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儿童即时型牛奶和鸡蛋过敏的自然病程。

The Natural Course of Immediate-Type Cow's Milk and Egg Allergies in Children.

机构信息

Department of Pediatrics, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Dongtan, Republic of Korea.

Department of Pediatrics, Hangang Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Republic of Korea.

出版信息

Int Arch Allergy Immunol. 2020;181(2):103-110. doi: 10.1159/000503749. Epub 2019 Nov 21.

Abstract

BACKGROUND

Most of children with cow's milk (CM) and hen's egg allergies are known to outgrow their diseases with time, but recent studies have demonstrated that children tend to continue to have allergic symptoms in adolescence and adulthood. The aim of this study was to investigate the natural course of CM and egg allergies in Korean children and analyze prognostic factors.

METHODS

In this retrospective study, we reviewed data of children with CM allergy and with egg allergy using medical records and parental telephone interviews. Diagnosis of CM or egg allergy was based on positive oral food challenge test or convincing history of allergic symptoms in combination with positive allergen-specific IgE. Acquisition of tolerance was defined by the absence of allergic symptoms after reintroduction of the offending foods.

RESULTS

Half of the children outgrew CM allergy at a median age of 8.7 years. CM-specific IgE level at the first reaction was a significant prognostic factor for oral tolerance in CM allergy (p < 0.05). The median age to acquire oral tolerance in 50% of patients with egg allergy was 5.6 years. Egg-specific IgE level at the first reaction and family history of allergic diseases significantly affected the prognosis in children with egg allergy (p < 0.05).

CONCLUSIONS

Half of Korean children with CM and egg allergies had symptom resolution at 8.7 and 5.6 years of age, respectively. Our results also suggest that CM- and egg-specific IgE levels at the first reaction are the most significant prognostic factors in predicting acquisition of oral tolerance.

摘要

背景

大多数对牛奶(CM)和鸡蛋过敏的儿童随着时间的推移会逐渐痊愈,但最近的研究表明,儿童在青春期和成年后仍可能继续出现过敏症状。本研究旨在调查韩国儿童 CM 和鸡蛋过敏的自然病程,并分析其预后因素。

方法

在这项回顾性研究中,我们使用病历和家长电话访谈回顾了对 CM 过敏和鸡蛋过敏的儿童的数据。CM 或鸡蛋过敏的诊断基于阳性口服食物挑战试验或过敏症状的明确病史,并结合阳性过敏原特异性 IgE。过敏消退定义为再次摄入致敏食物后无过敏症状。

结果

一半的儿童在中位年龄 8.7 岁时对 CM 过敏消退。首次反应时的 CM 特异性 IgE 水平是 CM 过敏口服耐受的重要预后因素(p < 0.05)。50%鸡蛋过敏儿童获得口服耐受的中位年龄为 5.6 岁。首次反应时的鸡蛋特异性 IgE 水平和过敏疾病家族史对鸡蛋过敏儿童的预后有显著影响(p < 0.05)。

结论

一半的韩国 CM 和鸡蛋过敏儿童分别在 8.7 岁和 5.6 岁时症状缓解。我们的研究结果还表明,首次反应时的 CM 和鸡蛋特异性 IgE 水平是预测口服耐受的最重要的预后因素。

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