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医疗保健提供者对α-半乳糖综合征的认知 - 美国,2022 年 3 月至 5 月。

Health Care Provider Knowledge Regarding Alpha-gal Syndrome - United States, March-May 2022.

出版信息

MMWR Morb Mortal Wkly Rep. 2023 Jul 28;72(30):809-814. doi: 10.15585/mmwr.mm7230a1.

DOI:10.15585/mmwr.mm7230a1
PMID:37498792
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10390085/
Abstract

Alpha-gal syndrome (AGS) is an emerging, tick bite-associated immunoglobulin E-mediated allergic condition characterized by a reaction to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), which is found in mammalian meat and products derived from mammals, including milk, other dairy products, and some pharmaceutical products. Symptoms range from mild (e.g., a rash or gastrointestinal upset) to severe (anaphylaxis); onset typically occurs ≥2 hours after exposure to alpha-gal. No treatment or cure is currently available. Despite the potential life-threating reactions associated with AGS, most patients perceive that health care providers (HCPs) have little or no knowledge of AGS. A U.S. web-based survey of 1,500 HCPs revealed limited knowledge of AGS, identified areas for continuing medical education, and described self-reported diagnostic and management practices. Overall, 42% of surveyed HCPs had never heard of AGS, and among those who had, fewer than one third knew how to diagnose the condition. Two thirds of respondents indicated that guidelines for the diagnosis and management of AGS would be useful clinical resources. Limited awareness and knowledge of AGS among HCPs likely contributes to underdiagnosis of this condition and inadequate patient management, and underestimates of the number of AGS patients in the United States, which currently relies on laboratory testing data alone.

摘要

阿尔法半乳糖综合征(AGS)是一种新出现的、与蜱虫叮咬相关的免疫球蛋白 E 介导的过敏症,其特征是对在哺乳动物肉和源自哺乳动物的产品(包括牛奶、其他乳制品和一些药物产品)中发现的寡糖半乳糖-α-1,3-半乳糖(alpha-gal)产生反应。症状范围从轻微(例如皮疹或胃肠道不适)到严重(过敏反应);发病通常在接触 alpha-gal 后≥2 小时发生。目前尚无治疗或治愈方法。尽管 AGS 可能与危及生命的反应有关,但大多数患者认为医疗保健提供者(HCPs)对 AGS 知之甚少或一无所知。一项针对 1500 名 HCPs 的美国网络调查显示,他们对 AGS 的了解有限,确定了继续医学教育的领域,并描述了自我报告的诊断和管理实践。总体而言,42%的调查 HCPs 从未听说过 AGS,而在听说过的人中,不到三分之一的人知道如何诊断这种疾病。三分之二的受访者表示,AGS 的诊断和管理指南将是有用的临床资源。HCPs 对 AGS 的认识和了解有限,可能导致对这种疾病的诊断不足和患者管理不当,并低估了美国 AGS 患者的数量,目前仅依赖实验室检测数据。

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本文引用的文献

1
Geographic Distribution of Suspected Alpha-gal Syndrome Cases - United States, January 2017-December 2022.疑似α-半乳糖综合征病例的地理分布-美国,2017 年 1 月至 2022 年 12 月。
MMWR Morb Mortal Wkly Rep. 2023 Jul 28;72(30):815-820. doi: 10.15585/mmwr.mm7230a2.
2
AGA Clinical Practice Update on Alpha-Gal Syndrome for the GI Clinician: Commentary.AGA 临床实践更新:胃肠病医师须知的 Alpha-Gal 综合征
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Knowledge, attitudes, and practices of Illinois medical professionals related to ticks and tick-borne disease.伊利诺伊州医学专业人员关于蜱虫及蜱传疾病的知识、态度和行为。
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The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome.问题的关键:了解和管理α-半乳糖综合征。
Immunotargets Ther. 2022 Sep 15;11:37-54. doi: 10.2147/ITT.S276872. eCollection 2022.
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Diagnostic testing for galactose-alpha-1,3-galactose, United States, 2010 to 2018.2010 年至 2018 年美国半乳糖-α-1,3-半乳糖的诊断检测。
Ann Allergy Asthma Immunol. 2021 Apr;126(4):411-416.e1. doi: 10.1016/j.anai.2020.12.019. Epub 2021 Jan 7.
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Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients.α-半乳糖苷综合征的诊断与管理:2500 例患者的经验教训。
Expert Rev Clin Immunol. 2020 Jul;16(7):667-677. doi: 10.1080/1744666X.2020.1782745. Epub 2020 Jul 8.
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Patients' Health Information Practices and Perceptions of Provider Knowledge in the Case of the Newly Discovered Alpha-gal Food Allergy.新发现的α-半乳糖食物过敏病例中患者的健康信息行为及对医疗服务提供者知识的认知
J Patient Exp. 2020 Feb;7(1):132-139. doi: 10.1177/2374373518808310. Epub 2018 Oct 23.
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Current and Future Distribution of the Lone Star Tick, Amblyomma americanum (L.) (Acari: Ixodidae) in North America.当前和未来北美的孤星蜱,美洲钝眼蜱(L.)(蜱螨目:硬蜱科)的分布。
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Diagnosis of Life-Threatening Alpha-Gal Food Allergy Appears to Be Patient Driven.危及生命的α-半乳糖食物过敏的诊断似乎由患者推动。
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