball team at junior high school, and subsequently experienced choking sensation, dyspnea, face edema, and it was sometimes impossible to continue play. He was diagnosed as bronchial asthma at some hospital, and prescribed many anti-asthma medications including inhaled corticosteroid, which did not take effect. His symptoms deteriorated in summer and ameliorated in winter. When he was 15 years old, he was referred to us by a pediatrician for reassessment of his symptoms. Flow-volume curve was normal, and bronchial provocation test (acetylcholine and histamine), and exercise challenge were negative. IgE antibodies specific to grass pollens were highly positive. We made a diagnosis of pollinosis to grass pollens instead of bronchial asthma. Oral antihistamines and intranasal corticosteroid partially improved his symptoms. We started rush-immunotherapy of grass-pollens (oats and bromegrass), Japanese cedar, and ragweed. His symptoms improved dramatically on the next season of grass pollens.

摘要

我们报告一名15岁男孩,他经历了不寻常的花粉过敏症状,并通过快速免疫疗法成功治愈。患者10岁外出时开始出现面部红斑、水肿及浆液性鼻漏。他初中时加入棒球队,随后出现哽噎感、呼吸困难、面部水肿,有时无法继续比赛。他在某医院被诊断为支气管哮喘,并服用了包括吸入性糖皮质激素在内的多种抗哮喘药物,但均无效。他的症状在夏季恶化,冬季缓解。15岁时,儿科医生将他转诊至我们这里重新评估症状。流量-容积曲线正常,支气管激发试验(乙酰胆碱和组胺)及运动激发试验均为阴性。对禾本科花粉特异性的IgE抗体呈高度阳性。我们诊断为禾本科花粉症而非支气管哮喘。口服抗组胺药和鼻内用糖皮质激素使他的症状部分改善。我们开始对禾本科花粉(燕麦和雀麦草)、日本柳杉和豚草进行快速免疫疗法。在下一季禾本科花粉季节,他的症状显著改善。

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