两例移植后获得性食物过敏患者在口服食物激发试验阴性后出现再致敏。
Two cases of transplant-acquired food allergy who developed resensitization after a negative oral food challenge.
作者信息
Nakaoka Akiko, Nomura Takayasu, Ozeki Kazuyoshi, Suzuki Tomotaka, Kusumoto Shigeru, Iida Shinsuke, Saitoh Shinji
机构信息
Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
Department of Hematology and Oncology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
出版信息
Allergy Asthma Clin Immunol. 2023 Mar 22;19(1):24. doi: 10.1186/s13223-023-00784-5.
BACKGROUND
Cases of food allergy after hematopoietic stem cell and solid organ transplantation in previously nonallergic transplant recipients were reported as transplant-acquired food allergy (TAFA), but information about its long-term outcome is still limited. A phenomenon where patients reacquire food allergy by resuming daily consumption after a negative oral food challenge has not yet been reported.
CASE PRESENTATION
We report two cases of TAFA after liver transplantation and cord blood transplantation. In each case, the threshold of daily consumption to cause allergic symptoms decreased when a negative oral food challenge was obtained.
CONCLUSIONS
Our cases show an importance of gastrointestinal tract as a route of food sensitization because thresholds that caused allergic reactions decreased during their resuming process. We need to be careful with possible resensitization once a negative substantial dose was confirmed.
背景
既往无食物过敏的造血干细胞和实体器官移植受者发生食物过敏的病例被报道为移植获得性食物过敏（TAFA），但其长期预后的信息仍然有限。尚未有患者在口服食物激发试验结果为阴性后通过恢复日常饮食再次发生食物过敏的现象的报道。
病例报告
我们报告了两例肝移植和脐血移植后发生TAFA的病例。在每例病例中，当口服食物激发试验结果为阴性时，引起过敏症状的每日食用阈值降低。
结论
我们的病例显示了胃肠道作为食物致敏途径的重要性，因为在恢复过程中引起过敏反应的阈值降低了。一旦确认口服大剂量食物试验结果为阴性，我们需要警惕可能的再次致敏。
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