ラテックスフルーツ症候群 [in Japanese] Latex-fruit syndrome [in Japanese]
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ラテックスに交叉反応するフルーツにより, 咽に痒みを生じたり口唇腫脹や蕁麻疹, 喘息, 重症例ではアナフィラキシーとなる即時型反応をラテックスフルーツ症候群と呼ぶ.これはバナナ, 栗などが, その抗原であるclass I chitinaseのN末端にラテックスの主要抗原であるheveinドメインを持つことによる.当科のラテックスアレルギー54例中28例 (52%) が食物アレルギーを合併しており, うち口腔アレルギー症状を16例 (30%) に認めた.重症例は栗, そば, アボカドで, また, 口腔アレルギー症状はメロン, キウイ, トマトなどで発症していた.ラテックスフルーツ症候群の診断と治療および対策について述べた.
Latex allergy is an IgE-mediated hypersensitiviy from latex-protein allergens that elicit localized contact urticaria, generalized urticaria, conjunctivitis, rhinitis, dyspnea, abdominal symptoms, and even anaphylaxis. Since we experienced the first case of latex allergy in May 1995, a total of 54 cases have been diagnosed by June 2000 at the Out-Patient Clinic of Dermatology, Fujita Health University Hospital. Among them there were 4 cases with anaphylaxis to chestnut. Some fruits such as chestnut and avocado may elicit an immediate type of hypersensitivity, the so-called latex-fruit syndrome which causes itchy oral sensations, local edema, urticaria, or anaphylaxis in latex-allergic patients. These fruits are known to have 32 to 34kD class I chitinases with an N-terminal hevein-domain, which is a major latex allergen included in prohevein as well as in hevein itself. We report here 28 cases with an immediate allergy to foods, mainly fruits, among the 54 latex-allergic patients. Of them, 11 had oral allergic symptoms, 11 had urticaria or constitutional symptoms, including anaphylaxis, 5 had both, and one had only contact urticaria to pumpkin. The causative foods were melon (8 cases), chestnut (6), kiwi (5), banana (4), tomato (4), pineapple (4), buckwheat (3), peach (2), grapefruit (1), and avocado (1). They were divided into two groups: one group included chestnut, avocado, banana, and buckwheat eliciting generalized urticaria or constitutional symptoms, and the other included melon, tomato, and kiwi eliciting only oral allergic symptoms. Anaphylactic patients needed intradermal injection of epinephrine. Prevention against latex sensitization and avoidance from contact with latex or taking related fruits in the sensitized cases are critical to preventt severe allergic conditions from cross reacting fruits.
Stomato-pharyngology 13(3), 311-317, 2001-06-01
Japan Society of Stomato-pharyngology