Mehta Raj
Florida Hospital Family Medicine Residency, 133 Benmore Drive, Winter Park, FL 32792.
FP Essent. 2018 Sep;472:16-19.
Food allergies are immune-mediated allergic adverse reactions that occur after exposure to specific foods. The most commonly recognized food allergies are immunoglobulin E (IgE)-mediated reactions (eg, urticaria, angioedema, anaphylaxis) that result from exposure to milk, egg, peanut, tree nuts, shellfish, fish, wheat, or soy. However, other foods can cause food allergies. Oral allergy syndrome is a common but underrecognized condition characterized by transient oropharyngeal symptoms that result from ingestion of uncooked fruits or vegetables. Non-IgE-mediated food allergies manifest with more delayed symptoms than IgE-mediated food allergies, and predominately cause gastrointestinal symptoms. Food allergies often are overreported because they may be confused with food intolerances or nonimmunologic adverse food reactions (eg, lactose intolerance, food poisoning, caffeine intolerance). Food allergies are diagnosed using IgE skin tests, IgE serum tests, or oral food challenge tests. These allergies are best managed by avoidance of the food or foods related to the allergy because they require ingestion rather than contact to precipitate symptoms. Injectable epinephrine should be prescribed for patients at risk of anaphylaxis. Careful food label reading and food preparation, awareness, and education are keys to prevention.
食物过敏是指在接触特定食物后发生的免疫介导的过敏性不良反应。最常见的食物过敏是由免疫球蛋白E（IgE）介导的反应（如荨麻疹、血管性水肿、过敏反应），这些反应是由于接触牛奶、鸡蛋、花生、坚果、贝类、鱼类、小麦或大豆引起的。然而，其他食物也可能导致食物过敏。口腔过敏综合征是一种常见但未得到充分认识的病症，其特征是因摄入未煮熟的水果或蔬菜而出现短暂的口咽症状。非IgE介导的食物过敏比IgE介导的食物过敏表现出更延迟的症状，并且主要引起胃肠道症状。食物过敏常常被过度报告，因为它们可能与食物不耐受或非免疫性食物不良反应（如乳糖不耐受、食物中毒、咖啡因不耐受）相混淆。食物过敏通过IgE皮肤试验、IgE血清试验或口服食物激发试验进行诊断。这些过敏最好通过避免食用与过敏相关的一种或多种食物来控制，因为它们需要摄入食物而不是接触食物来引发症状。对于有过敏反应风险的患者，应开具注射用肾上腺素的处方。仔细阅读食品标签和进行食物制备、提高意识以及接受教育是预防的关键。
