Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie der Universität Würzburg.
Dtsch Arztebl Int. 2008 Oct;105(42):715-23. doi: 10.3238/arztebl.2008.0715. Epub 2008 Oct 17.
10% to 20% of the population sees itself as suffering from food allergy, yet genuine, immune-mediated food allergy is suspected by patients and their physicians far more often than it is actually shown to be present. The unfounded suspicion of an IgE-mediated food allergy can substantially impair a patient's quality of life through needless dietary restriction and the accompanying anxiety. On the other hand, an IgE-mediated food allergy that has gone undiagnosed or that has not been taken seriously can manifest suddenly with anaphylaxis, which may be life-threatening. The present study, carried out on a large cohort of patients, underscores the importance of differentiating IgE-mediated food allergy from other, nonallergic types of food reaction.
419 patients that had been referred to our outpatient allergy clinic for suspected food allergies underwent a standardized allergological diagnostic evaluation, including thorough allergologic history-taking, IgE serology, and challenge tests when indicated.
214 patients (51.1%) were found to have an IgE-mediated food allergy. Almost half of these patients (24.3% of the overall group) had previously experienced food-induced anaphylaxis. In 205 patients (48.9%), however, an IgE-mediated food allergy was ruled out as far as possible.
Only a comprehensive allergological evaluation performed by an experienced allergologist in accordance with current guidelines can protect patients from the negative consequences of excessive concern about a nonexistent food allergy (e.g., needless dietary restriction) or, on the other hand, the negative consequences of inadequate attention to a genuine food allergy (anaphylaxis). A proper evaluation consists of detailed allergologic history-taking, skin tests, and challenge tests when indicated.
10%至 20%的人群认为自己患有食物过敏，但患者及其医生对真正的免疫介导性食物过敏的怀疑远远超过实际存在的情况。对 IgE 介导的食物过敏的无端怀疑会通过不必要的饮食限制和随之而来的焦虑，极大地影响患者的生活质量。另一方面，未被诊断或未被认真对待的 IgE 介导的食物过敏可能会突然出现过敏反应，从而危及生命。本研究在一大群患者中进行，强调了区分 IgE 介导的食物过敏与其他非过敏性食物反应的重要性。
419 名因疑似食物过敏而被转至我们的门诊过敏诊所的患者接受了标准化的过敏诊断评估，包括详细的过敏病史、IgE 血清学检查和有指征时进行的激发试验。
214 名患者（51.1%）被发现患有 IgE 介导的食物过敏。这些患者中几乎有一半（总体组的 24.3%）曾经历过食物诱发的过敏反应。然而，在 205 名患者（48.9%）中，尽可能排除了 IgE 介导的食物过敏。
只有经验丰富的过敏科医生根据当前指南进行全面的过敏评估，才能保护患者免受过度关注不存在的食物过敏（例如，不必要的饮食限制）或对真正的食物过敏（过敏反应）关注不足的负面影响。适当的评估包括详细的过敏病史、皮肤试验和有指征时的激发试验。
