临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (5): 360-365.doi: 10.12372/jcp.2023.22e1639

• 呼吸系统疾病专栏 • 上一篇    下一篇

儿童荞麦过敏23例临床特征分析

杜宇阳, 王晓阳, 邵明军, 刘传合()   

  1. 首都儿科研究所附属儿童医院变态反应科(北京 100020)
  • 收稿日期:2022-12-06 出版日期:2023-05-15 发布日期:2023-05-10
  • 通讯作者: 刘传合 E-mail:liuchcip@126.com
  • 基金资助:
    北京市医院管理局重点医学专业发展计划(ZYLX201829)

Summary of clinical characteristics of 23 children with buckwheat allergy

DU Yuyang, WANG Xiaoyang, SHAO Mingjun, LIU Chuanhe()   

  1. Department of Allergy, Children’s Hospital of Capital Institute of Pediatrics, Beijing 100020, China
  • Received:2022-12-06 Online:2023-05-15 Published:2023-05-10
  • Contact: LIU Chuanhe E-mail:liuchcip@126.com

摘要:

目的 分析和总结儿童荞麦过敏的临床特征,以提高对儿童荞麦过敏的认知和诊治水平。方法 回顾性分析2019年7月—2022年4月在首都儿科研究所附属儿童医院变态反应门诊就诊的荞麦过敏患儿的病史资料,皮肤点刺试验(SPT),血清过敏原特异性IgE检测和外周血嗜酸性粒细胞检测结果。结果 纳入荞麦过敏患儿23例,男14例、女9例,年龄7.8(5.5~10.0)岁。患儿在进食荞麦类食物、皮肤接触荞麦或吸入荞麦面粉后出现过敏症状;16例次在暴露于荞麦过敏原10分钟内出现症状,22例次在10~30分钟出现,6例次在30分钟~2小时出现。临床表现以皮肤症状(21例次,91.3%)最常见,其次为呼吸道症状(15例次,65.2%)、消化道症状(5例次,21.7%)及神经系统症状(1例次,4.3%)。16例患儿曾出现严重过敏反应。21例患儿行荞麦新鲜食物SPT,结果均为阳性,不同严重程度过敏患儿之间荞麦SPT反应程度分布差异有统计学意义(P<0.01),严重过敏反应患儿SPT“++++”发生的比例较高。23例患儿血清总IgE为120~1 489 kU/L。所有患儿有过敏性鼻炎史、湿疹史和过敏性疾病家族史,18例患儿有支气管哮喘史,22例患儿有荞麦壳枕头接触史。结论 荞麦过敏发病多见于学龄期儿童,临床表现具有多样性,严重过敏反应发生率高,使用荞麦壳枕头可能是荞麦致敏的重要途径。SPT对荞麦过敏的诊断及病情评估有重要价值。

关键词: 荞麦过敏, 临床特征, 儿童

Abstract:

Objective To analyze and summarize the clinical manifestation of buckwheat allergy in children in order to increase the awareness and diagnosis of buckwheat allergy in children. Methods Children with buckwheat allergy were enrolled from outpatients in the Department of Allergy, Children’s Hospital of Capital Institute of Pediatrics during July 2019 through April 2022. Clinical data was collected, including skin prick test (SPT), serum allergen specific immunoglobin E(IgE) and peripheral eosinophil detection. Results A total of 23 cases (14 males and 9 females) were enrolled, with a median age of 7.8 (5.5-10) years. The children developed allergic symptoms after intake of buckwheat products, skin exposure of buckwheat or inhalation of buckwheat flour. Allergic symptoms occurred within 10 minutes in sixteen cases, within 10 minutes to 30 minutes in twenty-two cases, and within 30 minutes to 2 hours in six cases after exposure to buckwheat allergen. The most common clinical manifestations were skin symptom (21/23 cases, 91.3%), followed by respiratory symptom (15/23 cases, 65.2%), digestive symptom (5/23 cases, 21.7%) and neurological symptom (1/21 cases, 4.3%). 16 cases had severe anaphylaxis. 21 cases were tested positive in buckwheat SPT, and the risk of anaphylaxis was increased when the SPT level was “++++” (P<0.01). The detection level of serum total IgE in 23 cases was 120 to 1489 kU/L. All the cases had a history of allergic rhinitis, eczema and family allergies. 18 of them have diagnosed with bronchial asthma. 22 of them had a history of using buckwheat husk pillows. Conclusions Buckwheat allergy in children has lately onset in school-aged children and adolescent, with varied clinical manifestations and high rate of anaphylaxis. Buckwheat husk pillows may be an important way for buckwheat sensitization. Skin prick test is of great value in the diagnosis and evaluation of buckwheat allergy.

Key words: buckwheat allergy, clinical characteristic, child