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在敏感的婴儿中成功引入花生,在家中报告了反应
Dirk H J Verhoeven1, Olga Benjamin-van Aalst2, Ted Klok3
1Department of Pediatrics, Reinier de Graaf Hospital, Delft, the Netherlands; Section of Allergology and Clinical Immunology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.
The journal of allergy and clinical immunology. In practice
|September 5, 2024
概括
大多数婴儿在早期引入花生后报告了对花生的家庭反应,可以安全地食用花生. 在12个月以下的婴儿中,口服食物挑战可以防止误诊并促进耐受性.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 儿科胃肠病学 儿科胃肠病学
- 临床营养学 临床营养学
背景情况:
- 早期引入花生是有效的预防花生过敏.
- 对于婴儿在引入后怀疑出现反应的最佳诊断策略尚不清楚.
研究的目的:
- 评估婴儿在早期引入后在家中对花生产生反应的最佳诊断途径.
- 在这个人群中评估口服食品挑战 (OFC) 的安全性和有效性.
主要方法:
- 在花生NL队列研究中,高风险的婴儿被提前引入花生.
- 一小组 186 个婴儿与家庭反应接受皮肤刺伤测试和OFCs 在8个月的中位年龄.
- 有负OFCs的婴儿在家里被重新引入花生.
主要成果:
- 69%的婴儿在皮肤刺伤测试中表现出敏感性;80%的婴儿有>4毫米的乳头.
- 在163名婴儿中,有120名 (73.6%) 患有轻度至中度家庭反应的婴儿有负面的OFC.
- 在负的OFC后,96%的婴儿长期安全食用花生,81%的婴儿食用3.0g的份量.
结论:
- 据报道,有65%的婴儿在家里对花生产生反应,表现为负的OFCs.
- 对大多数负OFCs的婴儿来说,安全地重新引入和继续食用花生是可能的.
- 挑战12个月以下的婴儿可以防止花生过敏的错误诊断,并促进耐受性诱导.
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