蚂蚁毒液:瑞士罕见的过敏反应。

J D Seebach, C Bucher, M Anliker, P Schmid-Grendelmeier, B Wüthrich
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摘要

在瑞士,与其他国家不同的是,与对蜜蜂和黄蜂毒液的过敏相比,对蚂蚁的过敏反应是一种罕见的现象。在这篇报告中,我们提出了一系列的病例报告和对不同类型的蚂蚁过敏的回顾。由于旅行的增加和种群的异质性,我们观察到一些患者对进口火蚁(Solenopsis)的毒液敏感或过敏,这是一种发现于美洲的蚂蚁。此外,对栖息在中欧和北欧的筑丘木蚁(Formica rufa)叮咬的过敏反应已被记录在案。对火蚁的反应可能会危及生命,而对造土墩的木蚁的反应会导致明显的局部反应,其中2例出现呼吸困难和喘息。这些反应可能是由于对蚂蚁毒液的初级致敏或对黄蜂毒液过敏的交叉反应。对潜在蚂蚁毒液过敏患者的评估包括详细的个人病史、皮肤测试和特异性IgE测定。然而,迄今为止,只有火蚁的提取物可用于商业诊断测试。根据我们的观察,我们假设火蚁和土墩木蚁的毒液之间存在交叉反应性,因此,在确定对土墩木蚁的敏感性时,使用火蚁诊断似乎是合适的。对于严重的抗毒液过敏患者,我们建议通过免疫疗法进行脱敏,而对于出现轻微过敏反应的患者,例如在被建土墩的木蚁叮咬后,我们为患者提供紧急药物治疗。由于目前对欧洲蚂蚁过敏的了解有限,进一步的研究是必要的。
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[Ant venoms: a rare cause of allergic reactions in Switzerland].

In Switzerland, unlike other countries, allergic reactions to ants are a rare phenomenon when compared to the well known allergies to bee and wasp venom. In this report we present a series of case reports and a review of the different types of allergy to ants. Due to increased travel and heterogeneity of the population, we have observed several patients with sensitisation or allergy to the venom of imported fire ants (Solenopsis), a species of ant found in the Americas. Furthermore, allergic reactions to bites of the mound-building wood ant (Formica rufa), whose habitat is Central and Northern Europe, have been documented. Whereas reactions to fire ants can be life-threatening, reactions to mound-building wood ants have led to marked local reactions and in 2 cases to dyspnoea and wheezing. These reactions could be due either to primary sensitisation to ant venom or cross-reactivity in the presence of an allergy to wasp venom. Evaluation of patients presenting with a potential ant venom allergy includes a detailed personal history, skin testing and determination of specific IgE. However, to date only extracts from fire ants are commercially available for diagnostic tests. In the light of our observations we assume cross-reactivity between the venoms of fire ants and mound-building wood ants, and it therefore seems appropriate to use fire ant diagnostics in determining sensitisation to mound-building wood ants. In patients with severe fire ant-venom allergy we recommend desensitisation by immunotherapy, whereas in patients presenting with minor allergic reactions, e.g. after bites by mound-building wood ants, we provide the patients with emergency medication. Since current knowledge of ant allergies in Europe is limited, further studies are warranted.

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