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[过敏症的全身治疗]

[Systemic treatment of allergies].

作者信息

Staubach Petra, Ghoreishi Yalda, Wagner Nicola

机构信息

Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.

Hautklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland.

出版信息

Dermatologie (Heidelb). 2025 Apr;76(4):211-218. doi: 10.1007/s00105-025-05483-3. Epub 2025 Mar 17.

Abstract

Allergic rhinokonjunctivitis or asthma bronchiale and urticaria with or without angioedema are the most prevalent allergic diseases in childhood. Symptomatic relief can be achieved with antihistamines, corticosteroids and partially with the anti-immunoglobulin E (IgE) antibody omalizumab. Bradykinin-dependent angioedema, especially in childhood as the primary manifestation of hereditary angioedema (HAE), has to be ruled out as a differential diagnosis of histamine-induced angioedema. For HAE different therapy options in acute attacks and long-term prophylaxis are available. Timely initiation of specific immunotherapy for IgE-mediated allergy to aeroallergens, sublingually or subcutaneously (SCIT) applied, should be considered. Insect venom allergy can be treated with SCIT. Diagnosis of eosinophilic esophagitis is often delayed. Bolus events may be indicative of the disease. Elimination diets, proton pump inhibitors, topical corticosteroids and dupilumab may be used.

摘要

变应性鼻结膜炎、支气管哮喘以及伴有或不伴有血管性水肿的荨麻疹是儿童期最常见的过敏性疾病。使用抗组胺药、皮质类固醇,部分情况下使用抗免疫球蛋白E(IgE)抗体奥马珠单抗可实现症状缓解。必须排除缓激肽依赖性血管性水肿,尤其是作为遗传性血管性水肿(HAE)主要表现的儿童期缓激肽依赖性血管性水肿,以此作为组胺诱导的血管性水肿的鉴别诊断。对于HAE,有针对急性发作和长期预防的不同治疗方案。应考虑及时开始针对气传变应原IgE介导的过敏进行特异性免疫治疗,采用舌下或皮下注射(SCIT)。昆虫毒液过敏可用SCIT治疗。嗜酸性食管炎的诊断往往延迟。突发情况可能提示该病。可采用排除饮食、质子泵抑制剂、局部皮质类固醇和度普利尤单抗进行治疗。

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