Takahashi Kentaro, Taniguchi Masami, Fukutomi Yuma, Sekiya Kiyoshi, Watai Kentaro, Mitsui Chihiro, Tanimoto Hidenori, Oshikata Chiyako, Tsuburai Takahiro, Tsurikisawa Naomi, Minoguchi Kenji, Nakajima Hiroshi, Akiyama Kazuo
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
Allergol Int. 2014 Mar;63(1):51-6. doi: 10.2332/allergolint.13-OA-0575.
Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mite-contaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital.
In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan.
Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3 cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to Der p and Der f were more than class 2 in all cases.
Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.
近期已认识到摄入被螨虫污染的食物后会发生过敏反应。迄今为止的病例系列和病例报告表明，被螨虫污染的小麦粉是口腔螨虫过敏反应的主要原因。然而，我们医院发现了8例口腔螨虫过敏反应病例，其病因是被螨虫污染的御好烧预拌粉，这是一种美味的日式煎饼预拌粉。
除了我们的8例病例外，还系统检索了MEDLINE和《医学中央杂志》数据库中日本口腔螨虫过敏反应患者的资料。
共确定了36例患者，包括我们的8例口腔螨虫过敏反应病例。36例中的34例（94%）食用了在家中用御好烧预拌粉或章鱼烧预拌粉制作的御好烧或章鱼烧，这些预拌粉之前已开封并在室温下储存数月。对包括我们的1例在内的16例病例的可疑预拌粉进行显微镜检查，发现有螨虫污染，如粉尘螨（Der f）（5例）、腐食酪螨（Tyr p）（4例）和屋尘螨（Der p）（3例）。这些患者中针对每种螨虫的特异性IgE通常上调。特别是，所有病例中针对Der p和Der f的特异性IgE滴度均超过2级。
在日本，被螨虫污染的调味面粉是口腔螨虫过敏反应的主要原因。
