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Title 鶏卵による食物蛋白誘発胃腸炎 (Food protein-induced enterocolitis syndrome) について
Subtitle 総説
Authors 明石真幸, 冠城祥子
Authors (kana)
Organization 慶應義塾大学医学部小児科学教室
Journal 日本小児アレルギー学会誌
Volume 37
Number 2
Page 156-162
Year/Month 2023 /
Article 報告
Publisher 日本小児アレルギー学会
Abstract 抄録: 食物蛋白誘発胃腸炎(Food protein-induced enterocolitis syndrome: FPIES)は非IgE依存性食物アレルギーの一病型であり, 原因食物を摂取した1〜4時間後に皮膚症状や呼吸器症状などのIgE依存性反応を伴わない繰り返す嘔吐で特徴づけられている. 2017年の国際コンセンサスガイドライン公開により, 世界各国でFPIESに関する報告が増えている. 海外におけるFPIESの原因食品は, 牛乳・米・魚が多く, 鶏卵がそれに続いている. 一方, 日本ではこの数年で鶏卵, 特に卵黄によるFPIESの患者が急激に増加しており, 現在では原因食品として最も頻度が高い. このため, 鶏卵FPIESの発症年齢, 予後などの疫学面では日本を中心に解明が進んでいるが, 原因抗原・感作経路・嘔吐の機序・免疫学的機序については不明な点が多い. 診断の補助となる検査, 安全で信頼性の高い食物経口負荷試験や長期管理の方法も確立されていない. 今後これらが明らかにされることで, 急増する鶏卵FPIES患者数に歯止めがかかることが期待される.
Practice 臨床医学：内科系
Keywords 食物蛋白誘発胃腸炎, 鶏卵, 抗原, 卵黄, antigen, egg yolk, food protein-induced enterocolitis syndrome, hen's egg

English

Title Food protein-induced enterocolitis syndrome with hen's egg
Subtitle
Authors Masayuki Akashi, Sachiko Kaburagi
Authors (kana)
Organization Department of Pediatrics, Keio University School of Medicine
Journal The Japanese Journal of Pediatric Allergy and Clinical Immunology
Volume 37
Number 2
Page 156-162
Year/Month 2023 /
Article Report
Publisher Japanese Society of Pediatric Allergy and Clinical Immunology
Abstract Summary: Food protein-induced enterocolitis syndrome (FPIES) is a type of non-IgE-mediated food allergy that can be characterized by repeated vomiting not accompanied by IgE-mediated reactions, such as skin or respiratory symptoms, within 1 - 4 hours from the time of ingestion of the causative food product. Since the publication of the international consensus guidelines in 2017, reports on FPIES have increasingly been published by countries across the world. In most countries, the most frequent causative foods that cause FPIES include cow's milk, rice, fish, as well as hen's egg. In Japan, the incidence of FPIES caused by hen's egg, especially egg yolk, has been rapidly increasing since the last few years. Consequently, Japan has been leading the research on hen's egg-induced FPIES in terms of its epidemiological factors, such as age of onset and prognosis. However, much remains unknown about the causative antigens, route of sensitization, and vomiting and immunological mechanism. In addition, no established protocols are available for its diagnostic testing, safe and reliable oral food challenges, and long-term management. We hope to curb the increase in number of patients experiencing hen's egg-induced FPIES by clarifying these points in the future.
Practice Clinical internal medicine
Keywords antigen, egg yolk, food protein-induced enterocolitis syndrome, hen's egg
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