Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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신생아에서 우유 특이 IgE 항체검사 양성을 보인 환아에 대한 분석

Analysis of cow's milk specific IgE positive patients in newborns

  • 이길상 (대구파티마병원 소아과) ;
  • 백남경 (대구파티마병원 소아과) ;
  • 김원덕 (대구파티마병원 소아과)
  • 투고 : 2006.06.20
  • 심사 : 2006.08.22
  • 발행 : 2006.10.15
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초록

목 적 : 신생아에서 우유 알레르기가 의심되는 경우 우유 특이 IgE 항체 측정이 우유 알레르기 진단에 유용한지 알아보고자 하였다. 또한 추적관찰이 가능한 경우 우유 특이 IgE 항체 검사결과와 다른 알레르기 질환의 발현과의 연관성도 알아보고자 하였다. 방 법 : 생후 4주이내의 신생아로 우유 특이 IgE 항체 검사양성을 보인 87명을 대상으로 하였다. 대상 환아는 병력 청취와 진찰 소견에서 우유 알레르기가 의심되어 우유 단백 제거 요법을 시행하여 증세의 호전을 보이고 우유 특이 IgE 항체 검사에서 양성을 보인 환아로 하였다. 또한 이들 87명의 환아 중 추적관찰이 가능했던 40명을 대상으로 우유 특이 IgE 항체 검사결과와 알레르기 질환 발현과의 상관관계를 알아보았고 이들 항체와 알레르기 질환의 가족력과의 상관관계도 알아보았다. 결 과 : 대상 환아의 평균 나이는 $17.2{\pm}5.4$일 이었다. 우유 특이 IgE 항체 검사 결과 milk 양성은 87명이었고 casein 양성은 24명, ${\alpha}$-lactoalbuminn 양성은 38명, ${\beta}$-lactoglobulin 양성은 75명이었다. 6개월 이상의 추적관찰이 가능했던 환아는 40명(45.9%)이었고 부모가 알레르기 질환을 가진 경우는 10명(25%), 환아의 추적 관찰 결과 알레르기 질환을 가진 경우가 15명(37.5%)으로 천식 4명, 아토피 피부염 11명이었다. 추적관찰 결과 신생아기에 casein에 양성을 보인 경우 알레르기 질환의 발현과 연관성이 통계적으로 유의하게 높았다. 그러나 우유 특이 IgE 항체 양성과 알레르기 가족력과의 연관성은 통계적 유의성이 없었다. 결 론 : 신생아에서 IgE 매개성 및 혼합성 우유 알레르기가 의심되는 경우는 우유 제거 식이 요법과 우유 특이 IgE 항체 검사를 시행한다면 진단에 도움이 될 수 있다고 생각된다.

Purpose : The purpose of this study was to research whether measurement of cow's milk specific IgE on the newborn would be helpful in the diagnosis of cow's milk allergy. We tried to find out the relation between cow's milk specific IgE and other allergy diseases by following up cases. Methods : We reviewed clinical features of 87 episodes in infants less than 4 weeks old who were positive in cow's milk specific IgE test. For the study group, history taking, physical examinations, elimination and cow's milk specific IgE tests were carried out. We investigated the connection among cow' milk specific IgE, allergic disease and family history in 40 of 87 patients we could follow up on. Results : The mean age of the study group was $17.2{\pm}5.4days$. The subjects were classified in four groups according into allergens : 87 milk allergy positive patients, 24 casein positive, 38 ${\alpha}$-lactoalbumin positive, and 75 ${\beta}$-lactoglobulin positive. The number of patients who had follow-ups for more than 6 months to was 40(45.9 percent). The patients whose parents had allergic disease numberred 10(25 percent). Fiften patients had allergic diseases, 4 had asthma and 11 atopic dermatitis. According to the follow-up study, there is a significant relation between casein positive patients and allergic disease. But there is no statistical and significant relation between cow's milk specific IgE and a family history of allergic disease. Conclusion : For the newborn babies, elimination tests and cow's milk specific IgE tests can be useful in the diagnosis of IgE-mediated or mixed milk allergies.

키워드

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