Oole-Groen Cirsten J, Brand Paul L P
Isala klinieken, Amalia kinderafdeling, Zwolle, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(10):A5834.
To describe the results of double-blind placebo-controlled food challenges (DBPCFC) with cow's milk, hen's eggs, soy, peanuts and hazelnuts in a general hospital.
Retrospective chart review.
Food challenges were performed between January 2006 and June 2011, in children 0-18 years of age, on two half-day hospital admissions with a 1-week interval. Tests were performed double-blind following a standardized protocol with validated recipes.
Overall, 234 food challenges were performed, with cow's milk (160), peanuts (35), hen's eggs (21), hazelnuts (11), and soy (7). In two thirds of the cases, the DBPCFC was negative (cow's milk: 57.5%; peanuts: 40.0%; hen's eggs: 66.7%, hazelnuts: 90.9%, soy: 100%). There were no significant associations between patient characteristics and a positive DBPCFC, except for symptoms in the history from 3 different organ systems (p = 0.007). In 2 children (0.9%), serious systemic allergic reactions occurred. Symptoms were recorded on 29.3% of challenges with placebo. In a fifth of the children with a negative test (30/137), symptoms returned when reintroducing the allergen into the diet, mostly (66.7%) transient. Of the 85 tests regarded as positive by the attending physician, 19 (22.4%) were false-positive, i.e. they were not positive according to predefined criteria; a false-positive test result occurred in particular with non-specific symptoms.
The DBPCFC can be safely performed in a general hospital for a range of food allergens. The test result is negative in most cases except for peanuts. Non-specific symptoms may hinder the interpretation of the DBPCFC and can result in false-positive results.
描述在综合医院中进行的牛奶、鸡蛋、大豆、花生和榛子双盲安慰剂对照食物激发试验（DBPCFC）的结果。
回顾性病历审查。
2006年1月至2011年6月期间，对0至18岁儿童进行食物激发试验，分两次在医院住院半天，间隔1周。试验按照标准化方案采用经验证的食谱进行双盲操作。
总共进行了234次食物激发试验，其中牛奶（160次）、花生（35次）、鸡蛋（21次）、榛子（11次）和大豆（7次）。在三分之二的病例中，DBPCFC结果为阴性（牛奶：57.5%；花生：40.0%；鸡蛋：66.7%，榛子：90.9%，大豆：100%）。除了来自3个不同器官系统的既往症状外（p = 0.007），患者特征与阳性DBPCFC之间无显著关联。2名儿童（0.9%）发生了严重的全身过敏反应。安慰剂激发试验中有29.3%记录到症状。在试验结果为阴性的儿童中，五分之一（30/137）在重新引入过敏原到饮食中时症状复发，大多数（66.7%）为短暂性。在主治医生认为阳性的85次试验中，19次（22.4%）为假阳性，即根据预定义标准并非阳性；假阳性试验结果尤其出现在非特异性症状的情况下。
在综合医院中可以安全地对多种食物过敏原进行DBPCFC。除花生外，大多数情况下试验结果为阴性。非特异性症状可能会妨碍对DBPCFC结果的解读，并可能导致假阳性结果。
