Abstract:
A 14-year-old girl presented to our hospital with food-dependent exercise-induced anaphylaxis (FDEIA), possibly caused by rice. Despite experiencing four previous episodes of suspected FDEIA, she did not seek medical attention at her own discretion. On the fifth occurrence of symptoms, the general practitioner suspected FDEIA and referred the patient to our hospital. The only common factor in all five episodes was the consumption of rice, leading to the examination of the patient under suspicion of FDEIA caused by rice. Skin prick test results were positive for bran and polished rice, and exercise after consumption of polished rice resulted in anaphylaxis. Therefore, we diagnosed FDEIA caused by polished rice. Immunoblotting confirmed the presence of immunoglobulin E reacting with 14-16kDa rice bran protein in the patient\'s serum. The immunoblot inhibition test suggested that the rice bran protein to which the patient\'s serum reacted was also present in polished rice and no wash rice. As the patient may experience FDEIA after ingestion of no wash rice or rice flour, she was advised to eliminate these from her diet, treating them similarly to brown rice or polished rice.
摘要:
一名14岁女孩因食物依赖性运动引起的过敏反应(FDEIA)来到我们医院,可能是由大米引起的。尽管之前经历了四次疑似FDEIA事件,她没有自行决定就医。在第五次出现症状时,全科医生怀疑FDEIA,并将患者转介到我们医院。在所有五个事件中,唯一的共同因素是大米的消费,导致对患者进行检查,怀疑由大米引起的FDEIA。麸皮及精米的皮肤点刺试验结果呈阳性,食用精米后的运动会导致过敏反应。因此,我们诊断了由精米引起的FDEIA。免疫印迹证实患者血清中存在与14-16kDa米糠蛋白反应的免疫球蛋白E。免疫印迹抑制试验表明,患者血清反应的米糠蛋白也存在于精米和不洗米中。由于患者在摄入不洗米或米粉后可能会经历FDEIA,她被建议从饮食中消除这些,处理它们类似于糙米或精米。