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소아 식품알레르기의 진단과 치료

Diagnosis and Treatment of Food Allergy in Children

김우경
대한 소아알레르기 호흡기학회 (The Korean Academy Of Pediatric Allergy And Respiratory Disease)|2006.12|Allergy Asthma & Respiratory Disease (알레르기 천식 호흡기질환)|제16권 제4호|pp. 274-283

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참고문헌

주제분류소아과학

초록

식품알레르기는 대부분의 사람들에게 무해한 음식에 대해 비정상적인 면역반응이 일어나는 것이다. 비록 식품알레르기에 대한 연구가 상당히 진행되었지만 다른 알레르기 질환과 같이 아직도 이 질환의 기전에 대해서 모르는 사실들이 많다. 그 이유로는 식품알레르기는 유전학적인 요인과 환경적인 요인이 복합된 질환이기 때문이다. 여기서는 식품알레르기 진단에 도움을 드리고자 식품알레르기를 의심해볼 수 있는 증상을 나누어 기술하였으며, 이를 토대로 알레르기 검사를 시행하여 불필요한 제한 식이, 특히 성장기에 있는 소아에서의 치료에 도움이 될 것이다.

Abstract

Food allergy is a common allergic manifestation in early childhood. However, some medical practitioners remain sceptical about the role of food allergies in a number of clinical syndromes, such as atopic dermatitis, colic and gastrooesophageal reflux in infancy, despite increasing evidences that food allergy can contribute to these conditions. Symptoms usually begin in the first 2 years of life, often after the first exposure to the known food. Diagnosis is made using medical history and can usually be detected by skin prick testing (SPT) or measuring food-specific serum IgE antibody levels. But to obtain final confirmation a double blind controlled food challenge (DBPCFC) must be performed. Delayed-onset reactions (occurring within several hours to days after ingestion) are often difficult to diagnose. The patients usually show negative SPT, so elimination or challenge protocols are required to make a definitive diagnosis. These forms of food allergy are not usually associated with anaphylaxis. Prevention and treatment are based on the avoidance of the culprit food. Children often develop tolerance to cows milk, egg, soy and wheat by school age, whereas allergies to nuts and shellfish are more likely to be lifelong. This article will help general practitioners and other clinicians understand the principles of diagnosis and management of food allergy in childhood, and suggests when to refer patients to specialist.

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