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Nutrition clinique et métabolisme
Volume 18, n° 1
pages 20-24 (mars 2004)
Doi : 10.1016/j.nupar.2004.01.007
Received : 7 October 2003 ; 
Prise en charge clinique d'une allergie alimentaire (AA)
Clinical management of food allergy

Stéphane  Guez a * ,  Hervé  Masson b ,  Hassene  Attout a ,  Claire  Seriès a
aUnité des maladies allergiques, service de médecine interne 3.3, hôpital Pellegrin, CHU de Bordeaux, bâtiment PQR, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France 
bCentre d'allergologie Barrière-du-Médoc, 390, boulevard du Président-Wilson, 33000 Bordeaux, France 

*Auteur correspondant.
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L'allergie alimentaire est un diagnostic difficile qui repose sur l'histoire clinique, les tests cutanés et les dosages d'IgE spécifiques. Un test de provocation oral est parfois nécessaire. Le traitement curatif repose sur l'éviction qui ne doit être impérative que pour les 2 à 3 % de patients adultes ou les 6 à 8 % d'enfants réellement allergiques, en raison du risque important de réactions anaphylactiques lors d'une ingestion accidentelle. Les perspectives thérapeutiques (désensibilisation, sérum anti-IgE) et les moyens de prévention (allaitement au sein et retard de la diversification alimentaire) devraient limiter l'augmentation constante de ces allergies et en faciliter la prise en charge surtout pour les allergènes les plus fréquents et les plus puissants (arachide).

Mots clés  : Allergie alimentaire ; Tests cutanés ; IgE spécifiques ; Test de provocation oral ; Éviction.

Abstract

Food allergy is of difficult diagnosis relying on clinical history, skin prick tests and specific IgE antibodies measurements. Therefore, a double blind placebo-controlled oral food challenge is sometimes necessary. The primordial treatment consists in dietetic elimination which is only required for 2% or 3% of adults, and for 6% or 8% of children, who are really allergic because of the risk of anaphylactic reaction after an unintended ingestion. In future, new treatments (immunotherapy, monoclonal antibodies against IgE) and dietary prevention (breast-feeding, delayed introduction of solid foods) should limit the constant increase of these allergies, and facilitated the management, especially for the most frequent and powerful allergens (peanuts).

Mots clés  : Food allergy ; Skin prick test ; Specific IgE ; Double blind oral challenge ; Dietary prevention.




© 2003  Elsevier SAS. All Rights Reserved.

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