儿童小麦过敏21例临床特征分析  

Clinical characteristics of 21 children with wheat allergy

作　　者：王晓阳 刘传合[1] 邵明军[1] 沙莉[1] 赵京[1] Wang Xiaoyang;Liu Chuanhe;Shao Mingjun;Sha Li;Zhao Jing(Department of Allergy,Children′s Hospital of Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院变态反应科,北京100020

出　　处：《中华实用儿科临床杂志》2021年第17期1316-1319,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家重点研发计划"精准医学研究"专项(2016YFC0901103);北京市医院管理局重点医学专业发展计划(ZYLX201829)。

摘　　要：目的对儿童小麦过敏的临床特征进行分析和总结,提高对儿童食物过敏的认识和诊断水平。方法对2018年12月至2019年11月在首都儿科研究所附属儿童医院变态反应科就诊的疑似小麦过敏患儿进行病史收集、血清过敏原特异性免疫球蛋白E(IgE)检测、外周血嗜酸性粒细胞检测及新鲜食物皮肤点刺试验。结果共纳入患儿21例。男15例,女6例;年龄(21.5±12.8)个月。患儿分别在摄食小麦制品或接触小麦面粉后出现过敏症状。临床表现以皮肤症状(20/21例,95.2%)最常见,其他依次为呼吸道症状(7/21例,33.3%)、消化道症状(6/21例,28.6%)及神经系统症状(1/21例,4.8%)。11例患儿曾出现严重过敏反应。21例患儿血清小麦特异性IgE检测水平为1.46~100.00 kU/L,当特异性IgE水平在Ⅴ级及以上时,患儿出现严重过敏反应的风险增加(P<0.05)。其中5例患儿行小麦皮肤点刺试验,均呈阳性。患儿外周血嗜酸性粒细胞比例为0.04~0.12。患儿均有其他食物过敏史及家族过敏史。结论儿童小麦过敏发病早,临床表现呈多样性,以皮肤症状为主;血清特异性IgE检测对小麦过敏的诊断及病情评估具有重要价值,高度致敏者易发生严重过敏反应。Objective To analyze and summarize the clinical features of wheat allergy in children,and to increase the awareness and diagnosis of food allergy in children.Methods Children suspected with wheat allergy in the Department of Allergy,Children′s Hospital of Capital Institute of Pediatrics from December 2018 to November 2019 were included.Clinical data were collected,including the demographic profile,serum allergen specific immunoglobulin E(IgE)detection,peripheral eosinophil detection,and skin prick testing.Results A total of 21 cases were included,consisting of 15 males and 6 females,aged(21.5±12.8)months.The children developed allergic symptoms after intake of wheat products or contact with wheat flour.The most common clinical manifestations were cutaneous(20/21 cases,95.2%),followed by respiratory(7/21 cases,33.3%),digestive(6/21 cases,28.6%)and nervous(1/21 cases,4.8%)symptoms.Eleven children had anaphylaxis.Laboratory allergy test showed that the detection level of serum wheat-specific IgE in 21 children was 1.46 to 100.00 kU/L,and when the specific IgE level was in gradeⅤor above,the risk of serious allergic reaction was increased in children(P<0.05).Five of them tested positive in the wheat skin prick test.The peripheral eosinophil ratio in children was 0.04-0.12.All children had a history of other food allergies and family allergies.Conclusions Wheat allergy in children has early onset and diversified clinical manifestations,mainly skin symptoms.Serum specific IgE detection shows an important role in the diagnosis and evaluation of wheat allergy.The highly sensitized individuals are prone to anaphylaxis.

关 键 词：儿童 小麦过敏 临床特征 

分 类 号：R725.9[医药卫生—儿科]