Dietary advice, dietary adherence and the acquisition of tolerance in egg-allergic children: a 5-yr follow-up
Dietary advice, dietary adherence and the acquisition of tolerance in egg-allergic children: a 5-yr follow-up
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DOI：
10.1111/j.1399-3038.2008.00784.x
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发表时间：
2009-05-01
影响因子：
4.4
通讯作者：
Campbell, Dianne Elizabeth
中科院分区：
文献类型：
--
作者：
Allen, Clare Wendy;Kemp, Andrew Stewart;Campbell, Dianne Elizabeth
IgE介导的鸡蛋过敏是一种常见的儿童食物过敏，影响约1-2%的2岁儿童。避免鸡蛋是鸡蛋过敏的主要治疗方法;然而，目前还不清楚鸡蛋过敏儿童的父母接受了什么类型的饮食建议，以及在多大程度上遵守了这种饮食建议。本研究旨在评估：（i）父母在三级医院环境中接受的饮食建议的类型和来源，（ii）父母如何密切遵守所给予的建议，（iii）哪些患者特征影响饮食的遵守，以及（iv）严格遵守饮食建议是否是儿童是否长大后不再对鸡蛋过敏的可识别因素。2006年，向261名2003年在三级儿科过敏诊所就诊并被诊断为鸡蛋过敏的儿童的父母发送了一份调查问卷，其中包括84名在此期间（2003-2006年）接受了院内开放式口服鸡蛋挑战的儿童。问题包括人口统计学数据，鸡蛋过敏的细节，饮食避免和实现不受限制的鸡蛋摄入。在确认收到的199份问卷中，167份（84%）被退回。队列的平均年龄为6.6岁，自首次反应以来平均随访5.5年。68%的受试者报告一直避免所有含有鸡蛋的食物。47%的儿童曾意外接触过鸡蛋。初始反应的严重程度似乎并不影响对建议饮食的坚持。在84名接受开放式鸡蛋挑战的儿童中，57名儿童能够摄入鸡蛋而没有临床反应，并被归类为已经超过了鸡蛋过敏。这些儿童与那些鸡蛋挑战阳性的儿童在他们接受的饮食建议或他们严格避免鸡蛋的程度方面没有区别。此外，在意外摄入的频率或初始反应的严重程度方面，已经超过鸡蛋过敏的儿童与那些在医院挑战中仍然对鸡蛋过敏的儿童没有区别。严格避免鸡蛋和意外摄入鸡蛋似乎没有影响获得的耐受性。
IgE-mediated egg allergy is a common childhood food allergy affecting about 1-2% of 2-yr-old children. Egg avoidance is the mainstay of treatment for egg allergy; however, it is unclear what type of dietary advice parents of children with egg allergy receive and to what extent this dietary advice is adhered to. This study aimed to assess: (i) the type and source of dietary advice parents receive in a tertiary hospital setting, (ii) how closely parents adhere to advice given, (iii) what patient characteristics influenced adherence to diet and (iv) whether strict adherence to dietary advice was an identifiable factor in whether children outgrew their egg allergy. In 2006, a questionnaire was sent to 261 parents of children seen in a tertiary paediatric allergy clinic in 2003 and diagnosed with egg allergy which included 84 children who had undergone an in-hospital open oral egg challenge during this time period (2003-2006). Questions included demographic data, details of egg allergy, dietary avoidance and attainment of unrestricted egg ingestion. Of 199 questionnaires confirmed received, 167 were returned (84%). The mean age of the cohort was 6.6 yr with an average of 5.5 yr of follow-up since the first reaction. Sixty-eight percent of subjects reported avoidance of all food containing egg all the time. Forty-seven percent of the children had been accidentally exposed to egg. The severity of the initial reaction did not appear to influence adherence to an advised diet. Of the 84 children who underwent in-hospital open egg challenges, 57 children were able to ingest egg without clinical reaction and were classified as having outgrown their egg allergy. These children did not differ from those who were challenge positive to egg in terms of either the dietary advice they received or the degree to which they had undertaken strict avoidance of egg. In addition, children who had outgrown their egg allergy did not differ from those who remained egg-allergic on in-hospital challenge in terms of either the frequency of accidental ingestion or the severity of initial reaction. Strict avoidance of egg and accidental ingestion of egg did not appear to influence the acquisition of tolerance.