Eng P A, Wüthrich B
Allergiestation der Dermatologischen Klinik, Universitätsspital Zürich.
Schweiz Rundsch Med Prax. 1994 Apr 5;83(14):402-6.
From 1978 until 1993 we diagnosed 167 cases of inhalative allergy to silk-filled bed quilts. The patients experienced asthma attacks predominantly during the night. Occupational exposure to silk materials was found in six cases. The mean age at first manifestation of symptoms (31 years, range 8 to 58) was relatively high, indicating an aggressive inhalation allergen. Beside a case of occupational asthma in a silk filature, we present two patients with nightly respiratory symptoms: an 8-year-old boy, whose asthma immediately disappeared during his holidays away from home, and a 48-year-old woman diagnosed only eight years after the beginning of an asthma unresponsive to therapy. Elimination of the silk-waste-containing bed quilts led to complete recovery of respiratory symptoms. Prick and intracutaneous skin testing as well as scratch tests using material of silk-filled quilts and the RAST (Pharmacia k 73) to silk waste turned out to be sensitive diagnostic parameters. Many of these bed quilts filled with silk-waste are still used today. Beside the house-dust mites they are a further cause of nightly attacks and should also be considered in allergic work-up.
从1978年至1993年，我们诊断出167例对丝绵被的吸入性过敏病例。患者主要在夜间出现哮喘发作。其中6例发现有职业性接触丝绸材料的情况。症状首次出现时的平均年龄（31岁，范围8至58岁）相对较高，表明这是一种具有侵袭性的吸入性过敏原。除了1例缫丝厂的职业性哮喘病例外，我们还介绍了2例有夜间呼吸道症状的患者：一名8岁男孩，他在离家度假期间哮喘立即消失；还有一名48岁女性，在哮喘开始且治疗无效8年后才被诊断出来。去除含丝绵的被子后，呼吸道症状完全恢复。使用丝绵被材料进行点刺试验、皮内试验以及划痕试验，以及针对丝绵的放射性变应原吸附试验（Pharmacia k 73），结果显示都是敏感的诊断参数。如今仍有许多这种填充丝绵的被子在使用。除了屋尘螨外，它们是夜间发作的另一个原因，在过敏检查中也应予以考虑。
