Revue Francaise d Allergologie最新文献

英文中文

Réintroduction médicamenteuse en allergologie : niveau de confiance et intention de reprise 过敏症药物再引入：信心水平和恢复意图

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-26 DOI: 10.1016/j.reval.2025.104618

C. André, C. Bara, H. Maillard

Introduction

Drug provocation tests are gold standard to confirm or exclude drug allergy. Few studies have specifically investigated patients’ adherence after a negative test and the determinants of their level of trust in the procedure. We aimed to assess both the trust level and the intention to resume the reintroduced drugs in adult patients who had completed a full allergology workup, including a negative drug provocation test.

Methods

This retrospective, cross-sectional, observational, descriptive, and analytical study was conducted in the Allergy unit of Le Mans hospital between April and July 2025. It included 305 drug provocation tests with negative outcomes performed in 230 patients reintroduced between 2017 and 2021.

Results

A total of 64.3% of surveyed patients reported a satisfactory trust level (at least 7/10) in the drug provocation tests for a future resumption of the drug. Among our patients, 35.4 % had already resumed the treatment after reintroduction. The mean trust score was 7.02/10, rising to 8.90/10 among “confident” patients who were willing to resume the drug at home. The reintroduction of a corticosteroid or the presence of polyallergy in the patient's record appeared to be the two main factors of reluctance to resume treatment. Forty-four percent of patients did not recall having a written record of the drug provocation test outcome.

Conclusion

We found post-drug provocation test adherence to be consistent with the literature. A specific focus on patients at high risk of non-adherence could improve their level of treatment resumption. Providing a document confirming the absence of allergy, or adding a “drug tested and reintroduced” note to the patient's digital health record, appear to be promising approaches to counter forgetting and/or misreporting to healthcare professionals managing the patient in the future.

药物激发试验是确认或排除药物过敏的金标准。很少有研究专门调查患者在阴性测试后的依从性以及他们对手术信任程度的决定因素。我们的目的是评估成人患者的信任水平和恢复重新引入药物的意愿，这些患者已经完成了完整的过敏学检查，包括药物激发试验阴性。方法回顾性、横断面、观察性、描述性和分析性研究于2025年4月至7月在勒芒医院过敏科进行。它包括在2017年至2021年期间重新引入的230名患者中进行的305次药物激发试验，结果为阴性。结果64.3%的受访患者对药物激发试验表示满意（至少7/10）。在我们的患者中，35.4%的患者在重新引入后已经恢复治疗。平均信任得分为7.02/10，在“自信”的患者中，愿意在家继续服药的人上升到8.90/10。重新引入皮质类固醇或患者记录中存在多重过敏似乎是不愿恢复治疗的两个主要因素。44%的患者不记得有药物激发试验结果的书面记录。结论用药后激发试验依从性与文献一致。对高危不依从性患者的特别关注可以提高他们的治疗恢复水平。提供一份确认没有过敏的文件，或者在患者的数字健康记录中添加“药物测试和重新引入”的注释，似乎是很有希望的方法，可以防止将来向管理患者的医疗保健专业人员遗忘和/或误报。

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引用次数: 0

Importance of neutrophil-lymphocyte, platelet-lymphocyte ratio in urticaria 中性粒细胞-淋巴细胞、血小板-淋巴细胞比例在荨麻疹中的重要性

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-24 DOI: 10.1016/j.reval.2025.104620

Öner Özdemir

引用次数: 0

Pomegranate-induced refractory anaphylaxis in a toddler 蹒跚学步儿童石榴致难治性过敏反应

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-24 DOI: 10.1016/j.reval.2025.104640

E. Bahadir, B. Can Duran, S. Demirsöz, C. Aytekin, S. Özmen

Pomegranate (Punica granatum) is a fruit rich in antioxidants and commonly consumed worldwide. However, although generally well tolerated, it has rarely been implicated in severe allergic reactions, including anaphylaxis. We report the case of a 3.5-year-old boy with a five-month history of recurrent periorbital angioedema. Careful history revealed pomegranate ingestion preceding one of these episodes. During an oral food challenge with pomegranate, he developed refractory anaphylaxis requiring repeated intramuscular administrations of epinephrine and a continuous epinephrine infusion. This case highlights that, despite being an uncommon food allergen, pomegranate can provoke life- threatening systemic reactions in children. Clinicians should be aware of this potential and consider it in the differential diagnosis of unexplained recurrent angioedema or anaphylaxis.

