口腔过敏综合征。文献综述

A. Bogomolov
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摘要

目的:改进口腔过敏综合征(OAS)的鉴别诊断和治疗方法。材料和方法。本文回顾了文献,并分析了OAS患者的诊断方法和治疗原则。结果和讨论。OAS是一种仅限于口腔黏膜的食物过敏,主要由生水果、蔬菜、调味品和坚果引起。由于采用不同的患者纳入和排除标准,不同研究的OAS患病率数据差异很大。然而,有报告称,其发病率在儿童中从4.7%到20%以上,在成人中从13%到53.8%。在儿童人群中,OAS大多被诊断为青少年,这是可靠的。在病因学上,OAS是由食物过敏原引起的;这些大多是进入病人口咽部的未经加工的水果和生蔬菜。引起OAS的食物过敏原实际上是被胃液灭活的,所以通常在食物被吞下后反应就停止了。结论。OAS是食物过敏的一种亚型,可以在过敏症专家、皮肤科医生和全科医生的实践中发现。接触食物后,患者会出现以下症状:嘴唇和口咽瘙痒;感觉异常;口腔、舌头、上颚和口咽部粘膜血管性水肿;有时声音嘶哑是可能的。OAS的现代治疗包括使用复杂的方法,包括坚持消除饮食、药物治疗和过敏原特异性免疫治疗。抗组胺药、皮质类固醇和肾上腺素(肌肉注射)是药物治疗中最常用的药物。
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Oral allergy syndrome. Literature review
Objective — to improve the methods of differential diagnosis and management of patients with oral allergy syndrome (OAS). Materials and methods. A literature review is presented and diagnostic approaches and principles of management of patients with OAS are analyzed. Results and discussion. OAS is a type of food allergy limited to the oral mucosa and triggered primarily by raw fruits, vegetables, flavorings, and nuts. Data on the prevalence of OAS vary considerably from study to study due to the use of different patient inclusion and exclusion criteria. However, there are reports of its frequency from 4.7 to more than 20 % in children and from 13 to 53.8 % in adults. It is reliably known that among the children’s population, OAS is mostly diagnosed in teenagers. Etiologically, OAS is caused by food allergens; mostly these are unprocessed fruits and raw vegetables that enter the patient’s oropharynx. Food allergens that cause OAS are actually inactivated by the gastric juice, so the reaction usually stops after the food is swallowed. Conclusions. OAS is a subtype of food allergy that can be found in the practice of allergists, dermatologists, general practitioners. After contact with food, patients experience the following symptoms: itching of the lips and oropharynx; paresthesia; angioedema of the mucous membrane of the oral cavity, tongue, palate and oropharynx; sometimes hoarseness is possible. Modern therapy of OAS involves the use of a complex approach, which includes adherence to an elimination diet, pharmacotherapy, and allergen-specific immunotherapy. Antihistamines, corticosteroids, and adrenaline (intramuscular) are most often used in pharmacotherapy.
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