반복적인 두드러기를 주소로 내원한 4세 남아에서 발견된 글루텐 알레르기 1례
A Case of Gluten Allergy in a 4-Year-Old Boy With Recurrent Urticaria
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
저자들은 잦은 두드러기를 호소했던 소아에서 발견한 gluten 알레르기 환아 1례를 경험하였기에 밀 단백분석 및 고찰을 함께 보고하는 바이다.
Abstract
Wheat is the most widely cultivated grain and an important source of food and dietary protein. Wheat proteins are classified based on extraction in different solvents, which are albumin, globulin, prolamin (gliadin) and glutenin. The term ‘gluten’ contains approximately equal amounts of gliadin and glutenin and is the major determinant of the properties of wheat flour conferring cohesiveness and viscoelasticity that allows its dough to be processed into many kinds of food. Gluten is known to be responsible for triggering celiac disease and wheat allergy. Wheat allergy is primarily an IgE-mediated response. Clinical manifestations of wheat allergy are similar to those of other food allergies, with symptoms on the skin, gut and respiratory tract. Recent studies have shown that IgE to gliadin can be an indicator for risk of severe immediate reaction-like anaphylaxis and wheat- dependent, exercise-induced anaphylaxis (WDEIA). However, current in vitro test reagents for the diagnosis of wheat allergy mainly contain water-soluble wheat protein and a small amount of gluten, so there are some limitations to diagnose gluten allergy. Furthermore, there is no acceptable method to measure gluten in food products for preparing effective gluten-free diet. To overcome these limitations and to improve quality of life of wheat allergy sufferers, more work is needed. We report a case of a 4-year-old boy with gluten allergy who presented with urticaria after ingestion kneaded wheat flour with a brief review of the literature.
참고문헌 (17)
- Tatham AS, "Allergens to wheat and related cereals", Clin Exp Allergy, 38, pp.1712~1726 (2008)
- Hischenhuber C, "Review article:safe amounts of gluten for patients with wheat allergy or coeliac disease", Aliment Pharmacol Ther, 23, pp.559~575 (2006)
- Poole JA, "Timing of initial exposure to cereal grains and the risk of wheat allergy", Pediatrics, 117, pp.2175~2182 (2006)
- Ostblom E, "Patterns of quantitative food-specific IgE-antibodies and reported food hypersensitivity in 4-year-old children", Allergy, 63, pp.418~424 (2008)
- Inomata N, "Wheat allergy", Curr Opin Allergy Clin Immunol, 9, pp.238~43 (2009)
- Osborne TB, "The vegitable proteins", pp.154~ (1924), Longmans Publications
- Pastorello EA, "Wheat IgE-mediated food allergy in European patients:alpha-amylase inhibitors,lipid transfer proteins and low-molecular-weight glutenins Allergenic molecules recognized by double-blind,placebo-controlled food challenge", Int Arch Allergy Immunol, 144, pp.10~22 (2007)
- Sicherer SH, "Determinants of systemic manifestations of food allergy", J Allergy Clin Immunol, 106, pp.S251~S257 (2000)
- Palosuo K, "Wheat omega-5 gliadin is a major allergen in children with immediate allergy to ingested wheat", J Allergy Clin Immunol, 108, pp.634~638 (2001)
- Ito K, "IgE antibodies to omega-5 gliadin associate with immediate symptoms on oral wheat challenge in Japanese children", Allergy, 63, pp.1536~1542 (2008)
- Kozel MM, "Chronic urticaria:aetiology,management and current and future treatment options", Drugs, 64, pp.2515~2536 (2004)
- Rasanen L, "Allergy to ingested cereals in atopic children", Allergy, 49, pp.871~876 (1994)
- Varjonen E, "Skin-prick test and RAST responses to cereals in children with atopic dermatitis.Characterization of IgE-binding components in wheat and oats by an immunoblotting method", Clin Exp Allergy, 25, pp.1100~1107 (1995)
- Daengsuwan T, "Ig E antibodies to omega-5 gliadin in children with wheat-induced anaphylaxis", Allergy, 60, pp.506~509 (2005)
- Varjonen E, "Antigliadin IgE--indicator of wheat allergy in atopic dermatitis", Allergy, 55, pp.386~391 (2000)
- Palosuo K, "Update on wheat hypersensitivity", Curr Opin Allergy Clin Immunol, 3, pp.205~209 (2003)
- Pourpak Z, "Wheat allergy:clinical and laboratory findings", Int Arch Allergy Immunol, 133, pp.168~173 (2004)