Shank Jessica J, Olney Stacey C, Lin Fang L, McNamara Michael F
From the Departments of Obstetrics & Gynecology and Allergy & Immunology, Naval Medical Center San Diego, San Diego, California.
Obstet Gynecol. 2009 Aug;114(2 Pt 2):415-416. doi: 10.1097/AOG.0b013e3181a20721.
Anaphylaxis associated with breast-feeding is a rare but potentially life-threatening event.
This woman reported anaphylaxis with three previous pregnancies while breast-feeding. With her fourth pregnancy she was treated with corticosteroids and antihistamines after delivery. Despite treatment, she developed urticaria, facial edema, and throat tightening, less severe than prior episodes. Her symptoms resolved with epinephrine and antihistamine but recurred with subsequent breast-feeding. On postpartum day 4 she had no symptoms while breast-feeding.
Three cases of postpartum breast-feeding anaphylaxis have been reported. Although the pathophysiology is unclear, it may involve the decrease in progesterone and rise of prolactin causing mast cell degranulation. Avoidance of nonsteroidal antiinflammatories and prophylaxis with corticosteroids and antihistamines may offer the best protection.
与母乳喂养相关的过敏反应是一种罕见但可能危及生命的事件。
该名女性报告称，前三次怀孕时在母乳喂养期间均出现过敏反应。第四次怀孕后，她在分娩后接受了皮质类固醇和抗组胺药治疗。尽管接受了治疗，但她仍出现荨麻疹、面部水肿和喉咙发紧的症状，症状程度较之前发作时轻。她的症状经肾上腺素和抗组胺药治疗后缓解，但在随后的母乳喂养时复发。产后第4天，她在母乳喂养时没有出现症状。
已报告3例产后母乳喂养过敏反应病例。虽然其病理生理机制尚不清楚，但可能涉及孕酮水平下降和催乳素水平升高导致肥大细胞脱颗粒。避免使用非甾体抗炎药以及使用皮质类固醇和抗组胺药进行预防可能提供最佳保护。