石榴（Punica granatum）是一种富含抗氧化剂的水果，在世界范围内普遍食用。然而，尽管通常耐受性良好，但很少涉及严重的过敏反应，包括过敏反应。我们报告一个3.5岁的男孩，有5个月的复发性眼眶周围血管性水肿史。仔细的病史显示，在这些发作之前摄入了石榴。在口服石榴食物挑战期间，他出现了难治性过敏反应，需要反复肌肉注射肾上腺素和持续输注肾上腺素。这个案例强调，尽管石榴是一种不常见的食物过敏原，但它可以引起儿童危及生命的全身反应。临床医生应该意识到这种可能性，并在不明原因复发性血管性水肿或过敏反应的鉴别诊断中加以考虑。

引用次数: 0

Response to Dr. Özdemir's Letter 回复Özdemir博士的信

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-24 DOI: 10.1016/j.reval.2025.104619

S. Çevik , U. Altaş , H. Alkaya , A. Sarısaltık , M.Y. Özkars

引用次数: 0

Un cas rare de DRESS syndrome suite à la prise d’acénocoumarol 服用阿西诺库玛罗后的罕见DRESS病例

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-21 DOI: 10.1016/j.reval.2025.104621

A. Lahrougui, M. Aboudourib, L. Bendaoud, S. Amal, O. Hocar

We describe a rare case of DRESS syndrome in a 55-year-old patient who was hospitalized for a cardiac arrhythmia requiring the introduction of acenocoumarol. Three weeks after taking acenocoumarol, the patient developed a generalized morbiliform maculopapular exanthema, surmounted by petechial purpuric lesions on the back, trunk and both lower limbs, associated with facial edema and a fever of 38.1°, with no clinically palpable adenopathies. Biological tests revealed hypeosinophilia and major hepatic cytolysis. According to the REGISCAR (Registry of Severe Cutaneous Adverse Reaction) score at 5 based on the clinical and biological aspects concomitant with drug intake, we retained the diagnosis of DRESS syndrome induced by acenocoumarol intake. The patient was treated with oral and topical cotricotherapy with good clinical and biological improvement.

我们描述了一例罕见的DRESS综合征，患者为55岁，因心律失常住院，需要使用阿塞诺古玛罗。服用阿塞诺古美尔3周后，患者出现全身性病状黄斑丘疹，背部、躯干及双下肢出现点状紫癜性病变，伴有面部水肿，发热38.1°，临床无可触及的腺病。生物学试验显示嗜酸性细胞增多和肝细胞溶解。根据REGISCAR （Registry of Severe Cutaneous Adverse Reaction，严重皮肤不良反应登记）基于药物摄入的临床和生物学方面评分为5分，我们保留了阿塞诺古玛罗摄入引起的DRESS综合征的诊断。患者经口服和局部cotrictherapy治疗，临床和生物学均有良好改善。

引用次数: 0

Sensibilisation aux allergènes polliniques au Maroc : revue des données cliniques publiées de 2000 à 2025 摩洛哥对花粉过敏原的认识：2000 - 2025年发表的临床数据综述

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2026-01-01 Epub Date: 2025-12-21 DOI: 10.1016/j.reval.2025.104639

O. Bouaissa

Pollens are among the main seasonal allergens that trigger allergic respiratory diseases, which represent a real public health challenge worldwide. In Morocco, several studies have been conducted to identify the most involved pollens and the associated respiratory diseases. The review of clinical studies published from 2000 to 2025 confirms the dominance of olive tree and grasses at the top of pollen allergens in Morocco. Other pollens, such as cypress, Parietaria, Artemisia, mimosa, and date palm, have shown significant allergenic power but only locally. This distribution is mainly influenced by floristic richness, climate, and air pollution. Allergic rhinitis is the most common response to all pollens, often accompanied by asthma, followed by conjunctivitis and, in some cases, urticaria. Another range of pollens tested only in Casablanca or revealed through surveys deserves further study. Moreover, other chronic diseases reported in these same surveys require clinical investigations. This will help optimize the management and care of allergic respiratory diseases, particularly those triggered by pollens.

花粉是引发过敏性呼吸道疾病的主要季节性过敏原之一，这是全球范围内真正的公共卫生挑战。在摩洛哥，已经进行了几项研究，以确定最常见的花粉和相关的呼吸系统疾病。对2000年至2025年发表的临床研究的回顾证实，在摩洛哥，橄榄树和草在花粉过敏原中占主导地位。其他花粉，如柏树、梧桐树、青蒿、含羞草和枣椰树，也显示出显著的致敏能力，但仅限于局部。这种分布主要受植物区系丰富度、气候和空气污染的影响。过敏性鼻炎是对所有花粉最常见的反应，通常伴有哮喘，其次是结膜炎，在某些情况下，荨麻疹。另一种仅在卡萨布兰卡测试或通过调查发现的花粉值得进一步研究。此外，在这些调查中报告的其他慢性疾病需要临床调查。这将有助于优化过敏性呼吸道疾病的管理和护理，特别是那些由花粉引发的疾病。

