Molkhou P, Metayer C
Hôpital Saint-Vincent-de-Paul, Paris.
Allerg Immunol (Paris). 1988 Jan;20(1):3-6.
60 children aged 3 months to 5 years (mean age 2 years) with early onset symptoms (cutaneous, respiratory or gastrointestinal) after ingestion of cow's milk, egg or fish, were investigated with skin prick tests, dosage of total IgE and specific IgE against these 3 food antigens. The case finding criteria used was positive elimination and challenge tests with the offending foods. In those instances in which intolerance to more than one food was suspected, cow's milk, egg and fish were reintroduced separately after remissions of symptoms with food exclusion. Specific IgE (Phadebas RAST) against the offending foods were found in 70% of cases, with early onset symptoms. RAST higher than 0.35 PRU were considered positive. Results showed that specific IgE antibodies in the serum tend to diminish with time: faster with cow's milk than with egg and specially fish. A sample of 15 children out of the 42 patients with positive RAST was followed up during a period of 3 years. 20 of them were treated with Nalcron, five with Ketotifen, and seventeen with both drugs. Eleven children were greatly improved or improved (74%) there was no clinical change in 4 (26%). Three groups can be considered: - One group with normal IgE levels after 2 years with no clinical symptoms/and no relapse after food challenge. - A second group with no symptom or mild symptoms with positive low levels of IgE. - The third group with resisting allergy to foods remains RAST positive. We conclude that frequency of positive RAST against food allergens is relatively high. High concentrations of IgE antibodies are almost exclusively seen in infants with an atopic disease.
60名年龄在3个月至5岁(平均年龄2岁)之间、在摄入牛奶、鸡蛋或鱼类后出现早期症状(皮肤、呼吸或胃肠道症状)的儿童,接受了皮肤点刺试验、总IgE剂量测定以及针对这3种食物抗原的特异性IgE检测。所采用的病例发现标准是对可疑致敏食物进行阳性排除和激发试验。在怀疑对多种食物不耐受的情况下,在通过食物排除症状缓解后,分别重新引入牛奶、鸡蛋和鱼类。在70%有早期症状的病例中发现了针对可疑致敏食物的特异性IgE(Phadebas RAST)。RAST高于0.35 PRU被视为阳性。结果显示,血清中的特异性IgE抗体往往会随时间减少:牛奶的减少速度比鸡蛋快,尤其是鱼类。对42例RAST阳性患者中的15名儿童进行了为期3年的随访。其中20名接受了奈可罗治疗,5名接受了酮替芬治疗,17名同时接受了两种药物治疗。11名儿童病情大幅改善或有所改善(74%),4名(26%)病情无临床变化。可分为三组:- 一组在2年后IgE水平正常,无临床症状/食物激发后无复发。- 第二组无症状或症状轻微,IgE水平低且呈阳性。- 第三组对食物过敏有抵抗力,RAST仍为阳性。我们得出结论,针对食物过敏原的RAST阳性频率相对较高。高浓度的IgE抗体几乎仅见于患有特应性疾病的婴儿。