Rodríguez Trabado Ana, Cámara Hijón Carmen, García-Trujillo José Antonio, Magriz Trascón Irene, Fernández Pereira Luis Miguel
Allergy Department, Nuestra Señora del Prado Hospital, Talavera de la Reina, Toledo, Spain.
Immunology Department, San Pedro de Alcántara Hospital, Avda. Pablo Naranjo, S/N, 10002 Cáceres, Spain.
Case Rep Med. 2017;2017:2127167. doi: 10.1155/2017/2127167. Epub 2017 Aug 15.
Maltitol is a sugar alcohol that is frequently used as a noncaloric sweetener, although it is also used as an excipient, a plasticizer in gelatin capsules, and an emollient. It has not been previously described as an agent involved in immediate hypersensitivity reactions.
We report on an anaphylactoid reaction with pharyngeal occlusion suffered by a 60-year-old man after ingestion of a candy containing maltitol syrup. A prick-to-prick test was performed with the candy and maltitol powder. Other allergens were excluded as causative agents of the adverse reaction, although the patient refused to undergo an oral challenge test with the candy. A basophil activation test (BAT) was performed with maltitol powder, and a dose-response curve was generated. The test was also performed in 3 healthy controls.
Both prick-to-prick tests were negative. The result of the BAT was positive at all the concentrations tested in the patient's blood and negative in all the controls.
The BAT can help to clarify the agents implicated in an adverse reaction and can reduce the risk involved in diagnosis. The BAT can also prove useful in the study of reactions caused by low-molecular-weight antigens, for which routine diagnostic tests are not feasible.
麦芽糖醇是一种糖醇，尽管它也用作辅料、明胶胶囊中的增塑剂和润肤剂，但它经常被用作无热量甜味剂。以前尚未将其描述为参与速发型超敏反应的介质。
我们报告了一名60岁男性在摄入含有麦芽糖醇糖浆的糖果后发生的伴有咽部阻塞的类过敏反应。用该糖果和麦芽糖醇粉末进行了点刺试验。排除了其他过敏原作为不良反应的致病因素，尽管患者拒绝接受该糖果的口服激发试验。用麦芽糖醇粉末进行了嗜碱性粒细胞活化试验（BAT），并生成了剂量反应曲线。该试验也在3名健康对照者中进行。
两次点刺试验均为阴性。BAT结果在患者血液中所有测试浓度下均为阳性，而在所有对照者中均为阴性。
BAT有助于明确不良反应所涉及的介质，并可降低诊断风险。BAT在研究由低分子量抗原引起的反应时也可能有用，对于这类反应，常规诊断试验不可行。
