儿童花粉症并发自报食物过敏的临床特征

Clinical characteristics of self-reported food allergy in children with pollenosis

目的分析儿童花粉症并发自报食物过敏的临床特点及严重过敏反应的危险因素。方法采集2019年1月至2020年10月北京儿童医院过敏反应科门诊诊断“花粉-食物过敏综合征(pollen-food allergy syndrome,PFAS)”或“口腔变态反应综合征(oral allergy syndrome,OAS)”患儿的临床资料,进行回顾性分析。结果共纳入98例PFAS患儿,其中男孩60%(59/98),发病年龄(5.63±3.05)岁。29%(28/98)PFAS发病年龄为0~3岁。98%(97/98)存在夏秋季花粉致敏,85%(83/98)表现为过敏性鼻-结膜炎。共计自报175例次食物过敏反应急性发作,最常见食物依次为桃33.1%、芒果10.9%、西瓜7.4%、苹果5.1%。食物诱发发作最常见临床表现为口周水肿/皮疹/瘙痒,占53%;19%表现为全身皮痒/皮疹,呼吸系统、胃肠道受累分别为25%和6%。30%(29/98)患儿曾发生至少1次严重过敏反应。严重过敏反应组发病年龄明显高于非严重过敏反应组[(6.69±3.26)岁vs.(5.18±2.87)岁,P=0.026]。桃是最常见的诱发严重过敏反应的食物。结论PFAS最常见于夏秋季花粉致敏儿童,婴幼儿不少见。除OAS外,可发生累及全身皮肤、呼吸、消化道多系统的全身反应。年长儿更易发生严重过敏反应。桃是最常见的诱发严重过敏反应的食物。

Objective To characterize the clinical profiles of self-reported food allergy and to analyze the risk factors of anaphylaxis in children with pollenosis.Methods Clinical data of patients were collected and analyzed retrospectively,who were diagnosed as“pollen-food allergy syndrome(PFAS)”or“oral allergy syndrome(OAS)”in Department of Allergy,Beijing Children's Hospital since January,2019 to October,2020.Results Data of 98 patients with PFAS were collected.60%(59/98)of them are boys.The average age during first anaphylaxis attack was(5.63±3.05)year-old.Age of onset was 0-3 year-old among 29%(28/98)of PFAS patients.98%(97/98)of patients were sensitized to weed pollens.85%(83/98)of patients were diagnosed as allergic rhinoconjunctivitis.Totally 175 self-reported food-induced acute reactions were recorded.Common self-reported allergenic food were peach(33.1%),melon(10.9%),watermelon(7.4%),and apple(5.1%).53%of reactions were localized to lips and oral mucosa,while 19%presented general urticaria.Respiratory and gastrointestinal system were involved in 25%and 6%of reactions respectively,while 30%(29/98)patients experienced at least one anaphylaxis.The average onset age of patients with anaphylaxis was significantly older than that of non-anaphylaxis patients[(6.69±3.26)year-old vs.(5.18±2.87)year-old,P=0.026].Peach was the most common allergenic food of anaphylaxis in patients with PFAS.Conclusion PFAS is most common in children with weed pollen allergy and not rare in infants.In addition to OAS,systemic reactions might occur,with the involvement of cutaneous,respiratory and gastrointestinal system.Severe allergic reactions are more likely occurred among elder children.Peach is the most common allergenic food of anaphylaxis.