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患有FPIES的成年人可能面临延迟诊断
Alexandra Hua1, Ian F Slack2,3, Kelly O'Shea2,3
1Department of Internal Medicine, University of Michigan, Ann Arbor, Mich.
The journal of allergy and clinical immunology. Global
|August 30, 2024
概括
患有食物蛋白诱导性肠球炎综合征 (FPIES) 的成年人经历了显著的诊断延迟,症状发作和诊断之间的中位数为10年. 这种延迟与并发性胃肠道疾病的不足识别和潜在掩盖有关.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 胃肠病学 胃肠病学
- 儿科和成人医学 儿童和成人医学
背景情况:
- 食物蛋白诱导性肠球炎综合征 (FPIES) 在成年人中越来越多地被认为是一种非IgE介导的食物过敏.
- 在成年FPIES病例中,诊断延迟或症状发作和诊断之间的时间尚未得到充分理解.
研究的目的:
- 调查成人FPIES患者的症状发病时的年龄 (ASO) 和诊断时的年龄 (AD) 之间的时间差距 (延迟).
- 评估早期症状发作或并发性胃肠道疾病是否影响这种延迟.
主要方法:
- 在2015-2022年间诊断的成人FPIES患者 (≥18岁) 的回顾性图表审查.
- 收集的数据包括患者人口统计,FPIES反应史和并发性肠道疾病.
- 统计分析以确定延迟的意义及其与发病年和胃肠道疾病的相关性.
主要成果:
- ASO和AD之间的中位延迟时间为10年 (P = .003).
- 在症状发作和潜伏年之间观察到强烈的负相关性 (-0.99) (P < .0001),表明近年来延迟较短.
- 患有先前存在的胃肠道疾病的患者表现出延长潜伏期的趋势,尽管在统计学上并不显著 (P = .124).
结论:
- 成年FPIES存在显著的诊断延迟,这表明有史以来的认可不足.
- 随着时间的推移,延迟的减少可能反映了对成人FPIES的认识增加.
- 并发性胃肠道疾病可能会掩盖FPIES症状,导致成年人诊断延迟.
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