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[乳胶 - 番木瓜综合征:一种罕见的关联]

[Latex-papaya syndrome: an infrequent association].

作者信息

Rojas-Mandujano Victoria, González-Juárez Kitzia, Hernández-Fernández Cecilia, O'Farrill-Romanillos Patricia María, Del Rivero Leonel, Herrera-Sánchez Diana Andrea

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Servicio de Alergia e Inmunología Clínica. Ciudad de México, México.

出版信息

Rev Alerg Mex. 2018 Jan-Mar;65(1):3-9. doi: 10.29262/ram.v65i1.302.

Abstract

BACKGROUND

Latex-fruit syndrome (LFS) is characterized by allergy to latex and plants. Papain, chymopapain, caricaine and class I chitinases are papaya's most allergenic proteins. The similarity between latex hevein epitopes and papaya class I chitinases might explain the latex-papaya syndrome (LPS).

OBJECTIVE

To describe the clinical characteristics of patients with LPS.

METHODS

Cross-sectional, observational, descriptive study where 11 patients diagnosed with latex allergy by skin prick test and clinically diagnosed with papaya-induced anaphylaxis were included. The results were analyzed with descriptive statistics.

RESULTS

Out of 11 patients with LPS, 72.7% were females (7 to 46 years), all with a history of papaya-induced anaphylaxis, identified by medical history and medical notes plus latex-positive skin prick tests, with 63.3% exhibiting anaphylaxis in the skin prick tests. Risk factors included multiple surgeries, another allergic disease, and being employed in the field of health; 63.6% were allergic to to other foods, 45.4% to medications, 45.4% had allergic rhinitis and 27.3% had asthma.

CONCLUSIONS

Hypersensitivity to papaya increases the risk of anaphylaxis in patients with latex allergy and, therefore, mortality. Clinical data is the main diagnostic tool. Education for the management of anaphylaxis with adrenaline self-administration is essential.

摘要

背景

乳胶-水果综合征(LFS)的特征是对乳胶和植物过敏。木瓜蛋白酶、木瓜凝乳蛋白酶、番木瓜蛋白酶和I类几丁质酶是木瓜中最具致敏性的蛋白质。乳胶橡胶素表位与木瓜I类几丁质酶之间的相似性可能解释了乳胶-木瓜综合征(LPS)。

目的

描述LPS患者的临床特征。

方法

本研究为横断面、观察性、描述性研究,纳入了11例经皮肤点刺试验诊断为乳胶过敏且临床诊断为木瓜诱发过敏反应的患者。采用描述性统计方法分析结果。

结果

在11例LPS患者中,72.7%为女性(7至46岁),均有木瓜诱发过敏反应的病史,通过病史、病历记录以及乳胶阳性的皮肤点刺试验确定,其中63.3%在皮肤点刺试验中出现过敏反应。危险因素包括多次手术、另一种过敏性疾病以及从事卫生领域工作;63.6%对其他食物过敏,45.4%对药物过敏,45.4%患有过敏性鼻炎,27.3%患有哮喘。

结论

对木瓜过敏会增加乳胶过敏患者发生过敏反应的风险,进而增加死亡率。临床资料是主要的诊断工具。对患者进行肾上腺素自我注射治疗过敏反应的教育至关重要。

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