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用安慰剂控制的基因素挑战驳斥了对基因素不耐受性的怀疑
Rebekka Karolin Bent1, Claudia Kugler1, Valentina Faihs1
1Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany.
The journal of allergy and clinical immunology. In practice
|August 30, 2023
概括
基因组胺不耐受 (HIT) 很少被基因组胺挑战证实,许多患者表现出安慰剂反应. 胃肠道症状和较低的二胺氧化酶 (DAO) 可能表明HIT,但缺乏诊断特异性.
科学领域:
- 临床免疫学 临床免疫学
- 胃肠病学 胃肠病学
- 过敏 过敏是一种过敏.
背景情况:
- 组胺不耐受症 (HIT) 经常被诊断为患有不明原因的多症状疾病的患者.
- 由于症状与其他疾病重叠,HIT诊断可能具有挑战性.
研究的目的:
- 为了排除HIT,使用一次盲目安慰剂控制的组胺激素挑战 (SBPCHC).
- 对于具有阳性基因组胺挑战的患者的临床特征进行表征.
- 评估HIT生物标志物的预测价值.
主要方法:
- 一次盲目安慰剂控制的基因组激素挑战 (SBPCHC) 给59名怀疑有HIT的患者.
- 临床数据,血清二胺氧化酶 (DAO) 度和组织胺皮肤测试小麦粉大小在具有积极和负面挑战的患者之间进行了比较.
主要成果:
- 大多数患者 (84.7%) 在SBPCHC的基础上被排除在HIT之外.
- 很大一部分患者 (62.7%) 经历了来自安慰剂的症状.
- 只有6.8%的病例出现了客观的组胺反应,另外8.5%的病例被诊断为可能的HIT.
- 胃肠道症状在HIT患者中更为普遍 (P = .01).
- 血清DAO活性在HIT患者中较低,但高度可变,限制了其诊断效用.
结论:
- 在大多数疑似案件中,SBPCHC有效地反驳了HIT.
- 由于常见的安慰剂反应,安慰剂控制的挑战至关重要.
- 虽然胃肠道症状和降低的DAO水平是潜在的标志物,但它们缺乏足够的特异性来确定HIT诊断.
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