临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (5): 334-339.doi: 10.12372/jcp.2025.25e0025

• 论著 • 上一篇    下一篇

儿童食物依赖运动诱发性严重过敏反应8例临床分析

周紫蓓, 周薇, 张娟, 李在玲()   

  1. 北京大学第三医院(北京 100096)
  • 收稿日期:2025-01-08 录用日期:2025-03-24 出版日期:2025-05-15 发布日期:2025-05-09
  • 通讯作者: 李在玲 电子信箱:topbj163@sina.com
  • 基金资助:
    国家重点研发计划(2023YFC2706503);北京大学第三医院院内队列建设项目(BYSYDL2022019)

Clinical analysis of eight cases of food-dependent exercise-induced anaphylaxis in children

ZHOU Zibei, ZHOU Wei, ZHANG Juan, LI Zailing()   

  1. Peking University Third Hospital, Beijing 100191, China
  • Received:2025-01-08 Accepted:2025-03-24 Published:2025-05-15 Online:2025-05-09

摘要:

目的 探讨儿童食物依赖运动诱发性严重过敏反应的临床特征及诊疗情况。方法 选择2019年8月至2024年8月于儿科普通病房收治的食物依赖运动诱发性严重过敏反应患儿进行回顾性分析,分析其临床特征和治疗结局。结果 共收治8例食物依赖运动诱发性严重过敏反应患儿,男性2例,女性6例,年龄最小者9岁,年龄最大者14岁,5例有I级亲属过敏史,7例有过敏性疾病个人史,食物类型包括小麦、蔬菜、海鲜、红肉、水果、芝麻,食物与运动间隔时间最长为3小时,运动与首发症状间隔时间为5~30分钟不等。所有患儿最终均有皮肤黏膜表现,呼吸及循环系统方面,6例(75%)最终均累及呼吸及循环系统,1例仅累及呼吸系统,1例仅累及循环系统。治疗方面,1例自行缓解,其余7例均肌注肾上腺素1次,所有患儿均存活。结论 食物依赖运动诱发性严重过敏反应起病急,进展迅速,易累及呼吸系统及循环系统,反复发作性病史及特异性疾病个人史对诊断具有辅助意义。

关键词: 食物依赖运动诱发性严重过敏反应, 食物过敏, 儿童

Abstract:

Objective To investigate the clinical characteristics and management strategies of food-dependent exercise-induced anaphylaxis (FDEIA) in children. Methods A retrospective analysis was conducted on 8 pediatric patients diagnosed with FDEIA between August 2019 and August 2024. Clinical features, treatment outcomes, and atopic histories were reviewed. Results Among the 8 cases (2 males, 6 females; aged 9-14 years), 62.5% had a family history of allergies and 87.5% had personal atopic diseases (most commonly allergic rhinitis and urticaria). Trigger foods included wheat, vegetables, seafood, red meat, fruits, and sesame. The maximum interval between food intake and exercise was 3 hours, with symptom onset occurring 5-30 minutes post-exercise. All patients presented with cutaneous manifestations, while 75% developed combined respiratory-circulatory involvement (hypotension in 50%, syncope in 25%, hypoxemia in 12.5%). Management included intramuscular epinephrine in 87.5% of cases, with full recovery in all patients. Conclusion FDEIA in children is characterized by rapid progression and multi-system involvement. A history of recurrent reactions and atopic comorbidities, combined with total serum IgE elevation (median 65.6-2172 kU/L) and specific IgE positivity (62.5%), aids diagnosis. Early epinephrine administration is critical for favorable outcomes.

Key words: food-dependent exercise-induced anaphylaxis, food allergy, child