Nilsson Caroline, Nordvall Lennart, Johansson S G O, Nopp Anna
Department of Clinical Science and Education, Södersjukhuset, Centre for Allergy Research, Karolinska Institutet and Sach's Children's Hospital, Södersjukhuset, 118 83 Stockholm, Sweden.
Department of Women's and Children's Health, Uppsala University Hospital, 751 85 Uppsala, Sweden.
Asia Pac Allergy. 2014 Oct;4(4):257-60. doi: 10.5415/apallergy.2014.4.4.257. Epub 2014 Oct 29.
Food allergy is common in children and young adults and may be difficult to diagnose and is at present treated with avoidance of the food in question. The aim of this report is to share our clinical experiences monitoring omalizumab treatment by basophil allergen threshold sensitivity, CD-sens. Five children, 6-16 years of age, with a severe milk allergy including episodes of anaphylaxis and IgE-antibodies, between 30 and 160 kUA/L to casein and alpha-lactalbumin (milk proteins), were treated with omalizumab. CD-sens, was tested prior to and after 4 months of omalizumab and if turned negative, it was followed by an oral milk challenge. All children became negative in CD-sens and had a negative milk challenge, but one child required doubling of the omalizumab dose to achieve a negative CD-sens before a challenge was done. Omalizumab appears useful in treatment of severe food allergy, e.g., anaphylaxis to milk, and CD-sens monitoring may decide when and how to perform a food challenge.
食物过敏在儿童和年轻人中很常见，可能难以诊断，目前的治疗方法是避免食用相关食物。本报告的目的是分享我们通过嗜碱性粒细胞过敏原阈值敏感性（CD-sens）监测奥马珠单抗治疗的临床经验。五名6至16岁的儿童患有严重的牛奶过敏，包括过敏反应发作，对酪蛋白和α-乳白蛋白（牛奶蛋白）的IgE抗体在30至160 kUA/L之间，接受了奥马珠单抗治疗。在奥马珠单抗治疗4个月之前和之后检测CD-sens，如果结果变为阴性，则随后进行口服牛奶激发试验。所有儿童的CD-sens均变为阴性，牛奶激发试验也为阴性，但有一名儿童在进行激发试验之前需要将奥马珠单抗剂量加倍才能使CD-sens变为阴性。奥马珠单抗似乎对治疗严重食物过敏（如牛奶过敏反应）有用，并且CD-sens监测可以决定何时以及如何进行食物激发试验。
