Service d'Anesthésie-Réanimation & SAMU de Paris, Université Paris-Descartes, INSERM UMRS-970 & Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, France.
Am J Transplant. 2011 Jul;11(7):1531-4. doi: 10.1111/j.1600-6143.2011.03576.x. Epub 2011 Jun 10.
We report a case of transient symptomatic transferred IgE-mediated peanut allergy after elective blood-group compatible liver transplantation. We show that the allergy was transient and therefore passive, authorizing further uneventful peanut consumption. Skin tests with commercial peanut extract and native peanut were performed in the recipient. Circulating specific IgE against peanut and recombinant peanut allergens (rArah1, rArah2, rArah3) was measured in stored serum samples collected from the recipient between 6 months before and 8 months after liver transplantation. Specific IgE levels in the donor were measured at the time of multiorgan donation. In the recipient, diagnosis of IgE-mediated peanut anaphylaxis was based on the clinical history and detection of specific IgE against peanut and recombinant major peanut allergens (rArah1, rArah2 and rArah3). Skin tests were negative and specific IgE undetectable 6 months after the clinical reaction. Oral peanut challenge was negative excluding persistent peanut allergy. This case confirms that IgE-mediated peanut allergy can be transferred by liver transplantation and shows that it may be transient and therefore passively acquired.
我们报告了一例在择期进行血型相容肝移植后出现短暂症状性 IgE 介导的花生过敏的病例。我们表明该过敏反应是短暂的，因此是被动获得的，这允许患者进一步无事件地食用花生。在受体中进行了商业花生提取物和天然花生的皮肤测试。在肝移植前 6 个月至移植后 8 个月期间，从受体中收集储存的血清样本，测量了针对花生和重组花生过敏原（rArah1、rArah2、rArah3）的循环特异性 IgE。在多器官捐献时测量了供体中的特异性 IgE 水平。在受体中，基于临床病史和对花生和重组主要花生过敏原（rArah1、rArah2 和 rArah3）的特异性 IgE 的检测，诊断为 IgE 介导的花生过敏。皮肤测试为阴性，特异性 IgE 检测不到，临床反应后 6 个月。口服花生挑战为阴性，排除持续的花生过敏。该病例证实了 IgE 介导的花生过敏可以通过肝移植传播，并表明其可能是短暂的，因此是被动获得的。
