Sugiyama Akiko, Kishikawa Reiko, Shimoda Terufumi, Nishie Haruko, Shimada Kiyotaka, Iwanaga Tomoaki, Furue Masutaka, Nishima Sankei
Clinical Research Center, National Fukuoka Hospital.
The Department of Dermatology, Graduate School of Medical Sciences, Kyushu University.
Arerugi. 2014 Jun;63(6):775-86.
Immediate-type wheat allergy due to hydrolyzed wheat protein (HWP-IWA) supplemented soap has been a serious social issue. We investigated the significance of challenge test and other tests not only to diagnose HWP-IWA but to know the symptoms of each patients.
From January 2010 to June 2012, we performed challenge test in 41 cases with positive prick test of Glupearl 19S®, a major allergic HWP found in Cha no Shizuku®.
Thirty nine of 41 cases were challenge test positive. In two patients who showed positive skin prick test but negative for challenge test, titer of specific IgE antibody and/or basophil histamine release test against Glupearl 19S® revealed positive reaction.
Challenge test is not included in indispensable examinations for the diagnosis of HWP-IWA in the recommended guidelines. However, challenge test is still a useful tool for assessing actual severity of each patient's symptoms and determining the timing of cessation of wheat avoidance. In addition, combined check-up with several laboratory examination and challenge test may help appropriate diagnosis of HWP-IWA.
因添加水解小麦蛋白的肥皂导致的速发型小麦过敏（HWP-IWA）一直是一个严重的社会问题。我们研究了激发试验及其他检查对于诊断HWP-IWA以及了解每位患者症状的意义。
2010年1月至2012年6月，我们对41例在茶之滴露（Cha no Shizuku®）中发现的主要过敏性HWP——Glupearl 19S®点刺试验呈阳性的患者进行了激发试验。
41例患者中有39例激发试验呈阳性。在2例皮肤点刺试验呈阳性但激发试验为阴性的患者中，针对Glupearl 19S®的特异性IgE抗体滴度和/或嗜碱性粒细胞组胺释放试验显示为阳性反应。
推荐指南中，激发试验并非诊断HWP-IWA必不可少的检查项目。然而，激发试验仍是评估每位患者实际症状严重程度以及确定停止避免食用小麦时机的有用工具。此外，结合多项实验室检查和激发试验进行检查可能有助于对HWP-IWA做出准确诊断。
