Data suggest that food allergies greatly impact a child's health and growth due to inadequate nutrient intake. Our study aimed to establish the long-term outcome of children with food allergies ...compared to a control group.
This study was a retrospective cohort study with longitudinal follow-up with a mean period of 4.85 years from the diagnosis to the last study visit. The patients' nutritional intake was assessed using a three-day food diary and analysed by a dietitian. Patients (61 boys and 33 girls, mean age 6.9 years) had a single food allergy including 21 patients with cow's milk, 34 with egg, and 39 with peanut allergies. The control group included 36 children (19 boys and 17 girls, mean age 8.03 years). Blood analysis was performed on all participants.
Data from our study showed that patients with cow's milk, egg or peanut allergies had normal growth and achieved catch-up growth from the diagnosis until the last study visit. In the cow's milk allergy group, the allergy was shown to affect calcium intake (
< 0.05), while egg and peanut allergies did not impact the dietary intake of nutrients. None of the investigated food allergies affected blood results (
< 0.05).
In the present study, we showed that single food allergies do not compromise growth in children if they are provided with appropriate support and that the affected children reach catch-up growth from the diagnosis.
Although children seem to be less susceptible to COVID-19, some of them develop a rare but serious hyperinflammatory condition called multisystem inflammatory syndrome in children (MIS-C). While ...several studies describe the clinical conditions of acute MIS-C, the status of convalescent patients in the months after acute MIS-C is still unclear, especially the question of persistence of changes in the specific subpopulations of immune cells in the convalescent phase of the disease.
We therefore analyzed peripheral blood of 14 children with MIS-C at the onset of the disease (acute phase) and 2 to 6 months after disease onset (post-acute convalescent phase) for lymphocyte subsets and antigen-presenting cell (APC) phenotype. The results were compared with six healthy age-matched controls.
All major lymphocyte populations (B cells, CD4 + and CD8+ T cells, and NK cells) were decreased in the acute phase and normalized in the convalescent phase. T cell activation was increased in the acute phase, followed by an increased proportion of γ/δ-double-negative T cells (γ/δ DN Ts) in the convalescent phase. B cell differentiation was impaired in the acute phase with a decreased proportion of CD21 expressing, activated/memory, and class-switched memory B cells, which normalized in the convalescent phase. The proportion of plasmacytoid dendritic cells, conventional type 2 dendritic cells, and classical monocytes were decreased, while the proportion of conventional type 1 dendritic cells was increased in the acute phase. Importantly the population of plasmacytoid dendritic cells remained decreased in the convalescent phase, while other APC populations normalized. Immunometabolic analysis of peripheral blood mononuclear cells (PBMCs) in the convalescent MIS-C showed comparable mitochondrial respiration and glycolysis rates to healthy controls.
While both immunophenotyping and immunometabolic analyzes showed that immune cells in the convalescent MIS-C phase normalized in many parameters, we found lower percentage of plasmablasts, lower expression of T cell co-receptors (CD3, CD4, and CD8), an increased percentage of γ/δ DN Ts and increased metabolic activity of CD3/CD28-stimulated T cells. Overall, the results suggest that inflammation persists for months after the onset of MIS-C, with significant alterations in some immune system parameters, which may also impair immune defense against viral infections.
Poorly developed teachers' competences for managing children's allergies can pose a significant problem for the wellbeing of children in the preschool and school environment. The purpose of this ...study is to explore the attitudes and theoretical understanding of the management of allergic reactions in children among future teachers.
A total of 572 future teachers participated in the study, 56% of whom were in the 1st year of undergraduate educational programmes, while 44% were in the 4th year. The participants answered the Teachers' Health Competences Development - Allergy Questionnaire.
The future teachers showed positive attitudes towards learning more about different child health issues. There was an average understanding of managing allergic reactions in children (59.4%; SD=16.1% success), with no statistically significant difference regarding the duration of education, science background or the students' self-allergy. There was, however, a statistically significant difference in achievement scores between future teachers in different educational programmes (
(3,568)=6.4,
≤.000). A subgroup of future teachers exposed to basic allergy education in the 1
year and tested again in the 4
year showed significantly better knowledge (
-
=83.0;
=.008).
The duration of future education, science background and self-allergy did not influence the level of knowledge regarding the management of allergic reactions in children. A basic educational programme in allergy management had a positive effect on future teachers' knowledge of managing allergic reactions in children. Our study indicates that all future teachers should be included in specific educational programmes in order to develop adequate health competences.
Stevens-Johnsonov sindrom (SJS) in toksična epidermalna nekroliza (TEN) sta redki življenje ogrožajoči bolezni, ki se kažeta z nastajanjem mehurjev ter odstopanjem povrhnjice kože in sluznic. ...Najpogosteje sta posledica imunsko sprožene reakcije na zdravilo, redkeje zaradi drugih vzrokov. Poleg prekinitve zdravljenja z zdravilom, ki je lahko sprožilo SJS/TEN, ali uvedbe zdravljenja bakterijske okužbe, če je ta kot vzročni dejavnik dokazana, uvedemo lokalno zdravljenje sprememb na očeh, koži in sluznicah, v težjih primerih pa še sistemsko zdravljenje z glukokortikosteroidi (GKS) in/ali intravenskimi imunoglobulini (IVIG). Za optimalni izid bolezni je bistveno sodelovanje med specialisti različnih strok.
