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当院における鶏卵アレルギーの 外来減感作療法の経過

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当院における鶏卵アレルギーの 外来減感作療法の経過 Powered By Docstoc
					                  Handout
 Efficacy of slow oral immunotherapy
         for cow’s milk allergy

Kiyotake Ogura1), Takanori Imai1), Motohiro Ebisawa2)

1)Sagamihara National Hospital, Department of Pediatrics
2)Sagamihara National Hospital, Clinical Research Center
for Allergy and Rheumatology, Japan
                 Reports of
       Oral Immunotherapy for cow's milk
                  Patriarca   Meflio   Staden    Longo   Skripak    Pajno

     Year           2003      2004      2007     2008     2008      2010

   Country          Italy     Italy    Germany   Italy    USA        Italy

                    3-55y     5-10y    6m-12y    5-17y   6-17y      4-12y
   Subjects
                    n=29      n=21      n=14     n=30    n=12       n=15

Desensitization
      or            79%       38%       48%      36%      17%        67%
  Tolerance
                                                                     Ann
                   Aliment
                                                                    Allergy
  Reference       Pharmacol Allergy     JACI     JACI     JACI
                                                                    Asthma
                    Ther.
                                                                   Immunol.
    Slow Oral Immunotherapy (sOIT)
in Sagamihara National Hospital(JPN)
                 Cow's
           Egg           Wheat
                  milk
  2009     6       12      3
  2010     28      28     26
  2011     15      12     11
  total    49      52     39      141
                         until Nov.1.2011
                 sOIT protocol
           [out-patient department ]
       Emergency medications & telephone call (24hr)
Exa      Anti-histamine
mina                       Processed foods
tion

                          Maintenance phase
                             >3 months*

                Build-       Cow's milk
                 up          200ml/day
                phase

                    *:no symptom or only mild symptoms
Grading of Symptoms (used by parents at home)
              Grade                  1 (Mild)             2 (Moderate)            3 (Severe)
                  Urticaria,
                                 Localized or Partial       Generalized                 -
                  Pruritus
   Skin
                      Itching           Weak                  Strong                    -

                   Swollen           Eyelid, Lip               Face                     -
 Mucosal                          Pruritus of throat
  Tissue         Sensation of                               Difficulty of
                                   or oral cavity,                                Hoarseness
                  discomfort                                Swallowing
                                 Tightness of throat
                 Abdominal
  Gastro-                               Mild                 Moderate                Severe
                   Pain
 intestinal
   Tract          Vomiting,            <1 time                                      >3 times
                                                              2 times
                  Diarrhea           (or Nausea)                                (or Continuous)
                                 Nasal congestion,
                       Nose                                       -                     -
                                Sneezing, Rhinorrhea
Respiratory
   Tract                                                                        "barky" cough,
                      Cough,                                Continuous
                                       Cough                                  Wheezing, Dyspnea,
                      Wheeze                                 coughing
                                                                                   Cyanosis
                   Cardio-
                                          -                       -               Hypotension
                  vascular
 Systemic
 Reaction                                                                           Loss of
                                     Change in          Fragile, Feeling of
                 Neurological                                                   consciousness,
                                    activity level       "pending doom"
                                                                                 Incontinence
                                                Reformed (H. Sampson:Pediatrics.2003; 111; 1601-8.)

				
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posted:7/28/2013
language:English
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