계란 알레르기가 있는 아토피피부염에서 난백 특이 IgE 항체의 추적 검사 및 계란 알레르기 지속에 대한 위험인자 분석
Study on Persistence of Egg Allergy and Its Risk Factors inInfants and Young Children with Atopic Dermatitis
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목 적 : 아토피피부염 환아의 약 30-40%에서 식품알레르기를 가지고 있으며 난백은 가장 흔한 알레르겐 중의 하나이다. 그러나 난백 알레르기의 자연경과에 관해서는 많이 보고되어 있지 않다. 본 연구에서는 계란 알레르기가 있는 아토피피부염 환아를 대상으로 난백 특이 IgE 항체 농도를 추적 관찰함으로써 계란 알레르기의 자연경과를 관찰하고 첫 내원 당시의 여러 임상적 특징들을 비교함으로써 자연경과와 관련된 위험인자들을 알아보는 것을 목적으로 하였다. 방 법 : 1세 미만의 아토피피부염 환아 중 계란 알레르기가 있으면서 CAP-FEIA를 이용하여 난백 특이 IgE 항체 검사를 두 번 이상 추적 검사한 125명을 대상으로 하였다. 계란 알레르기의 진단은 난백 특이 IgE 항체 농도가 2 U/mL 이상인 경우로 하였다. 난백 특이 IgE 항체 검사를 추적 검사하여 계란 알레르기가 지속된 군(지속성군, persistent group)과 지속되지 않은 군(비지속성군, non-persistent group)으로 분류하였다. 중앙값 15개월간 추적 관찰하였고 계란 알레르기의 지속 여부를 예측할 수 있는 위험인자를 알아보기 위해 두 군 간에 첫 내원시 난백 특이 IgE 항체 농도, 다른 식품 알레르겐에의 감작, 알레르기 질환의 가족력, 모유수유 여부 등을 비교하였다.
Abstract
Purpose : We attempted to observe the natural course of egg allergy and to investigate the risk factors predicting the likelihood of persistence of egg allergy in infants and young children with atopic dermatitis. Methods : A total of 125 infants with atopic dermatitis and egg allergy were enrolled in this study. Egg allergy was defined when the serum egg white-specific IgE was equal or greater than 2 U/mL by CAP-FEIA.(Pharmacia, Uppsala, Sweden) After follow-up evaluation of serum egg white-specific IgE, they were classified into two groups: “persistent” group(egg white- specific IgE ≥2 U/mL in children younger than 2 years and ≥7 U/mL in those older than 2 years) and “non-persistent” group. Median follow-up duration was 15 months. Specific IgE levels at first visit, family histories of allergic diseases, histories of breast milk feeding and the presence of sensitization to multiple food allergens were compared between the two group. Results : The numbers of the “persistent” group and the “non-persistent” group were 75(60%) and 50(40%), respectively. The “persistent” group had higher egg white-specific IgE levels at first visit, more sensitization to multiple food allergens, and more breast-feeding than the non-persistent group.(P<0.05) Family histories of allergic diseases were not significantly different between the two groups.(P>0.05) Conclusion : Sixty percent of infants with atopic dermatitis and egg allergies showed persistent egg allergies during the median follow-up of 15 months. Infants with higher egg white-specific IgE level and sensitization to multiple food allergens at the initial evaluation are likely to develop persistent egg allergies.
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