{"title":"一例因食用被书虱污染的燕麦片(Liposcelis bostrychophila)而引发过敏性休克的临床病例。","authors":"Chinatsu Matsumoto, Yuji Kawakami, Osamu Ishibashi, Ikumi Sagara, Masaya Sakaguchi, Yuya Harada, Misaki Takahashi, Shiro Niiyama, Takashi Inui, Hidetsugu Fukuda","doi":"10.1111/1346-8138.17419","DOIUrl":null,"url":null,"abstract":"<p><p>A 52-year-old man presented to our department with generalized erythema, watery stools, and vomiting 30 min after ingesting coconut, oatmeal, and vegetable juice. On arrival, his blood pressure was 120/79 mm Hg, heart rate was 126 beats per min, blood oxygen saturation was 96%, and lip cyanosis was observed. The patient experienced diffuse redness throughout the body and was diagnosed as having severe anaphylaxis. A skin prick test for the leftover coconut, oatmeal, and vegetable juice, which the patient had consumed immediately before the onset of symptoms, showed a positive reaction only to the leftover oatmeal. Direct microscopic examination of the leftover oatmeal revealed numerous insect bodies that appeared as booklice. Using Western blot analysis and quantitative polymerase chain reaction, Lip b 1, a specific antigen for Liposcelis bostrychophila (badonnel), an indoor pest that inhabits various places and feeds on various indoor materials, including stored foods, was detected only in the extract of the leftover oatmeal. Based on these results, we identified an insect body infesting oatmeal, L. bostrychophila. The serum level of L. bostrychophila-specific immunoglobulin antibodies was higher than the cutoff value; therefore, we identified the disease as anaphylaxis caused by accidental ingestion of L. bostrychophila that infested the oatmeal stored in the container. We report the first case of L. bostrychophila-infested oatmeal as an orally ingested allergen in Japan.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A clinical case of anaphylaxis after eating oatmeal contaminated with booklice (Liposcelis bostrychophila).\",\"authors\":\"Chinatsu Matsumoto, Yuji Kawakami, Osamu Ishibashi, Ikumi Sagara, Masaya Sakaguchi, Yuya Harada, Misaki Takahashi, Shiro Niiyama, Takashi Inui, Hidetsugu Fukuda\",\"doi\":\"10.1111/1346-8138.17419\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A 52-year-old man presented to our department with generalized erythema, watery stools, and vomiting 30 min after ingesting coconut, oatmeal, and vegetable juice. On arrival, his blood pressure was 120/79 mm Hg, heart rate was 126 beats per min, blood oxygen saturation was 96%, and lip cyanosis was observed. The patient experienced diffuse redness throughout the body and was diagnosed as having severe anaphylaxis. A skin prick test for the leftover coconut, oatmeal, and vegetable juice, which the patient had consumed immediately before the onset of symptoms, showed a positive reaction only to the leftover oatmeal. Direct microscopic examination of the leftover oatmeal revealed numerous insect bodies that appeared as booklice. Using Western blot analysis and quantitative polymerase chain reaction, Lip b 1, a specific antigen for Liposcelis bostrychophila (badonnel), an indoor pest that inhabits various places and feeds on various indoor materials, including stored foods, was detected only in the extract of the leftover oatmeal. Based on these results, we identified an insect body infesting oatmeal, L. bostrychophila. The serum level of L. bostrychophila-specific immunoglobulin antibodies was higher than the cutoff value; therefore, we identified the disease as anaphylaxis caused by accidental ingestion of L. bostrychophila that infested the oatmeal stored in the container. We report the first case of L. bostrychophila-infested oatmeal as an orally ingested allergen in Japan.</p>\",\"PeriodicalId\":94236,\"journal\":{\"name\":\"The Journal of dermatology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of dermatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1111/1346-8138.17419\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of dermatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1111/1346-8138.17419","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
一名 52 岁的男子在摄入椰子、燕麦片和蔬菜汁 30 分钟后,因全身红斑、水样便和呕吐而到我科就诊。到达时,他的血压为 120/79 mm Hg,心率为每分钟 126 次,血氧饱和度为 96%,口唇发绀。患者全身弥漫性发红,被诊断为严重过敏性休克。对患者发病前食用过的剩椰子、燕麦片和蔬菜汁进行皮肤点刺试验,结果显示只有剩燕麦片呈阳性反应。对吃剩的燕麦片进行直接显微镜检查后,发现有许多昆虫尸体,看起来就像书虱。通过 Western 印迹分析和定量聚合酶链式反应,我们只在剩燕麦片的提取物中检测到了 Lip b 1,这是一种针对 Liposcelis bostrychophila(badonnel)的特异性抗原。根据这些结果,我们确定了一种侵扰燕麦片的昆虫虫体--L. bostrychophila。血清中嗜麦绿蝇特异性免疫球蛋白抗体水平高于临界值,因此,我们确定该病是由于误食了寄生在容器中燕麦片上的嗜麦绿蝇而引起的过敏性休克。我们报告了日本首例因口服燕麦片而感染嗜麦芽蝇过敏原的病例。
A clinical case of anaphylaxis after eating oatmeal contaminated with booklice (Liposcelis bostrychophila).
A 52-year-old man presented to our department with generalized erythema, watery stools, and vomiting 30 min after ingesting coconut, oatmeal, and vegetable juice. On arrival, his blood pressure was 120/79 mm Hg, heart rate was 126 beats per min, blood oxygen saturation was 96%, and lip cyanosis was observed. The patient experienced diffuse redness throughout the body and was diagnosed as having severe anaphylaxis. A skin prick test for the leftover coconut, oatmeal, and vegetable juice, which the patient had consumed immediately before the onset of symptoms, showed a positive reaction only to the leftover oatmeal. Direct microscopic examination of the leftover oatmeal revealed numerous insect bodies that appeared as booklice. Using Western blot analysis and quantitative polymerase chain reaction, Lip b 1, a specific antigen for Liposcelis bostrychophila (badonnel), an indoor pest that inhabits various places and feeds on various indoor materials, including stored foods, was detected only in the extract of the leftover oatmeal. Based on these results, we identified an insect body infesting oatmeal, L. bostrychophila. The serum level of L. bostrychophila-specific immunoglobulin antibodies was higher than the cutoff value; therefore, we identified the disease as anaphylaxis caused by accidental ingestion of L. bostrychophila that infested the oatmeal stored in the container. We report the first case of L. bostrychophila-infested oatmeal as an orally ingested allergen in Japan.