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引用次数: 0

Rectorragies révélatrices d’une allergie alimentaire après une transplantation hépatique : à propos d’un cas 肝脏移植后显示食物过敏的直肠：关于一个病例

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2025-11-01 Epub Date: 2025-08-11 DOI: 10.1016/j.reval.2025.104600

M. Sabib, T. Meskini, S. Ettair

Les allergies alimentaires et hypersensibilités médicamenteuses sont des complications de plus en plus reconnues après transplantation hépatique pédiatrique, avec une prévalence pouvant atteindre 54,3 %. Les allergies alimentaires IgE-médiées se manifestent fréquemment par des signes cutanés et des symptômes gastro-intestinaux tels que douleurs abdominales et diarrhées, tandis que les rectorragies comme présentation initiale restent rares. Nous rapportons le cas original d’une fillette de 12 mois ayant bénéficié d’une transplantation hépatique à l’âge de 9 mois. Elle présentait une atrésie des voies biliaires, initialement traitée par dérivation bilio-digestive sans succès, ayant évolué vers une cirrhose hépatique compliquée d’insuffisance hépatocellulaire, motivant la greffe hépatique et la mise en place d’une immunosuppression par tacrolimus. Elle a présenté deux épisodes de rectorragies de grande abondance. Une évaluation allergologique a confirmé une allergie IgE-médiée à l’œuf et une proctocolite hémorragique associée à une hypersensibilité aux protéines du lait de vache. De plus, une hypersensibilité à l’aspirine a été confirmée par un test de provocation orale. La prise en charge a inclus un régime d’éviction de l’œuf de poule et du lait de vache ainsi qu’un protocole de désensibilisation à l’aspirine, entraînant une amélioration clinique juste après éviction des allergènes. La survenue de ces rectorragies pourrait s’expliquer par des perturbations immunitaires induites par la transplantation hépatique, notamment sous tacrolimus. Cet immunosuppresseur favorise une réponse Th2 avec production accrue d’IgE. Associé aux antibiotiques, il altère le microbiote intestinal et augmente la perméabilité digestive, facilitant la sensibilisation aux allergènes. Ce cas souligne l’importance d’un dépistage allergologique pré-greffe et d’un suivi étroit après transplantation. Une vigilance particulière doit être accordée aux manifestations cliniques atypiques, telles que les rectorragies, afin de ne pas méconnaître une cause allergique et d’optimiser la prise en charge.

食物过敏和药物过敏是儿科肝脏移植后日益被认识到的并发症，患病率高达54.3%。IgE介导的食物过敏通常表现为皮肤体征和胃肠道症状，如腹痛和腹泻，而最初的直肠症状仍然很少。我们报告了一个12个月大的女孩在9个月大时接受肝脏移植的原始病例。它表现为胆道萎缩，最初通过胆道-消化引流治疗，但没有成功，后来发展为复杂的肝细胞衰竭肝硬化，导致肝移植和他克莫司免疫抑制的建立。它举办了两届非常丰富的校长会议。过敏评估证实了IgE介导的鸡蛋过敏和出血性直肠炎与牛奶蛋白过敏相关。此外，口服刺激试验证实了对阿司匹林的过敏反应。治疗包括去除鸡蛋和牛奶的饮食，以及阿司匹林脱敏方案，在去除过敏原后立即产生临床改善。这些直肠疾病的发生可能是由于肝脏移植引起的免疫紊乱，特别是在他克莫司下。这种免疫抑制剂促进Th2反应，增加IgE的产生。与抗生素一起使用，它会改变肠道微生物群，增加消化通透性，促进对过敏原的敏感性。该病例强调了移植前过敏筛查和移植后密切监测的重要性。应特别注意非典型的临床表现，如直肠出血，以便不忽视过敏原因，并优化治疗。

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引用次数: 0

Syndrome d’entérocolite médicamenteuse induite par la ropivacaïne injectée par voie péri-nerveuse : premier cas rapporté 罗哌卡因神经周围注射引起的药物性小肠结肠炎综合征：首次报告病例

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2025-11-01 Epub Date: 2025-08-11 DOI: 10.1016/j.reval.2025.104586

