Yamada Saki, Matsubara Kousaku, Chinuki Yuko, Hori Masayuki, Masaki Taro
Department of Pediatrics, Kobe City Nishi-Kobe Medical Center.
Department of Dermatology, Shimane University Faculty of Medicine.
Arerugi. 2019;68(9):1141-1147. doi: 10.15036/arerugi.68.1141.
We present a case of early childhood-onset pork-cat syndrome possibly due to sensitization by both cats and dogs. A 6-year-old girl was referred to our hospital because of repetitive episodes of urticaria when she consumed pork meat. The patient lived with a dog and the ground floor of her house was a veterinary clinic run by her veterinarian parents. Blood tests demonstrated high specific IgE (≥50UA/ml) against cat dander, dog dander, pork, Sus s 1, Fel d 2, Can f 1, Can f 2, and Can f 3. The skin prick test was positive for raw pork and beef. Western blotting analysis detected hot spots on 67-kDa proteins in pork meat and cat dander extract. Cross-reactivity between these two proteins was confirmed by an inhibition test. Furthermore, crossreactivity between pork meat and dog dander extract was also noted. Taken together, the diagnosis of porkcat syndrome was made, and both cats and dogs were suggested to have led to the sensitization. The patient was advised to only eat well-cooked pork, and has been followed thereafter without additional reactions. The previously reported cases of this syndrome developed during adolescence and young adulthood because a considerable period from the sensitization to the development cross-reactivity with pork meat is required. To our best knowledge, this is the youngest reported case of pork-cat syndrome among English and Japanese literatures. The nomenclature of this syndrome as pet animal-meat syndrome improves the understanding of the underlying pathogenesis of cross-reactivity between animal albumins and meat albumins.
我们报告一例可能因对猫和狗均致敏而导致的儿童期起病的猪肉 - 猫综合征。一名6岁女孩因食用猪肉后反复出现荨麻疹发作而被转诊至我院。该患者与一只狗生活在一起，她家的一楼是由她身为兽医的父母经营的一家兽医诊所。血液检测显示，患者针对猫皮屑、狗皮屑、猪肉、猪蛋白1、猫蛋白2、犬小孢子菌1、犬小孢子菌2和犬小孢子菌3的特异性IgE水平较高（≥50UA/ml）。皮肤点刺试验显示生猪肉和牛肉呈阳性。蛋白质印迹分析在猪肉和猫皮屑提取物中的67 kDa蛋白上检测到热点。通过抑制试验证实了这两种蛋白之间的交叉反应性。此外，还注意到猪肉与狗皮屑提取物之间的交叉反应性。综合来看，诊断为猪肉 - 猫综合征，提示猫和狗均导致了致敏。建议患者只食用熟透的猪肉，此后一直进行随访，未再出现其他反应。此前报道的该综合征病例多在青春期和青年期发病，因为从致敏到与猪肉发生交叉反应的发展需要相当长的一段时间。据我们所知，这是英文和日文文献中报道的最年轻的猪肉 - 猫综合征病例。该综合征命名为宠物 - 肉类综合征有助于更好地理解动物白蛋白与肉类白蛋白之间交叉反应的潜在发病机制。
