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[牛奶过敏的口服快速脱敏:临床和免疫学随访]

[Oral rush desensitization for cow milk allergy: Clinical and immunological follow-up].

作者信息

González Jiménez D, Larrea Tamayo E, Díaz Martin J J, Molinos Norniella C, Pérez Solis D, Menéndez Arias C, Jiménez Treviño S, Bousoño García C

机构信息

Gastroenterología y Nutrición Pediátrica, Área de Gestión Clínica de Pediatría, Hospital Central de Asturias, Oviedo, España.

出版信息

An Pediatr (Barc). 2013 Dec;79(6):346-51. doi: 10.1016/j.anpedi.2013.04.006. Epub 2013 May 29.

Abstract

OBJECTIVE

The aim of this study was to evaluate the safety and efficacy of oral rush desensitization in children with cow milk allergy.

MATERIAL AND METHODS

Prospective study. We included IgE-mediated cow milk allergy children over 3 years in 3 Spanish hospitals. Increasing doses of cow milk for 5 days from 1 cc of 1% to 200 cc of pure milk were administered. Clinical follow-up was conducted and we compared specific IgE levels at onset, 6, 12 and 24 months after desensitization.

RESULTS

We included 18 children (13 males) between 3 and 14 years (mean 5.96). A total of 271 doses were administered; there were 55 adverse reactions (84% mild). At the end of the protocol, 100% showed some degree of tolerance (39% total). Full tolerance was achieved in 72% of patients after two years. Two children failed to achieve tolerance. There was a significant decrease in the levels of specific IgE to cow milk and alpha-lactalbumin at 24 months, and to casein at 6, 12 and 24 months, compared to baseline.

CONCLUSIONS

Oral rush desensitization is a safe and effective therapeutic option for patients with persistent cow milk allergy to medium term.

摘要

目的

本研究旨在评估口服快速脱敏疗法对牛奶过敏儿童的安全性和有效性。

材料与方法

前瞻性研究。我们纳入了西班牙3家医院中3岁以上的IgE介导的牛奶过敏儿童。从1毫升1%的牛奶开始,连续5天递增牛奶剂量,直至200毫升纯牛奶。进行临床随访,并比较脱敏治疗开始时、治疗后6个月、12个月和24个月时的特异性IgE水平。

结果

我们纳入了18名年龄在3至14岁(平均5.96岁)之间的儿童(13名男性)。共给予271剂;有55例不良反应(84%为轻度)。在方案结束时,100%的儿童表现出一定程度的耐受性(39%完全耐受)。两年后,72%的患者实现了完全耐受。两名儿童未能实现耐受。与基线相比,24个月时对牛奶和α-乳白蛋白的特异性IgE水平显著降低,6个月、12个月和24个月时对酪蛋白的特异性IgE水平也显著降低。

结论

口服快速脱敏疗法对持续性牛奶过敏患者来说是一种中期安全有效的治疗选择。

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