Sanchez-Borges M, Capriles-Hulett A, Fernandez-Caldas E, Suarez-Chacon R, Caballero F, Castillo S, Sotillo E
Immunology Service, Centro Medico-Docente La Trinidad, Caracas.
J Allergy Clin Immunol. 1997 Jun;99(6 Pt 1):738-43. doi: 10.1016/s0091-6749(97)80005-x.
Although insect and arthropod contamination of certain foods has been recognized for many years, allergic manifestations caused by ingestion of mite allergens have only rarely been reported.
The purpose of this study is to present clinical observations in patients who experienced acute anaphylaxis after eating mite-contaminated foods.
Thirty atopic subjects who were first seen with systemic anaphylaxis precipitated by the ingestion of wheat-containing foods underwent skin prick tests with inhalant and food extracts, as well as with uncontaminated and mite-contaminated wheat flour. Flour samples were examined microscopically for identification and counting of mites. Der p 1 and Der f 1 levels were quantitated by using immunochemical methods.
The most common symptoms were breathlessness, angioedema, wheezing, and rhinorrhea, which started between 10 and 240 minutes after eating. Abundant mites were present in the flour obtained from 28 patients; Suidasia spp. mites were found in grated bread from the other two patients. Positive prick test responses to Dermatophagoides farinae-and mite-contaminated flour and negative skin test responses to wheat extract, other food extracts, and uncontaminated wheat flour were found in all patients. Skin test responses were positive in volunteers with mite allergy even after heating the mite-contaminated flour at 100 degrees C. Screening of 35 unselected flour samples demonstrated the presence of mites in 13 of them (37.1%).
Systemic anaphylaxis can occur after the ingestion of heated or unheated mite-contaminated foods. This problem may be more prevalent in tropical and subtropical countries than previously recognized.
尽管某些食物受到昆虫和节肢动物污染已被认识多年，但因摄入螨过敏原引起的过敏表现却鲜有报道。
本研究旨在呈现食用受螨污染食物后发生急性过敏反应患者的临床观察结果。
30名特应性受试者因摄入含小麦食物引发全身性过敏反应首次就诊，接受了吸入性和食物提取物以及未受污染和受螨污染的小麦粉皮肤点刺试验。对面粉样本进行显微镜检查以鉴定和计数螨。采用免疫化学方法定量检测Der p 1和Der f 1水平。
最常见的症状为呼吸困难、血管性水肿、喘息和鼻溢，在进食后10至240分钟之间出现。从28名患者获取的面粉中存在大量螨；在另外两名患者的磨碎面包中发现了嗜渣螨属螨。所有患者对粉尘螨和受螨污染面粉的点刺试验反应呈阳性，而对小麦提取物、其他食物提取物和未受污染小麦粉的皮肤试验反应呈阴性。即使将受螨污染的面粉在100℃加热后，对螨过敏的志愿者的皮肤试验反应仍呈阳性。对35份未挑选的面粉样本进行筛查显示，其中13份（37.1%）存在螨。
摄入加热或未加热的受螨污染食物后可发生全身性过敏反应。这一问题在热带和亚热带国家可能比之前认识到的更为普遍。
