Woltsche-Kahr I, Kränke B
Abteilung für Umweitdermatologie und Venerologie, Universitätsklinik für Dermatologie und Venerologie, Graz.
Dtsch Med Wochenschr. 1997 Jun 6;122(23):747-50. doi: 10.1055/s-2008-1047684.
Within one year a 36-year-old man had three episodes of loss of consciousness associated with a fall in blood pressure. No cause was established despite repeated hospital admissions. But an anaphylactic reaction was suspected as the cause after yet another syncope when the administration of antihistamines and steroids had quickly improved the patient's state. In retrospect it became clear that the loss of consciousness had occurred after the eating of bananas.
Total IgE level was 695 kU/l and there was marked sensitization to bananas (IgE radio-allergosorbent test [RAST] class 2) and latex (IgE RAST class 2), confirmed by marked immediate-type reactions to these substances in the prick test.
Dietary advice was given and the significance of the latex sensitization explained. The patient was given an allergy pass and drugs for emergency use.
Anaphylactic reaction should be included in the differential diagnosis of loss of consciousness of uncertain cause. The prognosis of such a reaction is excellent only if treated at once. Both diagnosis and treatment are relatively simple.
一名36岁男性在一年内发生了三次与血压下降相关的意识丧失发作。尽管多次住院,但病因未明。然而,在又一次晕厥后,由于给予抗组胺药和类固醇后患者状态迅速改善,怀疑是过敏反应所致。回顾时发现,意识丧失发生在食用香蕉之后。
总IgE水平为695 kU/l,对香蕉(IgE放射变应原吸附试验[RAST] 2级)和乳胶(IgE RAST 2级)有明显致敏,点刺试验中对这些物质有明显的速发型反应证实了这一点。
给予饮食建议并解释乳胶致敏的意义。给患者发放了过敏通行证和急救药物。
过敏反应应纳入病因不明的意识丧失的鉴别诊断中。这种反应只有立即治疗,预后才良好。诊断和治疗都相对简单。