运动诱发严重过敏反应3例

Exercise-induced Anaphylaxis: Three Cases Reports

目的分析运动诱发严重过敏反应（exercise-induced anaphylaxis,EIA）特点,以提高对该病认识。方法回顾性分析2014年1月至2015年8月北京协和医院变态反应科诊治的3例EIA患者的临床资料。结果 3例患者分别为男性1例和女性2例,年龄为25-35岁,均表现为反复荨麻疹。其中2例患者曾出现晕厥,每次发作前均处于运动状态,与进食无关,空腹情况下运动也会发生。过敏原皮试及血清特异性IgE检测均阴性,除外能引起上述症状的其他疾病后,诊断为EIA。通过调整运动习惯和对早期症状的识别,发作次数明显减少,未再出现严重过敏反应。结论 EIA是一少见但威胁生命的疾病,主要依靠详细的病史排除性诊断。通过调整运动习惯可显著减少过敏的发生;对于曾经有致命发作的患者,应随身携带肾上腺素。

Objective To analyze the clinical characteristics of exercise-induced anaphylaxis（ EIA）. Methods The medical records of the three patients with EIA were reviewed retrospectively, who attended Department of Allergy,PUMC Hospital from Jan 2014 to Aug 2015. Results The male female ratio was1 ∶ 2. The diagnoses of EIA were confirmed between age 25 and 35. Frequent recurrences of wheals were shown in all three patients and collapses occurred in two cases. Each episode was induced by exercise,unrelated to taking foods. All the results of specific IgE detection and skin test for suspected food allergens were negative. The diagnoses of EIA should be made on the basis of exclusion of other disorders with similar clinical characteristics. Frequency of attack decreased distinctly,based on the combination of recognition of early symptoms and adjustment of exercise habits. Conclusions EIA is a rare but potentially lifethreatening syndrome. The diagnosis of EIA should be based on a meticulous history and exclusion of other disorders with similar clinical characteristics. Adjustment of exercise habitscan result in decreasing of episodes frequencysignificantly. The EIA patients with history of life-threatening attacks should always carryepinephrine about with themselves.