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[一例因食用精米导致的食物依赖运动诱发过敏反应病例]

[A CASE OF FOOD-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS DUE TO POLISHED RICE].

作者信息

Oike Naoko, Iwawaki Yukiko, Naito Michihiro, Tagami Kazunori, Nakata Joon, Matsui Teruaki, Takasato Yoshihiro, Kobayasi Takae, Izumi Hidehiko, Ito Komei

机构信息

Department of Pediatrics, Kasugai Municipal Hospital.

Institute of Health and Nutrition, Nagoya University of Arts and Sciences.

出版信息

Arerugi. 2024;73(5):416-421. doi: 10.15036/arerugi.73.416.

Abstract

A 14-year-old girl presented to our hospital with food-dependent exercise-induced anaphylaxis (FDEIA), possibly caused by rice. Despite experiencing four previous episodes of suspected FDEIA, she did not seek medical attention at her own discretion. On the fifth occurrence of symptoms, the general practitioner suspected FDEIA and referred the patient to our hospital. The only common factor in all five episodes was the consumption of rice, leading to the examination of the patient under suspicion of FDEIA caused by rice. Skin prick test results were positive for bran and polished rice, and exercise after consumption of polished rice resulted in anaphylaxis. Therefore, we diagnosed FDEIA caused by polished rice. Immunoblotting confirmed the presence of immunoglobulin E reacting with 14-16kDa rice bran protein in the patient's serum. The immunoblot inhibition test suggested that the rice bran protein to which the patient's serum reacted was also present in polished rice and no wash rice. As the patient may experience FDEIA after ingestion of no wash rice or rice flour, she was advised to eliminate these from her diet, treating them similarly to brown rice or polished rice.

摘要

一名14岁女孩因食物依赖运动诱发的过敏反应(FDEIA)前来我院就诊,可能由大米引起。尽管此前曾有过4次疑似FDEIA发作,但她并未自行寻求医疗帮助。在症状第5次出现时,全科医生怀疑是FDEIA,并将患者转诊至我院。所有5次发作的唯一共同因素是食用大米,因此对该患者进行检查,怀疑是由大米引起的FDEIA。皮肤点刺试验结果显示,米糠和精米呈阳性,食用精米后运动引发过敏反应。因此,我们诊断为精米引起的FDEIA。免疫印迹法证实患者血清中存在与14 - 16kDa米糠蛋白反应的免疫球蛋白E。免疫印迹抑制试验表明,患者血清反应的米糠蛋白在精米和免洗米中也存在。由于患者在摄入免洗米或米粉后可能会出现FDEIA,建议她从饮食中排除这些食物,将它们与糙米或精米同等对待。

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