口服免疫疗法治疗花生过敏：接受肾上腺素治疗的过敏反应的多实践经验。
Oral immunotherapy for peanut allergy: multipractice experience with epinephrine-treated reactions.
机构信息
Department of Pediatrics, Medical City Children's Hospital, Dallas, Tex.
New England Food Allergy Treatment Center, Connecticut Children's Medical Center, West Hartford, Conn.
出版信息
J Allergy Clin Immunol Pract. 2014 Jan-Feb;2(1):91-6. doi: 10.1016/j.jaip.2013.10.001.
BACKGROUND
Peanut allergy creates the risk of life-threatening anaphylaxis that can disrupt psychosocial development and family life. The avoidance management strategy often fails to prevent anaphylaxis and may contribute to social dysfunction. Peanut oral immunotherapy may address these problems, but there are safety concerns regarding implementation in clinical practice.
OBJECTIVE
The purpose of this report is to communicate observations about the frequency of epinephrine-treated reactions during peanut oral immunotherapy in 5 different allergy/immunology practices.
METHODS
Retrospective chart review of peanut oral immunotherapy performed in 5 clinical allergy practices.
RESULTS
A total of 352 treated patients received 240,351 doses of peanut, peanut butter, or peanut flour, and experienced 95 reactions that were treated with epinephrine. Only 3 patients received 2 doses of epinephrine, and no patient required more intensive treatment. A total of 298 patients achieved the target maintenance dose for a success rate of 85%.
CONCLUSION
Peanut oral immunotherapy carries a risk of systemic reactions. In the context of oral immunotherapy, those reactions were recognized and treated promptly. Peanut oral immunotherapy may be a suitable therapy for patients managed by qualified allergists/immunologists.
背景
花生过敏会导致危及生命的过敏反应，从而干扰心理社会发展和家庭生活。避免管理策略通常无法预防过敏反应，并且可能导致社交功能障碍。花生口服免疫疗法可能解决这些问题，但在临床实践中实施存在安全问题。
目的
本报告旨在交流在 5 个不同过敏/免疫学实践中进行花生口服免疫治疗期间接受肾上腺素治疗的反应频率的观察结果。
方法
对 5 个临床过敏实践中进行的花生口服免疫治疗的回顾性图表审查。
结果
共有 352 名接受治疗的患者接受了 240,351 剂花生、花生酱或花生粉，并经历了 95 次用肾上腺素治疗的反应。只有 3 名患者接受了 2 剂肾上腺素，没有患者需要更密集的治疗。共有 298 名患者达到了维持剂量的目标，成功率为 85%。
结论
花生口服免疫疗法存在全身反应的风险。在口服免疫治疗的背景下，这些反应得到了及时的识别和治疗。花生口服免疫疗法可能是由合格的过敏症专家/免疫学家管理的患者的合适治疗方法。
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