Prispevek predstavi skupino bolnikov, obravnavanih na Kliničnem oddelku za otroško alergologijo, revmatologijo in klinično imunologijo Pediatrične klinike UKC v Ljubljani in pregled literature. V letih 2011–2019 smo zdravili šest otrok s SJS/TEN. Pri štirih otrocih je bil sprožilni dejavnik zdravilo, pri enem okužba z Mycoplasmo pneumonie, pri enem bolniku pa etiologije nismo mogli opredeliti. Z GKS in IVIG so bili zdravljeni štirje otroci, en otrok z okužbo z M. pneumonie je bil zdravljen z azitromicinom in IVIG, en otrok pa je prejel le zdravila lokalno. Izid bolezni je bil pri vseh otrocih dober, in sicer tudi brez poznih posledic bolezni.
To estimate the incidence and describe the spectrum of inflammatory and autoimmune diseases linked to SARS-CoV-2 infection and COVID-19 vaccination in children from two neighbouring south central ...European countries.
We performed a multi-centre prospective cohort study of children under 18 years diagnosed with inflammatory/autoimmune diseases linked to SARS-CoV-2 infection or COVID-19 vaccination, who were admitted to the paediatric tertiary care hospitals in Slovenia and Friuli Venezia Giulia, Italy, from January 1, 2020, to December 31, 2021. Disease incidence was calculated based on laboratory-confirmed cases only.
Inflammatory and autoimmune diseases linked to SARS-CoV-2 were diagnosed in 192 children (127 laboratory-confirmed), of whom 112 had multisystem inflammatory syndrome (MIS-C), followed by vasculitis, neurological and cardiac diseases. Calculated risk of MIS-C was 1 in 860 children after SARS-CoV-2 infection and cumulative incidence of MIS-C was 18.3/100,000 of all children. Fifteen children had severe COVID-19. Two patients with MIS-C and a patient with myositis presented after COVID-19 vaccination. All 3 had at presentation also a serologically proven recent SARS-CoV-2 infection. After MIS-C, nine patients were vaccinated against COVID-19 and 25 patients had a SARS-CoV-2 reinfection, without recurrence of MIS-C.
Autoimmune diseases following SARS-CoV-2 infection in children were 8.5 times as common as severe COVID-19. MIS-C was the most common manifestation and its incidence in this predominantly white population was higher than previously reported. MIS-C does not seem to recur after SARS-CoV-2 reinfection or COVID-19 vaccination. Autoimmune diseases were much more common after SARS-CoV-2 infection than after COVID-19 vaccination.
To cite this article:Žitnik SEK, Vesel T, Avčin T, Šilar M, Košnik M, Korošec P. Monitoring honeybee venom immunotherapy in children with the basophil activation test. Pediatr Allergy Immunol 2011 ...Doi: 10.1111/j.1399‐3038.2011.01233.x
Background: New in vitro methods are essential for developing better follow‐up criteria for venom immunotherapy (VIT).
Methods: Thirty‐one children with a history of honeybee venom–induced systemic anaphylaxis were included in this prospective, single‐blinded study. The basophil CD63 activation test (BAT) was assessed before starting VIT, at the end of the build‐up phase (day 5), 6 months later, and after 2–4 yr of VIT.
Results: Basophil CD63 activation test allowed identification of the culprit insect in 74% of honeybee venom–allergic children. In comparison, IgE reactivity was single positive in only 52% of children. Five days after starting VIT, BAT was highly comparable to before VIT. However, after 6 months and further after 2–4 yr of VIT, a significant and approximately fourfold decrease was demonstrated in CD63 response at sub‐maximal 0.1 μg/ml allergen concentration, which mainly represents cellular sensitivity. No such differences were found at a higher 1 μg/ml of allergen concentration. Person‐to‐person analyses showed that after 2–4 yr of VIT, a marked CD63 decrease was evident in 85% of children. In addition, elevated basophil sensitivity measured before VIT was associated with the appearance of side effects observed during the build‐up phase of VIT.
Conclusion: Basophil CD63 allergen–specific sensitivity seems to be a promising tool for monitoring protective immune response in honeybee VIT.
A 17‐year‐old boy with refractory psoriatic arthritis and alpha‐1 antitrypsin deficiency who developed a syringotropic hypersensitivity reaction after 9 months of therapy with infliximab and ...leflunomide is described. Clinically, our patient showed a vasculitic‐like skin rash involving both palms and soles, and histopathological examination revealed a syringotropic lymphocytic infiltrate directed toward the intra‐epidermal portion of the eccrine ducts. These features have not been previously associated with infliximab or leflunomide therapy and represent a unique cutaneous hypersensitivity reaction that does not fit any known description of an immune‐mediated hypersensitivity reaction.
Hypersensitivity to glucorticoids in children Vesel, Tina; Šilar, Mira; Accetto, Meta ...
Clinical and translational allergy,
18 July 2014, 2014-07-18, 2014-Jul-18, 20140718, Letnik:
4, Številka:
S3
Journal Article