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有速发型食物过敏典型体征和症状的幼儿食物过敏原致敏情况:单致敏与多致敏儿童的比较

Food allergen sensitization in young children with typical signs and symptoms of immediate-type food allergies: a comparison between monosensitized and polysensitized children.

作者信息

Kim Na Yeon, Kim Ga Ram, Kim Joon Hwan, Baek Ji Hyeon, Yoon Jung Won, Jee Hye Mi, Baek Hye Sung, Jung Yong Ho, Choi Sun Hee, Kim Ki Eun, Shin Youn Ho, Yum Hye Yung, Han Man Yong, Kim Kyu-Earn

机构信息

Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Korea.

Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

出版信息

Korean J Pediatr. 2015 Sep;58(9):330-5. doi: 10.3345/kjp.2015.58.9.330. Epub 2015 Sep 21.

Abstract

PURPOSE

The clinical interpretation of children sensitized to allergens is challenging, particularly in children with food allergies. We aimed to examine clinical differences between children with monosensitization and those with polysensitization to common food allergens and to determine risk factors for polysensitization in young children <10 years of age with immediate-type food allergies.

METHODS

The study included children <10 years of age with signs and symptoms indicative of immediate-type food allergies. Serum total IgE level was measured, and ImmunoCAP analysis for food allergens was performed.

RESULTS

The mean age of the study subjects was 1.6±1.6 years (75 boys and 51 girls). Thirty-eight children (30.2%) were monosensitized and 88 children (69.8%) were polysensitized. Multivariate logistic regression analysis showed that the development of polysensitization to common food allergens was positively associated with a parental history of allergic rhinitis (adjusted odds ratio [aOR], 6.28; 95% confidence interval [CI], 1.78-22.13; P=0.004), season of birth (summer/fall) (aOR, 3.10; 95% CI, 1.10-8.79; P=0.033), and exclusive breastfeeding in the first 6 months of age (aOR, 3.51; 95% CI, 1.20-10.25; P=0.022).

CONCLUSION

We found significant clinical differences between children with monosensitization and those with polysensitization to common food allergens and identified risk factors for the development of polysensitization in young children with immediate-type food allergies. Clinicians should consider these clinical risk factors when evaluating, counseling, treating, and monitoring young children with food allergies.

摘要

目的

对致敏儿童进行临床解读具有挑战性,尤其是在食物过敏儿童中。我们旨在研究对常见食物过敏原单致敏儿童与多致敏儿童之间的临床差异,并确定10岁以下速发型食物过敏幼儿多致敏的危险因素。

方法

该研究纳入了有速发型食物过敏体征和症状的10岁以下儿童。测量血清总IgE水平,并进行食物过敏原的免疫CAP分析。

结果

研究对象的平均年龄为1.6±1.6岁(75名男孩和51名女孩)。38名儿童(30.2%)为单致敏,88名儿童(69.8%)为多致敏。多因素logistic回归分析显示,对常见食物过敏原多致敏的发生与过敏性鼻炎家族史呈正相关(校正比值比[aOR],6.28;95%置信区间[CI],1.78 - 22.13;P = 0.004)、出生季节(夏季/秋季)(aOR,3.10;95% CI,1.10 - 8.79;P = 0.033)以及出生后前6个月纯母乳喂养(aOR,3.51;95% CI,1.20 - 10.25;P = 0.022)。

结论

我们发现对常见食物过敏原单致敏儿童与多致敏儿童之间存在显著临床差异,并确定了10岁以下速发型食物过敏幼儿多致敏发生的危险因素。临床医生在评估、咨询、治疗和监测食物过敏幼儿时应考虑这些临床危险因素。

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