Bito Toshinori, Kanda Eriko, Tanaka Minako, Fukunaga Atsushi, Horikawa Tatsuya, Nishigori Chikako
Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Allergol Int. 2008 Dec;57(4):437-9. doi: 10.2332/allergolint.C-08-62. Epub 2008 Dec 1.
A 24 year-old woman with atopic dermatitis occasionally developed symptoms, including dyspnea and generalized urticaria, following ingestion of food containing cows milk. Similar episodes had continued, and had been treated empirically since the age of 16 years.
Although a skin test and IgE RAST showed positive reactions to cows milk, a provocation test with cows milk alone did not induce any symptoms. Therefore, food-dependent exercise-induced anaphylaxis (FDEIA) was suspected, but examination using various combinations of cows milk, aspirin and exercise failed to elicit any symptoms. Finally, a provocation test during the ovulatory phase with cows milk followed by aspirin and exercise evoked systemic urticaria, dyspnea and hypotension.
The symptoms against cows milk began when she took baths with bath salts containing cows milk as its main ingredient for one year at the age 15 years. Sensitization to cows milk through eczematous skin is indicated from this history. Hormonal change during a premenstrual or ovulatory phase is also an important factor for the development of FDEIA in this case.
一名24岁的特应性皮炎女性在摄入含牛奶的食物后偶尔会出现症状，包括呼吸困难和全身性荨麻疹。类似发作持续存在，自16岁起一直按经验治疗。
尽管皮肤试验和IgE RAST显示对牛奶呈阳性反应，但单独用牛奶进行激发试验未诱发任何症状。因此，怀疑是食物依赖运动诱发的过敏反应（FDEIA），但使用牛奶、阿司匹林和运动的各种组合进行检查均未引发任何症状。最后，在排卵期进行牛奶激发试验，随后服用阿司匹林并运动，诱发了全身性荨麻疹、呼吸困难和低血压。
她在15岁时用主要成分含牛奶的浴盐洗澡一年后开始出现针对牛奶的症状。从这段病史表明通过湿疹皮肤对牛奶产生了致敏。在该病例中，经前或排卵期的激素变化也是FDEIA发生的一个重要因素。
