Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea.
Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea.
J Korean Med Sci. 2019 Jan 2;34(2):e11. doi: 10.3346/jkms.2019.34.e11. eCollection 2019 Jan 14.
Oral allergy syndrome (OAS) is an immunoglobulin E (IgE)-mediated hypersensitivity that occurs frequently in older children with pollen sensitization. This study focused on the clinical characteristics of OAS in children with atopic dermatitis (AD) and birch sensitization.
s: A total of 186 patients aged 2-18 years with AD and birch sensitization were enrolled in this study between January 2016 and March 2017. Their levels of serum total IgE and birch- and ragweed-specific IgE (sIgE) were measured using ImmunoCAP (Thermo Fisher Scientific, Uppsala, Sweden). Information regarding causative foods and symptoms were obtained via interviews. The patients were divided into 3 groups according to their ages (group 1, 2-6 years; group 2, 7-12 years; and group 3, 13-18 years).
Eighty-one of the 186 (43.5%) children with AD who were sensitized to birch pollen were diagnosed as having OAS. The prevalence of OAS in group 1 (the children who had AD and birch sensitization aged 2-6 years) was 36.6%. A greater predominance of men was noted in the non-OAS group (77.1%) compared to the OAS group (60.5%). Apples were the most common causative food in group 2 and 3 while kiwis were the most common cause of OAS in group 1. There was a statistically significant correlation between birch-sIgE levels and the prevalence of OAS ( = 0.000). The cut-off value was 6.77 kU/L with 55.6% sensitivity and 79.0% specificity (area under the curve 0.653).
In our study, the prevalence of OAS in children with AD and birch sensitization was 43.5%. Even in the preschool age group, the prevalence of OAS was considerable. Patients with high levels of birch-sIgE were more likely to have OAS. Clinicians should therefore be vigilant about OAS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.
口腔过敏综合征（OAS）是一种 IgE 介导的过敏反应，常发生于花粉致敏的大龄儿童。本研究主要关注特应性皮炎（AD）和桦树致敏患儿的 OAS 临床特征。
2016 年 1 月至 2017 年 3 月，我们共纳入 186 例 2-18 岁的 AD 合并桦树致敏患儿，采用 ImmunoCAP（Thermo Fisher Scientific，Uppsala，瑞典）检测血清总 IgE 和桦树、豚草特异性 IgE（sIgE）。通过访谈获取致敏食物和症状信息。根据年龄将患儿分为 3 组（1 组：2-6 岁；2 组：7-12 岁；3 组：13-18 岁）。
186 例 AD 合并桦树花粉致敏患儿中，81 例（43.5%）被诊断为 OAS。1 组（2-6 岁）的 OAS 患病率为 36.6%。非 OAS 组（77.1%）中男性占比显著高于 OAS 组（60.5%）。2 组和 3 组中最常见的致敏食物是苹果，而 1 组中最常见的 OAS 致敏食物是猕猴桃。桦树 sIgE 水平与 OAS 患病率呈显著正相关（ = 0.000）。cut-off 值为 6.77 kU/L，其灵敏度为 55.6%，特异度为 79.0%（曲线下面积为 0.653）。
在本研究中，AD 合并桦树致敏患儿的 OAS 患病率为 43.5%。即使在学龄前儿童中，OAS 的患病率也相当高。桦树 sIgE 水平高的患儿更易患 OAS。因此，对于桦树花粉致敏程度高的患者，甚至是有桦树致敏的幼儿，临床医生都应警惕 OAS。
