Morales C, Peñarrocha M, Bagán J V, Burchés E, Pelaez A
Service of Allergy, University Hospital Clinic, Valencia, Spain.
Clin Exp Allergy. 1995 Mar;25(3):260-4. doi: 10.1111/j.1365-2222.1995.tb01038.x.
A study was made of six patients with Melkersson-Rosenthal syndrome (MRS) to establish the aetiological role of foodstuffs and/or additives and the possible associated immunological alterations. In all cases Melkersson-Rosenthal syndrome (MRS) was diagnosed both clinically and histologically, excluding other causes of orofacial granulomatosis (OFG). A detailed study of possible triggering factors was performed in all patients. Blood analysis, x-rays and cultures, were always within normal limits, with the exception of the finding of circulating immune complexes (CICs) in three patients with facial palsy associated, and C-reactive protein positivity in two patients who presented persistent labial oedema. All patients were subjected to skin-prick tests with common inhalant allergens and with foods when sensitization to foods were suspected, and patch tests with European Standard Series and pastry components, organic dyes, perfumes and fragrances series. The results were negative in all cases. When asymptomatic, the patients were subjected to a double-blind oral challenge, under placebo control, with additives (monosodium glutamate, tartrazine, sulfites, erythrosine, paraoxybenzoate, sodium benzoate, lactose, aspirin, and annate), which was again negative. In no case did the patients refer the appearance of outbreaks with exposure to foods or contactants, and the course of the disease was unaffected by exclusion diets and the elimination of contactants. To conclude, we observed no sensitization to foods, additives or contactants in our patients. Likewise, there were no antecedents of atopy or hereditary predisposition related to the aetiopathogeny of MRS. The significance of the CIC encountered only in patients with facial paralysis remains to be established, due to the limited number of patients studied.
对6例梅尔克森 - 罗森塔尔综合征（MRS）患者进行了一项研究，以确定食物和/或添加剂的病因学作用以及可能相关的免疫改变。在所有病例中，均通过临床和组织学诊断为梅尔克森 - 罗森塔尔综合征（MRS），排除了其他口面部肉芽肿病（OFG）的病因。对所有患者进行了可能触发因素的详细研究。血液分析、X线检查和培养结果均在正常范围内，但3例伴有面瘫的患者发现循环免疫复合物（CICs），2例出现持续性唇部水肿的患者C反应蛋白呈阳性。当怀疑对食物过敏时，所有患者均接受了常见吸入性变应原和食物的皮肤点刺试验，以及欧洲标准系列、糕点成分、有机染料、香水和香料系列的斑贴试验。所有病例结果均为阴性。无症状时，患者在安慰剂对照下接受添加剂（味精、酒石黄、亚硫酸盐、赤藓红、对羟基苯甲酸酯、苯甲酸钠、乳糖、阿司匹林和胭脂红）的双盲口服激发试验，结果仍为阴性。在任何情况下，患者均未提及接触食物或接触物后出现皮疹，且疾病进程不受排除饮食和去除接触物的影响。总之，我们的患者未出现对食物、添加剂或接触物的致敏情况。同样，也没有特应性或与MRS发病机制相关的遗传易感性病史。由于研究的患者数量有限，仅在面瘫患者中发现的CIC的意义仍有待确定。
