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首页> 外文期刊>Clinical and experimental allergy : >Incremental build-up food challenge - A new diagnostic approach to evaluate pseudoallergic reactions in chronic urticaria: A pilot study - Stepwise food challenge in chronic urticaria
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Incremental build-up food challenge - A new diagnostic approach to evaluate pseudoallergic reactions in chronic urticaria: A pilot study - Stepwise food challenge in chronic urticaria

机译：逐步增加食物挑战-评估慢性荨麻疹假性过敏反应的新诊断方法：一项先导研究-慢性荨麻疹的逐步食物挑战

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Background: The remission rate of patients with chronic urticaria (CU) due to elimination diets varies between 31% and 71%. However, the diagnostic value of subsequent traditional oral provocation tests with food additives in capsules remains unsatisfactory. Objectives: A newly incremental build-up food challenge (IBUF) for patients with CU was designed and implemented in an open pilot study. Primary endpoint was the percentage of patients developing urticaria during at least one step of IBUF after an initial complete remission due to a pseudoallergen-free elimination diet. Methods: In total, 153 patients with CU were submitted for 5 weeks to a pseudoallergen-free diet. All patients with remission were included to the 6-week IBUF protocol, containing pseudoallergen-rich foods in a systematic and additive manner. The recurrence and severity of CU was evaluated by urticaria score. Subjective disturbance and quality of life were evaluated by patients' diary, visual analogue scale and quality of life questionnaire (CU-Q 2oL). Subsequently, patients were followed up for 3-24 months after IBUF by a telephone interview. Results: A total of 104 patients completed the pseudoallergen-free diet, whereby 51% reported partial, 17% complete and 32% no remission due to the diet. All diet responders showed a decrease in subjective impairment, urticaria and quality of life score (P0.001 each). Eighty-six percent (12/14) of the patients reaching complete remission, showed a recurrence of urticaria symptoms during the IBUF protocol. Fifty-eight percent (7/12) of these patients still remained free of symptoms due to avoidance of IBUF-identified foods at telephone follow-up. In patients with partial remission to pseudoallergen-free diet, however, IBUF did not provide information about the cause of urticaria symptoms. Conclusions: The newly developed IBUF protocol seemed to be a promising method for identifying individually incompatible foods in some CU patients. IBUF should be verified by randomized controlled trials to gain additional evidence for its diagnostic value.
机译：背景：由于消除饮食而导致的慢性荨麻疹（CU）患者的缓解率介于31％和71％之间。然而，随后在胶囊中使用食品添加剂进行的传统口服刺激试验的诊断价值仍然不能令人满意。目的：在一项开放的先导研究中设计并实施了一种新的针对CU患者的累积食物挑战（IBUF）。主要终点是因无假性过敏原消除饮食而在首次完全缓解后IBUFF至少一步出现荨麻疹的患者百分比。方法：总共153例CU患者接受了5周的无拟过敏原饮食治疗。所有缓解的患者均被纳入6周的IBUF方案中，其中以系统和累加的方式含有富含假变应原的食物。通过荨麻疹评分评估CU的复发和严重程度。通过患者的日记，视觉模拟量表和生活质量问卷（CU-Q 2oL）评估主观障碍和生活质量。随后，在接受IBUF治疗后，通过电话采访对患者进行了3-24个月的随访。结果：总共104例患者完成了无拟变应原饮食，其中51％的患者报告了部分，17％的完全饮食和32％的饮食没有缓解。所有饮食反应者均表现出主观障碍，荨麻疹和生活质量得分的降低（每个P <0.001）。达到完全缓解的患者中有百分之八十六（12/14）在IBUF方案期间显示荨麻疹症状复发。由于在电话随访中避免使用IBUF识别的食物，这些患者中有58％（7/12）仍然没有症状。但是，在部分缓解无假性过敏饮食的患者中，IBUF并未提供有关荨麻疹症状原因的信息。结论：新开发的IBUF方案似乎是鉴别某些CU患者中个别不相容食品的有前途的方法。应该通过随机对照试验对IBUF进行验证，以获取其诊断价值的更多证据。

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