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儿童食物过敏:当前的诊断、治疗和管理策略。

Childhood food allergies: current diagnosis, treatment, and management strategies.

机构信息

Smith Child Health Research Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

出版信息

Mayo Clin Proc. 2013 May;88(5):512-26. doi: 10.1016/j.mayocp.2013.03.005.

Abstract

Food allergy is a growing public health concern in the United States that affects an estimated 8% of children. Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a specific food. Nearly 40% of children with food allergy have a history of severe reactions that if not treated immediately with proper medication can lead to hospitalization or even death. The National Institute of Allergy and Infectious Diseases (NIAID) convened an expert panel in 2010 to develop guidelines outlining evidence-based practices in diagnosing and managing food allergy. The purpose of this review is to aid clinicians in translating the NIAID guidelines into primary care practice and includes the following content domains: (1) the definition and mechanism of childhood food allergy, (2) differences between food allergy and food intolerance, (3) the epidemiology of childhood food allergy in the United States, (4) best practices derived from the NIAID guidelines focused on primary care clinicians' management of childhood food allergy, (5) emerging food allergy treatments, and (6) future directions in food allergy research and practice. Articles focused on childhood food allergy were considered for inclusion in this review. Studies were restricted to the English language and to those published within the past 40 years. A cross-listed combination of the following words, phrases, and MeSH terms was searched in PubMed and Google Scholar to identify relevant articles: food allergy, food hypersensitivity, child, pediatric, prevalence, and epidemiology. Additional sources were identified through the bibliographies of the retrieved articles.

摘要

食物过敏是美国日益严重的公共卫生问题,估计影响了 8%的儿童。食物过敏定义为特定免疫反应引起的不良健康影响,这种反应在反复接触特定食物时会发生。近 40%的食物过敏儿童有严重过敏反应史,如果不立即用适当的药物治疗,可能导致住院治疗甚至死亡。国家过敏和传染病研究所(NIAID)于 2010 年召集了一个专家小组,制定了指导方针,概述了诊断和管理食物过敏的循证实践。本次综述的目的是帮助临床医生将 NIAID 指南转化为初级保健实践,包括以下内容领域:(1)儿童食物过敏的定义和机制,(2)食物过敏和食物不耐受之间的差异,(3)美国儿童食物过敏的流行病学,(4)NIAID 指南中针对初级保健临床医生管理儿童食物过敏的最佳实践,(5)新兴的食物过敏治疗方法,以及(6)食物过敏研究和实践的未来方向。本文综述考虑纳入了重点关注儿童食物过敏的文章。研究仅限于英语和过去 40 年内发表的文章。在 PubMed 和 Google Scholar 中使用以下词、短语和 MeSH 术语的交叉列表组合进行搜索,以确定相关文章:食物过敏、食物超敏反应、儿童、儿科、流行率和流行病学。通过检索到的文章的参考文献确定了其他来源。

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