Unusual manifestations of hypersensitivity after a tick bite: report of two cases
Unusual manifestations of hypersensitivity after a tick bite: report of two cases
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DOI：
10.1016/s1081-1206(10)63082-7
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发表时间：
1997-07-01
影响因子：
5.9
通讯作者：
MoneretVautrin, DA
中科院分区：
文献类型：
--
作者：
Beaudouin, E;Kanny, G;MoneretVautrin, DA
背景资料：蜱能够通过叮咬传播各种病毒、寄生虫和细菌疾病，最著名的是由伯氏疏螺旋体引起的莱姆病。此外，蜱也可能引起过敏反应。目的：立即和延迟的皮肤反应的研究进行给证据的IgE依赖mechanism.Methods：两个伐木工人报告有皮肤反应蜱叮咬后。皮肤点刺试验和皮内试验进行了什么最有可能是在一个案件的硬蜱提取物。用放射免疫法测定木蜱全身提取物的特异性IgE。组织学和免疫组织学检查的皮肤活检获得从一个恶性皮肤病变，并从延迟反应皮内test.Results：其中一人有阳性的即时反应，点刺试验和皮内试验用相同的提取物。这两名患者有显着水平的木蜱特异性IgE抗体以及血清总IgE水平升高。组织学检查显示淋巴细胞真皮和血管周围浸润，在血管周围浸润的CD8+ T淋巴细胞和朗格汉斯细胞的证据。皮内皮肤试验后的延迟反应的地方活检也表明存在的真皮和血管周围淋巴细胞infiltration.Conclusion：IgE依赖性过敏蓖麻硬蜱可以解释过敏反应。标准化提取物必须用足够量的相关蜱唾液抗原制备，以允许通过皮肤和血清学试验对患者进行诊断，特别是可能对蓖麻硬蜱过敏的伐木工人。
Background: Ticks are able to transmit, through biting, various viral, parasitic, and bacterial diseases, the best known being Lyme disease due to Borrelia burgdorferi. In addition, ticks may also induce allergic reactions.Objective: A study of immediate and delayed skin reactions are undertaken to give evidence of an IgE-dependent mechanism.Methods: Two lumbermen reported having had skin reactions following bites by ticks. Skin prick tests and intradermal tests were performed with what was most probably Ixodes ricinus extract in one case. Specific IgE to whole body extract of wood tick were assayed by radioimmunoassay. Histological and immunohistologic examinations of skin biopsy obtained from a pruriginous skin lesion and from a delayed reaction following the intradermal test, were performed.Results: One of them had positive immediate reactions to a prick test and an intradermal test with the same extract. Both patients had significant levels of wood tick-specific IgE antibody as well as elevated serum total IgE levels. Histologic examinations of a pruriginous lesion revealed lymphocytic dermal and perivascular infiltration, with evidence of CD8+ T lymphocytes and Langerhans' cells in the perivascular infiltrates. A biopsy of the place of the delayed reaction following the intradermal skin test also showed the presence of dermal and perivascular lymphocytic infiltrates.Conclusion: IgE-dependent allergy to Ixodes ricinus can explain allergic reactions. Standardized extracts have to be prepared with sufficient amounts of the relevant tick salivary antigens to permit diagnosis by skin and serologic tests of patients, especially lumbermen who may be allergic to Ixodes ricinus.