Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (2): 159-162.doi: 10.24920/004208

• 病例报告 • 上一篇    

度普利尤单抗治疗食物依赖运动诱发严重过敏反应

朱丽萍,汤蕊,王青,李宏*()   

  1. 中国医学科学院 北京协和医学院 北京协和医院变态(过敏)反应科,过敏性疾病精准诊疗研究北京市重点实验室,国家免疫性疾病临床医学研究中心,北京100730,中国
  • 收稿日期:2023-01-28 接受日期:2023-04-24 出版日期:2023-06-30 发布日期:2023-05-18

Dupilumab for Treatment of Food-Dependent, Exercise-Induced Anaphylaxis: Report of One Case

Li-Ping Zhu,Rui Tang,Qing Wang,Hong Li*()   

  1. Allergy Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2023-01-28 Accepted:2023-04-24 Published:2023-06-30 Online:2023-05-18
  • Contact: *Hong Li, E-mail: lihong@pumch.cn

摘要:

食物依赖运动诱发严重过敏反应(food-dependent, exercise-induced anaphylaxis,FDEIA)是一种潜在可威胁患者生命的过敏性疾病,常在进食可疑致敏食物数小时内运动时发作。该病极罕见,患病率约为0.02%,目前尚无预防方法。现报告一例度普利尤单抗治疗11岁FDEIA患儿。该患儿在就诊前2年内发生了10余次不明原因的严重过敏反应,常规治疗后症状未获控制。后在我科行7次度普利尤单抗皮下注射治疗,为期33周。在第7次治疗时被诊断为菌菇引发的FDEIA。度普利尤单抗治疗期间,患儿每月至少有2次在进食蘑菇数小时内进行运动,但未再发严重过敏反应。目前尚未见报告阐明度普利尤单抗治疗食物诱导的IgE型严重过敏反应的临床意义,尤其是对于FDEIA这种罕见疾病。因此,本病例或可为儿童严重过敏反应症状的控制和改善提供新的治疗思路。

关键词: 食物依赖运动诱发严重过敏反应, 食物过敏, 蘑菇过敏, 度普利尤单抗

Abstract:

Food-dependent, exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening disorder that often occurs with exercise, and patients typically have eaten a specific food within hours before disease onset. This disease is exceedingly rare, with a prevalence of 0.02%. No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly. Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years. As the anaphylactic symptoms had not been controlled after traditional treatments, the patient was given subcutaneous injection of dupilumab seven times within 33 weeks. During dupilumab treatments, the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis. Thus, Dupilumab may improve the allergic reactions in FDEIA patients.

Key words: food-dependent, exercise-induced anaphylaxis, anaphylaxis treatment, food allergy, mushroom allergy, dupilumab

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