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[特应性皮炎患儿中由水果和蔬菜引起的食物过敏的诊断]

[Diagnosis of food allergy caused by fruit and vegetables in children with atopic dermatitis].

作者信息

Ottolenghi A, De Chiara A, Arrigoni S, Terracciano L, De Amici M

机构信息

Divisione di Pediatria, Presidio Ospedaliero M. Melloni di Milano, Italia.

出版信息

Pediatr Med Chir. 1995 Nov-Dec;17(6):525-30.

PMID:8668588
Abstract

Atopic dermatitis (A.D.) is a frequent, complex and multifactorial disease: Food Allergy (F.A.), probably underestimated, especially for fruits and vegetables, seems to play an important pathogenetic role in children. The purpose of this study is to estimate, on a sample of children with A.D., the prevalence of F.A. (for fruits and vegetables), and the reliability of diagnosis of Prick+Prick test compared with the usual Prick test, RAST and challenge. Twentysix patients (17 M and 9 F), ranging in age from 5 months to 8 years, were enrolled in the study. All fulfilled the criteria of Hanifin and Rajka for the diagnosis of A.D. Food RAST, prick tests with inhalant and food extracts and Prick+Prick tests with fresh fruits and vegetables were carried out. In the case of positive result to fruits and vegetables with skin tests and/or RAST, open challenge for every type of food considered responsible was carried out, after healing or improvement of dermatitis. Three children (11.53%) suffered from F.A. for fruits and vegetables: allergy to celery of one patient was discovered only by usual Prick test; allergy to tomato and kiwi in another patient was spotted by Prick+Prick only; while in another case by both tests. In this last patient Prick+Prick test revealed a real allergy for 5 aliments (carrot, tomato, celery, cucumber, fennel) of which only 2 (carrot and celery) also caused a reaction with the Prick test. The combined use of both tests made it possible to increase the diagnosis of F.A. both for the number of patients and for a complete identification of implicated foods.

摘要

特应性皮炎(A.D.)是一种常见、复杂且多因素的疾病:食物过敏(F.A.)可能被低估了,尤其是对于水果和蔬菜而言,它似乎在儿童发病机制中起着重要作用。本研究的目的是在一组特应性皮炎患儿样本中,评估食物过敏(针对水果和蔬菜)的患病率,以及与常规点刺试验、放射性变应原吸附试验(RAST)和激发试验相比,点刺+点刺试验诊断的可靠性。26例患者(17例男性和9例女性),年龄在5个月至8岁之间,被纳入研究。所有患者均符合Hanifin和Rajka的特应性皮炎诊断标准。进行了食物RAST试验、吸入性和食物提取物点刺试验以及新鲜水果和蔬菜点刺+点刺试验。如果皮肤试验和/或RAST对水果和蔬菜呈阳性结果,在皮炎愈合或改善后,对每种被认为有责任的食物进行开放性激发试验。三名儿童(11.53%)患有水果和蔬菜食物过敏:一名患者对芹菜的过敏仅通过常规点刺试验发现;另一名患者对番茄和猕猴桃的过敏仅通过点刺+点刺试验发现;而在另一个病例中,两种试验均检测到过敏。在最后一名患者中,点刺+点刺试验显示对5种食物(胡萝卜、番茄、芹菜、黄瓜、茴香)存在真正的过敏,其中只有2种(胡萝卜和芹菜)也引起了点刺试验的反应。两种试验的联合使用使得在患者数量和对相关食物的完全识别方面都增加了食物过敏的诊断。

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