移植可修复中风损坏的老鼠大脑

牛奶过敏——是被过度诊断了吗?

A new review published in the journal JAMA Pediatrics in April 2020 raises the concern that there may be a significant overdiagnosis of cow's milk allergy in babies and young children, stemming from the use of current medical recommendations.

2020年4月发表在《美国医学会杂志: 儿科学》杂志上的一篇新综述提出了这样一种担忧:由于使用了当前的医学建议，婴儿和幼儿对牛奶过敏可能存在严重的过度诊断。

The study was carried out by researchers at the Imperial College London and Sechenov University in Moscow. They examined official guidelines put out by nine different organizations to diagnose cow's milk allergy, between 2012 and 2109. These recommendations came from several countries, mostly in Europe.

这项研究是由伦敦帝国理工学院和莫斯科谢奇诺夫大学的研究人员进行的。他们研究了9个不同组织，在2012年至2109年间发布的诊断牛奶过敏的官方指南。这些建议来自几个国家，大部分是欧洲国家。

What is milk allergy?

什么是牛奶过敏?

Milk allergy is most typically diagnosed in children less than two years old. Researchers have traditionally classified it as IgE-mediated and non-IgE mediated. In the former type, the allergic reaction involves the antibody component called immunoglobulin E, which causes symptoms like vomiting, raised red rashes on the skin, and very rarely, a life-threatening reaction termed anaphylaxis that causes breathing problems. It can be reproducibly diagnosed by a skin test.

牛奶过敏最典型的诊断是两岁以下的儿童。传统上，研究人员将其分为ige介导型和非ige介导型。 研究人员传统上将其分为 IgE-mediated 和 non-IgE mediated。 在前一种类型中，过敏反应包括一种叫做免疫球蛋白E 的抗体成分，这种抗体会引起呕吐、皮肤出现红疹等症状，而且极少见的情况下，这种过敏反应被称为导致呼吸问题的危及生命的反应。 它可以通过皮肤试验进行重复性诊断。

The non-IgE type is different. While the symptoms may include vomiting, loose stools, and excessive crying, these are highly non-specific and are, moreover, far too frequently complained of in healthy young babies to be considered a pointer to any pathological condition.

非ige型则不同。虽然这些症状可能包括呕吐、大便不清和过度哭泣，但这些都是非特异性的，而且在健康的幼儿中经常被抱怨，以至于不能被认为是任何病理状态的指针。

How many children have cow's milk allergy?

有多少儿童对牛奶过敏?

The team of researchers discovered that symptoms like excessive crying, milk regurgitation, and loose stools were often listed as symptoms of cow's milk allergy by many of the guidelines. On the other hand, these symptoms are often commonly found in healthy babies as well.

研究小组发现，过度哭泣、牛奶反流、大便稀少等症状常常被许多指南列为牛奶过敏症状。 另一方面，这些症状也常见于健康的婴儿。

Using earlier data, from a recent birth cohort study in Europe, including more than 12,000 babies in 9 different countries, only about 1% were diagnosed with cow's milk allergy. However, in some other studies, the percentage of families who thought their children had such an allergy was as high as 14%. Also, between 2000 and 2018, in countries such as Australia and England, there was a sharp increase in the number of prescriptions for specialist formulas for babies who had cow's milk allergy. On the other hand, studies have generally shown no change in the incidence of this condition over time.

根据欧洲最近的一项出生队列研究(包括9个不同国家的1.2万多名婴儿)的早期数据，只有大约1%的婴儿被诊断出牛奶过敏。然而，在其他一些研究中，认为自己的孩子有过敏症的家庭比例高达14%。此外，在2000年至2018年期间，澳大利亚和英国等国家出现了牛奶过敏婴儿配方奶粉处方数量的急剧增长。另一方面，研究普遍表明，随着时间的推移，这种情况的发生率没有变化。

The official guidelines on how to identify cow's milk allergy could be one of the possible causes for this rise in false diagnoses, according to the study.

根据这项研究，关于如何鉴别牛奶过敏的官方指南可能是造成误诊率上升的原因之一。