Ono Rintaro, Motomura Chikako, Takamatsu Nobue, Kondo Yasuto, Akamine Yuko, Matsuzaki Hiroshi, Murakami Yoko, Amimoto Yuko, Taba Naohiko, Honjyo Satoshi, Shibata Rumiko, Odajima Hiroshi
Division of Pediatrics, National Fukuoka Hospital.
Beppu University Faculty of Food Science and Nutrition.
Arerugi. 2015 Feb;64(2):149-55.
The patient was a 10-year-old girl who presented with a history of anaphylactic episodes on three occasions, that developed in association with exercise after she ate citrus fruit. She underwent tolerance tests, as food-dependent exercise-induced anaphylaxis (FDEIA) induced by citrus fruit was suspected. The result of the test for the combination of intake of oranges and exercise was negative. The patient presented with swollen eyelid and wheezing following combined intake of orange and aspirin, based on which she was diagnosed as having FDEIA. Many patients developing an allergic reaction to fruit are diagnosed as having oral allergy syndrome (OAS), and only few cases of FDEIA are reported. Immunoblot tests revealed antigens of 9 kDa, 39 kDa and 53 kDa in this patient, and an inhibition study with oranges revealed that the 39 kDa and 53 kDa antigens were probably antigen-specific allergens. Although the studied patient showed a strongly positive result for IgE antibodies specifically directed at cedar pollen, no common antigenicity with cedar pollen could be recognized. The final diagnosis was a type of FDEIA caused by 39 kDa and 53 kDa proteins, which are different from antigens previously identified in patients with citrus fruits allergy. It should be the first report of such a case.
该患者为一名10岁女孩，有三次过敏反应病史，均在食用柑橘类水果后运动时发作。由于怀疑是柑橘类水果诱发的食物依赖运动诱发过敏反应（FDEIA），她接受了耐受性测试。橙子摄入与运动相结合的测试结果为阴性。该患者在同时摄入橙子和阿司匹林后出现眼睑肿胀和喘息，据此被诊断为患有FDEIA。许多对水果产生过敏反应的患者被诊断为患有口腔过敏综合征（OAS），而报道的FDEIA病例很少。免疫印迹测试在该患者中发现了9 kDa、39 kDa和53 kDa的抗原，用橙子进行的抑制研究表明，39 kDa和53 kDa的抗原可能是抗原特异性过敏原。尽管该研究患者针对雪松花粉的IgE抗体显示出强阳性结果，但未发现与雪松花粉有共同抗原性。最终诊断为一种由39 kDa和53 kDa蛋白质引起的FDEIA，这与先前在柑橘类水果过敏患者中鉴定出的抗原不同。这应该是此类病例的首例报告。
