制定成人食物蛋白诱发小肠结肠炎综合征诊断评分系统，与中型食物过敏症区分开来。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-02-01 DOI:10.1016/j.anai.2024.09.019

Sho Watanabe MD, PhD , Ayako Sato MD, PhD , Keitaro Shibuya MD , Rina Kusuda DDS , Hiroko Suzuki MD, PhD , Saori Nagashima MD , Tsunehito Yauchi MD , Tatsuki Fukuie MD, PhD , Kiwako Yamamoto-Hanada MD, PhD , Yukihiro Ohya MD, PhD , Ichiro Nomura MD, PhD

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引用次数: 0

摘要

背景：成人食物蛋白诱发的小肠结肠炎综合征（FPIES）最近才被发现，目前国际上还没有该疾病的诊断标准。将成人食物蛋白诱导的小肠结肠炎综合征与直接型食物过敏反应区分开来，并在紧急情况下为每种反应提供特定治疗非常重要，但目前尚未开发出相应的方法：通过与直接型食物过敏（IgE-FA）进行比较，建立成人 FPIES 的诊断评分系统：这项回顾性队列研究以 Gonzalez 等人报告的成人 FPIES 诊断标准为基础，通过电话访问的方式对食物过敏的成人进行研究。我们比较了FPIES和IgE-FA患者的临床特征。通过多变量分析提取了与成人FPIES相关的因素，并根据几率比（OR）建立了诊断评分系统：结果：288 名食物过敏成人中有 48 人（16.7%）被确诊为 FPIES，其中 240 人（83.3%）患有 IgE-FA。海鲜是导致成人 FPIES 的最常见原因（68.8%）。多变量分析发现，发病年龄大于 26 岁、发病次数大于 10 次、潜伏期较长、出冷汗、腹胀和呕吐是成人 FPIES 的相关因素。使用ORs建立的成人FPIES诊断评分系统具有较高的曲线下面积（AUC = .978）、100%的灵敏度和87.0%的特异性：结论：首次建立了临床特征和成人 FPIES 诊断评分系统。该评分系统有助于在治疗与食物有关的急性反应时区分成人 FPIES 和 IgE-FA。

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Formulation of adult food-protein–induced enterocolitis syndrome diagnostic scoring system differentiating from immediate-type food allergy

Background

Adult food-protein–induced enterocolitis syndrome (FPIES) has recently been recognized, and there are no international diagnostic criteria for this disease. Differentiating adult FPIES from immediate-type food allergy reactions and providing specific treatment for each in an emergency are important, but methods have not been developed.

Objective

To develop a diagnostic scoring system for adult FPIES by comparing it with an immediate-type food allergy (IgE-mediated food allergy [IgE-FA]).

Methods

This retrospective cohort study of food-avoidant adults based on diagnostic criteria for adult FPIES was conducted through telephone interviews. We compared the clinical profiles of the patients with FPIES and IgE-FA. Adult FPIES-associated factors were extracted using multivariate analysis, and a diagnostic scoring system was developed based on odds ratios.

Results

A total of 48 (16.7%) of 288 adults with food allergies were diagnosed with FPIES; of these, 240 (83.3%) had IgE-FA. Seafood was the most common cause of FPIES in adults (68.8%). Multivariate analysis identified an age of onset older than 26 years, more than 10 episodes, a longer latency period, cold sweat, abdominal distention, and vomiting as adult FPIES-associated factors. An adult FPIES diagnostic scoring system was developed using odds ratios with a high area under the curve (0.978), 100% sensitivity, and 87.0% specificity.

Conclusion

Clinical profiles and an adult FPIES diagnostic scoring system were developed for the first time. This scoring system can be useful in differentiating adult FPIES and IgE-FA when treating food-related acute reactions.

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.