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阿曼有过敏症状患者的食物过敏原致敏模式

Food Allergen Sensitisation Patterns in Omani Patients with Allergic Manifestations.

作者信息

Al-Tamemi Salem, Naseem Shafiq-Ur-Rehman, Tufail-Alrahman Munira, Al-Kindi Mahmood, Alshekaili Jalila

机构信息

Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.

Department of Microbiology, Sultan Qaboos University Hospital, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2018 Nov;18(4):e483-e488. doi: 10.18295/squmj.2018.18.04.009. Epub 2019 Mar 28.

Abstract

OBJECTIVES

This study aimed to evaluate the relationship between food allergen sensitisation patterns and allergic manifestations in Omani patients and highlight the importance of specific immunoglobulin E (IgE) testing.

METHODS

This retrospective study included all patients referred due to allergic manifestations to the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, from November 2012 to November 2016. Specific IgE blood testing was performed to determine sensitisation to common foods known to cause allergic reactions.

RESULTS

A total of 164 patients were referred to SQUH over the study period, with 35.4% presenting with one allergic manifestation, 48.8% with 2-3 and 15.9% presenting with more than three manifestations. There was a family history of allergies in 70.7% of patients. Eosinophil counts and total and specific IgE levels were elevated in 18.9%, 54.9% and 73.2% of patients, respectively. Patients demonstrated sensitisation to cow milk (47.6%), wheat (41.5%), chicken eggs (34.8%), mixed tree nuts (34.1%), lentils (33.5%), peanuts (32.9%), soy (32.3%), shrimp (23.2%) and fish (15.2%). Overall, 19.5% were sensitised to a single allergen, 14% were sensitised to 2-3 and 39.6% were sensitised to more than three allergens. Almost one-third (29.3%) of patients suffered from food-induced anaphylaxis, of which 85.4% were prescribed self-injectable adrenaline.

CONCLUSION

To the best of the authors' knowledge, this study is the first to describe food allergen sensitisation patterns among Omani patients with allergic manifestations. In conjunction with clinical symptoms, the correct interpretation of specific IgE levels is important to diagnose food allergies and make safe decisions about reintroducing foods.

摘要

目的

本研究旨在评估阿曼患者食物过敏原致敏模式与过敏表现之间的关系,并强调特异性免疫球蛋白E(IgE)检测的重要性。

方法

这项回顾性研究纳入了2012年11月至2016年11月期间因过敏表现转诊至阿曼马斯喀特苏丹卡布斯大学医院(SQUH)的所有患者。进行了特异性IgE血液检测,以确定对已知会引起过敏反应的常见食物的致敏情况。

结果

在研究期间,共有164名患者转诊至SQUH,其中35.4%有1种过敏表现,48.8%有2 - 3种,15.9%有超过3种表现。70.7%的患者有过敏家族史。分别有18.9%、54.9%和73.2%的患者嗜酸性粒细胞计数、总IgE和特异性IgE水平升高。患者对牛奶(47.6%)、小麦(41.5%)、鸡蛋(34.8%)、混合坚果(34.1%)、扁豆(33.5%)、花生(32.9%)、大豆(32.3%)、虾(23.2%)和鱼(15.2%)致敏。总体而言,19.5%对单一过敏原致敏,14%对2 - 3种过敏原致敏,39.6%对超过3种过敏原致敏。近三分之一(29.3%)的患者患有食物诱导的过敏反应,其中85.4%被开了可自行注射的肾上腺素。

结论

据作者所知,本研究是首次描述有过敏表现的阿曼患者食物过敏原致敏模式。结合临床症状,正确解读特异性IgE水平对于诊断食物过敏和就重新引入食物做出安全决策很重要。

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本文引用的文献

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Fatal Anaphylaxis: Mortality Rate and Risk Factors.致命性过敏反应:死亡率和危险因素。
J Allergy Clin Immunol Pract. 2017 Sep-Oct;5(5):1169-1178. doi: 10.1016/j.jaip.2017.06.031.
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Epinephrine for First-aid Management of Anaphylaxis.肾上腺素用于过敏反应的急救处理。
Pediatrics. 2017 Mar;139(3). doi: 10.1542/peds.2016-4006. Epub 2017 Feb 13.
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Interpreting IgE sensitization tests in food allergy.解读食物过敏中的IgE致敏试验。
Expert Rev Clin Immunol. 2016;12(4):389-403. doi: 10.1586/1744666X.2016.1124761. Epub 2015 Dec 15.
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Pathogenesis of IgE-mediated food allergy.IgE介导的食物过敏的发病机制。
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