Milk and soy allergy.

Milk and soy allergy.
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DOI:
10.1016/j.pcl.2011.02.005
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发表时间:
2011-04
影响因子:
2.6
通讯作者:
Jaervinen, Kirsi M.
Jaervinen, Kirsi M.
中科院分区:
医学3区
文献类型:
--
作者:
Kattan, Jacob D.;Cocco, Renata R.;Jaervinen, Kirsi M.

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牛奶过敏(CMA)影响2%至3%的幼儿,并表现出广泛的免疫球蛋白E(IgE-)和非IgE介导的临床综合征,这对经济和生活方式有重大影响。早期诊断是基于有监督的口服食物激发(OFC),但令人信服的临床病史,皮肤点刺试验和牛奶(CM)特异性IgE的测量可以帮助诊断IgE介导的CMA,偶尔消除OFC的需要。合乎逻辑的是,对CMA的审查将与对大豆过敏的审查联系起来,因为大豆配方奶粉通常是不耐受牛奶的婴儿的替代营养来源。来自大豆和其他相关植物(如花生)的蛋白质之间的密切相似性,以及由此产生的交叉反应性和缺乏临床反应性的预测值,通常使大豆过敏的诊断更具挑战性。本文综述了牛奶和大豆过敏的流行病学、发病机制、临床特征、自然史和诊断。交叉反应和牛奶过敏的管理也进行了讨论。
Cow’s milk allergy (CMA) affects 2% to 3% of young children and presents with a wide range of immunoglobulin E (IgE-) and non-IgE-mediated clinical syndromes, which have a significant economic and lifestyle impact. Definitive diagnosis is based on a supervised oral food challenge (OFC), but convincing clinical history, skin prick testing, and measurement of cow’s milk (CM)-specific IgE can aid in the diagnosis of IgE-mediated CMA and occasionally eliminate the need for OFCs. It is logical that a review of CMA would be linked to a review of soy allergy, as soy formula is often an alternative source of nutrition for infants who do not tolerate cow’s milk. The close resemblance between the proteins from soy and other related plants like peanut, and the resulting cross-reactivity and lack of predictive values for clinical reactivity, often make the diagnosis of soy allergy far more challenging. This review examines the epidemiology, pathogenesis, clinical features, natural history and diagnosis of cow’s milk and soy allergy. Cross-reactivity and management of milk allergy are also discussed.
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