Dartmouth-Hitchcock Medical Center, Children's Hospital at Dartmouth, Lebanon, New Hampshire 03756, USA.
Curr Opin Pediatr. 2009 Oct;21(5):667-74. doi: 10.1097/MOP.0b013e32833069a8.
The present review serves to address food allergy, which is a common problem encountered by the general pediatrician. Between 4 and 6% of US children have an allergic reaction to at least one food, and the prevalence of some food allergies appears to be increasing.
A combination of genetic influences, characteristics of food antigen processing, and timing of food introduction may influence the development of food allergy. Avoidance of highly allergenic foods beyond 4-6 months may not be effective at preventing the development of food allergy in most children, and the effect of specific early introduction of allergenic foods is being investigated. Oral immunotherapy is under investigation but may be limited in future use by several factors, including a significant rate of allergic reactions.
Current management of food allergy focuses on accurate diagnosis, appropriate counseling regarding strict allergen avoidance with review of available educational resources, emergency preparedness, instruction on the use of self-injectable epinephrine, and ongoing surveillance for the possible development of tolerance.
本综述旨在讨论食物过敏,这是普通儿科医生经常遇到的问题。美国有 4%至 6%的儿童对至少一种食物有过敏反应,而且一些食物过敏的患病率似乎在增加。
遗传影响、食物抗原处理的特征以及食物引入的时间等多种因素可能会影响食物过敏的发生。在大多数儿童中,超过 4-6 个月避免食用高度致敏食物并不能有效预防食物过敏的发生,目前正在研究特定的早期引入致敏食物的效果。口服免疫疗法正在研究中,但由于多种因素的限制,包括过敏反应发生率较高,其未来的应用可能会受到限制。
目前食物过敏的管理重点是准确诊断,适当咨询严格避免过敏原,同时审查可用的教育资源、做好应急准备、指导使用自我注射肾上腺素,并持续监测可能发生的耐受情况。