NATURAL-HISTORY OF FOOD HYPERSENSITIVITY IN CHILDREN WITH ATOPIC-DERMATITIS
NATURAL-HISTORY OF FOOD HYPERSENSITIVITY IN CHILDREN WITH ATOPIC-DERMATITIS
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DOI：
10.1016/s0022-3476(89)80323-3
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发表时间：
1989-07-01
影响因子：
5.1
通讯作者：
SCANLON, SM
中科院分区：
文献类型：
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作者：
SAMPSON, HA;SCANLON, SM
坚持消除饮食的特应性皮炎和食物过敏患者每年重复进行双盲、安慰剂对照的口服食物挑战，以随访其食物过敏。1年后，75名患者中有19名患者的临床食物过敏症状消失（45名患者中有15名对一种食物过敏，21名对两种食物过敏的患者中有4名）。在121种食物中，有38种不再引起症状反应。2年后，患者接受了第二次再激发; 44例受试患者中有4例丧失了临床食物超敏反应。在20例接受第三次再激发的患者中，没有食物超敏反应丢失。食物过敏的损失率因食物而异; 1年后，对五种主要过敏原（鸡蛋，牛奶，大豆，小麦和花生）的症状性食物过敏损失率为26%，而对其他食物过敏原的损失率为66%。过敏症状的消失不受患者诊断年龄的影响，但牛奶过敏除外，老年患者更有可能失去临床食物超敏反应（p < 0.05）。血清总IgE和皮肤点刺试验对预测症状性食物过敏的消失没有帮助。皮肤试验风团大小没有显著减少，相应于临床食物过敏的丧失。在初始激发期间仅出现皮肤症状的患者最有可能失去症状性食物过敏。
Patients with atopic dermatitis and food hypersensitivity who were adhering to an elimination diet underwent repeat double-blind, placebo-controlled oral food challenges annually for follow-up of their food allergy. After 1 year, 19 of 75 patients lost all signs of clinical food hypersensitivity (15 of 45 patients allergic to one food, and 4 of 21 allergic to two foods). Of the individual foods, 38 of 121 no longer elicited symptomatic responses. After 2 years, patients underwent a second rechallenge; 4 of 44 patients tested lost their clinical food hypersensitivity. In 20 patients undergoing a third rechallenge, no food hypersensitivity was lost. Loss rate of food hypersensitivity varied among foods; after 1 year, there was a 26% loss of symptomatic food allergy to five major allergens (egg, milk, soy, wheat, and peanut) compared with a 66% loss rate to other food allergens. Loss of symptomatic allergy was not affected by the patient''s age of diagnosis, except with milk allergy, for which older patients were more likely to lose clinical food hypersensitivity (p < 0.05). Total serum IgE and prick skin tests were not useful for predicting loss of symptomatic food hypersensitivity. There was no significant decrease in skin test wheal size corresponding to loss of clinical food hypersensitivity. Patients developing only skin symptoms during the initial challenge were most likely to lose symptomatic food hypersensitivity.