J. Herry , C. Chassery , M. Virtos , D. Sabouraud , P. Beaumont , C. Ponvert

Rare cases of drug-induced enterocolitis syndrome have been reported with drugs administered by the oral (amoxicillin, pantoprazole) and intrarectal (paracetamol) routes. No cases have been described by injectable route. Diagnostic criteria, close to those of food protein-induced enterocolitis syndrome, have been proposed in 2019. We report the case of a 72-year-old patient scheduled for a total knee arthroplasty and recused on two occasions after rapid occurrence of drug-induced enterocolitis after peri-nervous injection of ropivacaine during a nerve block carried out before the surgery. Skin tests performed after the first reaction, according to EEACI/ENDA (European Academy of Allergy and Clinical Immunology) recommendations, were negative. The drug provocation test with ropivacaine was also negative. However, the symptoms recurred at the second anesthesia. A few cases of IgE-mediated hypersensitivity to local anesthetics have been reported, but, to our knowledge, this is the first case of drug-induced enterocolitis syndrome induced by an injectable drug, ropivacaine, recurring although skin tests and provocation test resulted negative.

经口服（阿莫西林，泮托拉唑）和直肠内（扑热息痛）途径给药的药物引起的肠结肠炎综合征的罕见病例已被报道。没有通过注射途径报告的病例。2019年提出了与食物蛋白性小肠结肠炎综合征相似的诊断标准。我们报告一例72岁的患者，原计划行全膝关节置换术，但在术前进行神经阻滞时，在神经周围注射罗哌卡因后，迅速发生药物性小肠结肠炎，两次被拒绝。根据EEACI/ENDA（欧洲过敏和临床免疫学学会）的建议，首次反应后进行的皮肤测试呈阴性。罗哌卡因激发试验也呈阴性。然而，第二次麻醉时症状复发。据报道，有几例ige介导的局部麻醉剂超敏反应，但据我们所知，这是第一例由注射药物罗哌卡因引起的药物性小肠结肠炎综合征，尽管皮肤试验和激发试验结果为阴性，但反复出现。

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引用次数: 0

Measles–mumps–rubella vaccine in children with food allergies 食物过敏儿童的麻疹-腮腺炎-风疹疫苗

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2025-11-01 Epub Date: 2025-10-01 DOI: 10.1016/j.reval.2025.104617

H. Yağmur , Ö. Atay , S. Asilsoy , N. Uzuner

引用次数: 0

Eculizumab-Induced Stevens-Johnson Syndrome: The first pediatric case report in the literature 依曲单抗诱导的史蒂文斯-约翰逊综合征：文献中的第一例儿科病例报告

IF 0.3 4区医学

Revue Francaise d Allergologie

Pub Date : 2025-11-01 Epub Date: 2025-09-25 DOI: 10.1016/j.reval.2025.104602

Ş.İ. Kökcü Karadağ , D. Tekcan , H. Nalçacıoğlu , Ö. Aydoğ , F. Öztürk

Stevens-Johnson Syndrome is a severe mucocutaneous disease that frequently arises in response to medications and is rarely observed. To our knowledge, we report the first pediatric case of SJS induced by Eculizumab, documenting the potential risks associated with this treatment in children and making a significant contribution to the medical literature. A three-year old male patient diagnosed with atypical hemolytic uremic syndrome and treated with Eculizumab exhibited classical symptoms of SJS shortly after receiving his fourth dose. These symptoms included severe oral and labial ulcers, conjunctival hyperemia, and extensive erythematous macular rashes. Initial laboratory tests revealed an abnormal white blood cell count and elevated inflammatory markers, with a subsequent skin biopsy confirming SJS. Immediate initiation of intravenous steroid therapy resulted in substantial improvement in the patient. This report underscores the critical importance of early recognition and management of SJS, particularly in pediatric patients receiving monoclonal antibody therapy. The key lessons highlight the need for healthcare providers to remain vigilant about this rare but potentially fatal adverse effect, and to promptly discontinue treatment and intervene effectively to improve patient outcomes.

史蒂文斯-约翰逊综合征是一种严重的皮肤粘膜疾病，经常出现在药物反应中，很少观察到。据我们所知，我们报告了第一例由Eculizumab引起的儿童SJS病例，记录了与该治疗相关的儿童潜在风险，并对医学文献做出了重大贡献。一名被诊断为非典型溶血性尿毒症综合征的三岁男性患者接受Eculizumab治疗后，在接受第四次剂量后不久出现了典型的SJS症状。这些症状包括严重的口腔和唇溃疡、结膜充血和广泛的红斑性黄斑疹。最初的实验室检查显示白细胞计数异常和炎症标志物升高，随后的皮肤活检证实SJS。立即开始静脉注射类固醇治疗导致患者的病情有了实质性的改善。该报告强调了早期识别和管理SJS的重要性，特别是在接受单克隆抗体治疗的儿科患者中。关键的经验教训强调，卫生保健提供者需要对这种罕见但可能致命的不良反应保持警惕，并及时停止治疗并进行有效干预，以改善患者的预后。

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