Fatal food-induced anaphylaxis.
Fatal food-induced anaphylaxis.
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DOI：
10.1001/jama.1988.03410100140041
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发表时间：
1988-09
期刊：
影响因子：
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通讯作者：
J. Yunginger;K. G. Sweeney;W. Sturner;Leigh A. Giannandrea;J. D. Teigland;Michael Bray;Peter A. Benson;James A. York;L. Biedrzycki;D. Squillace;R. Helm
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文献类型：
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作者：
J. Yunginger;K. G. Sweeney;W. Sturner;Leigh A. Giannandrea;J. D. Teigland;Michael Bray;Peter A. Benson;James A. York;L. Biedrzycki;D. Squillace;R. Helm
食物诱发的致命性过敏反应鲜有报道。在16个月内，我们确诊了7例此类病例，涉及5名男性和2名女性，年龄在11岁到43岁之间。所有患者都有特应性体质，在摄入相关食物后曾多次发生过敏反应（花生4例；山核桃1例；螃蟹1例；鱼1例）。其中6例是在离家外出时摄入了致敏食物。导致个体反应严重程度的因素包括：否认症状、同时饮酒、仅依赖口服抗组胺药治疗症状，以及因同时患有哮喘而长期使用糖皮质激素治疗导致的肾上腺抑制。在所有病例中，症状出现后均未立即使用肾上腺素。有6名患者提供了死前或死后的血清样本；在每一病例中都检测到针对相关食物的IgE抗体水平升高。对食物敏感的人在出现全身反应的第一迹象时必须立即自行使用肾上腺素。急救人员应了解环甲膜切开术是一种挽救生命的操作。
Fatal food-induced anaphylaxis is rarely reported. In 16 months, we identified seven such cases involving five males and two females, aged 11 to 43 years. All victims were atopic with multiple prior anaphylactic episodes after ingestion of the incriminated food (peanut, four; pecan, one; crab, one; fish, one). In six cases the allergenic food was ingested away from home. Factors contributing to the severity of individual reactions included denial of symptoms, concomitant intake of alcohol, reliance on oral antihistamines alone to treat symptoms, and adrenal suppression by chronic glucocorticoid therapy for coexisting asthma. In no case was epinephrine administered immediately after onset of symptoms. Premortem or postmortem serum samples were available from six victims; in each case elevated levels of IgE antibodies to the incriminated food were demonstrated. Food-sensitive individuals must self-administer epinephrine promptly at the first sign of systemic reaction. Emergency care providers should be aware of cricothyrotomy as a life-saving procedure.