Division of Immunology and Allergy, Department of Pediatrics, Dr. Sami Ulus Maternity and Children Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Pediatr Allergy Immunol Pulmonol. 2023 Sep;36(3):90-93. doi: 10.1089/ped.2023.0035. Epub 2023 Jul 11.
Cases of cow's milk allergy (CMA) who reacted to measles or measles, mumps, and rubella (MMR) vaccines containing alpha-lactalbumin have been reported. The purpose of this study was to assess patients with CMA who received measles or MMR vaccines containing alpha-lactalbumin, as well as the characteristics of those who developed reactions to these vaccines. Patients followed up in the allergy clinic for CMA and who received measles or MMR vaccines containing alpha-lactalbumin at 9 or 12 months of age were included in the study, and their characteristics were analyzed retrospectively from the hospital registry system. Forty-nine patients were included in the study. Six patients received the measles vaccine, whereas 43 patients received the MMR vaccine containing alpha-lactalbumin. Vaccine skin tests were performed on these 6 patients. One patient had a positive intradermal test, so an alternative vaccine not containing alpha-lactalbumin was administered. The other 5 patients were vaccinated, and no reaction was observed. Anaphylaxis was observed in 3 of 43 patients who received the MMR vaccine containing alpha-lactalbumin. In all of these patients, the first reaction to dairy products was anaphylaxis. In 2 of those patients, cow's milk-specific IgE (spIgE) levels were >100 kU/L, and alpha-lactalbumin-spIgE levels were also high at 97 and 90 kU/L. The third patient's cow's milk-spIgE level was 15.9 kU/L, whereas the alpha-lactalbumin-spIgE level was 0.04 kU/L. Especially in patients with an initial reaction of anaphylaxis to dairy products and high cow's milk-spIgE levels, the risk of reaction is high with the MMR vaccine.
据报道，有对含α-乳白蛋白的麻疹、腮腺炎和风疹（MMR）疫苗产生反应的牛奶过敏（CMA）病例。本研究旨在评估接受含α-乳白蛋白的麻疹或 MMR 疫苗的 CMA 患者，以及对这些疫苗产生反应的患者的特征。研究纳入在过敏诊所随访的 CMA 患者，他们在 9 或 12 个月大时接受含α-乳白蛋白的麻疹或 MMR 疫苗，从医院登记系统回顾性分析他们的特征。本研究纳入 49 例患者。6 例患者接受麻疹疫苗，43 例患者接受含α-乳白蛋白的 MMR 疫苗。对这 6 例患者进行疫苗皮肤试验。1 例患者皮内试验阳性，因此给予不含α-乳白蛋白的替代疫苗。其余 5 例患者接种疫苗，未观察到反应。43 例接受含α-乳白蛋白的 MMR 疫苗的患者中有 3 例发生过敏反应。在所有这些患者中，对乳制品的首次反应是过敏反应。在其中 2 例患者中，牛奶特异性 IgE（spIgE）水平>100 kU/L，α-乳白蛋白-spIgE 水平也分别为 97 和 90 kU/L。第 3 例患者的牛奶-spIgE 水平为 15.9 kU/L，而α-乳白蛋白-spIgE 水平为 0.04 kU/L。特别是在对乳制品初始反应为过敏反应且牛奶-spIgE 水平较高的患者中，MMR 疫苗的反应风险较高。
