食物依赖运动诱发过敏反应1例并文献复习

Food-dependent exercise-induced anaphylaxis:a case report and literature review

目的:加深临床医师对食物依赖-运动诱发的过敏反应(food-dependent exercise-induced anaphylaxis, FDEIAn)的认识。方法:收集2018年8月10日北京医院1例FDEIAn患者的病例资料,并复习国内46例FDEIAn患者文献资料。根据患者病史、临床表现、治疗及预后资料做回顾性分析。结果:47例患者中,无明确的食物过敏史患者46例,服用阿司匹林患者20例。FDEIAn患者从发病到确诊中位病程为12个月,临床表现涉及皮肤、呼吸、消化道、心血管、神经等多系统。本组患者中,反复发作患者39例(83%),其中曾至少发生过1次过敏性休克患者37例(78.7%),部分患者曾多次反复发作过敏性休克。发生过敏性休克的患者,以肾上腺素和糖皮质激素治疗为主。结论:目前临床医师对FDEIAn识别不足,正确认识该疾病,准确识别该疾病,并做出预警,对临床医师至关重要。

Objective:To further understand food-dependent exercise-induced anaphylaxis (FDEIAn)for the clinicians.Methods: The data of one FDEIAn patient in Beijing Hospital on August 10,2018 were collected,and the literature of 46 FDEIAn patients in China was reviewed.A retrospective analysis was made based on the patient's medical history,clinical manifestations,treatment,and prognosis.Results:Among the 47 patients,46 did not have a clear history of food allergy,and 20 had taken aspirin.The median course of FDEIAn from onset to diagnosis was 12 months.The clinical manifestations involved skin,respiratory system,digestive tract,cardiovascular system,and nervous system,etc.Of the 47 patients,39 (83%)had recurrent episodes,of which 37 (78.7%)had at least one episode of anaphylactie shock,some had multiple episodes of anaphylaetie shock.Patients with anaphylaetic shock are mainly treated with adrenaline and glucocorticoid.Conclusion :At present,clinicians do not recognize FDEIAn adequately.It is very important for clinicians to accurately identify the disease,and make early warning.