Background There are few prospective studies on the natural course of chronic urticaria (CU) in children. Objective We sought to examine the natural history of CU in children and to identify ...predictors for remission. Methods Children 4 to 15 years of age with CU were investigated with a complete blood cell count, erythrocyte sedimentation rate, antinuclear antibody titer, complement CH50 level, thyroid studies, autologous serum skin test, skin-prick tests, food challenges, and stool examination for parasites. They were considered to be in remission if symptoms did not recur for at least 12 months without medication. Results In all, 92 children (53.3% female) with CU were recruited and followed up for a median duration of 4.3 years (range 2.5-5.8 years). Chronic autoimmune urticaria (CAU) was identified in 40% of the patients. Food allergy was found in 8.7% and parasitic infestations in 5.4%. Remission rates at 1, 3, and 5 years after the onset of CU symptoms were 18.5%, 54%, and 67.7%, respectively. The remission rate did not differ in CAU compared with non-CAU. No predictor of CU remission was identified. Limitations The basophil histamine release assay was not performed. Conclusion Children with CU have a favorable outcome. CAU did not have an intractable course.
Atopy patch test in children with atopic dermatitis Visitsunthorn, Nualanong; Chatpornvorarux, Sunsanee; Pacharn, Punchama ...
Annals of allergy, asthma, & immunology,
12/2016, Letnik:
117, Številka:
6
Journal Article
Recenzirano
Atopic dermatitis is frequently associated with food and/or aeroallergen allergy.
To evaluate atopy patch tests (APTs) and skin prick tests (SPTs) in children with atopic dermatitis, using allergen ...extracts from locally lyophilized foods (cow's milk, egg white, egg yolk, wheat, soy, and shrimp), Dermatophagoides pteronyssinus, Dermatophagoides farinae, and American cockroach.
This study was a prospective, self-controlled study in children with atopic dermatitis. APTs, SPTs, and oral food challenge tests were performed in the cases with written informed consent.
Fifty-six children with atopic dermatitis were enrolled. According to the Severity Scoring of Atopic Dermatitis Index, moderate atopic dermatitis was the most common severity (49.1%) followed by mild (20%) and severe atopic dermatitis (13.2%). APT results were positive for food allergens in 49% of participants; SPT results were positive in 54.7%. The sensitivity, specificity, positive predictive value, and negative predictive value of APTs for foods were 40%, 90.2%, 65.2%, and 76.6%, respectively. For SPTs, those values were 40%, 93.9%, 75%, and 77.3%, respectively. APT results for D farinae, D pteronyssinus, and American cockroach were positive in 33.9%, 35.8%, and 21.8% of participants, respectively. SPT results for these allergens were positive in 28.3%, 24.5%, and 9.4% of participants, respectively. No serious complications occurred.
APTs with locally prepared lyophilized allergen extracts were safe and had high specificity, median positive predictive value, and low sensitivity for evaluation of suspected food allergy in children with atopic dermatitis.
clinicaltrials.gov Identifier: NCT01164293.
Rationale Within the past 2 decades, there was an increase in numbers of children presenting with IgE-mediated wheat reactions to Academic Centers in Thailand.
The Natural History of Shrimp Allergy in Thai Patients Ittiporn, Suttipong, MD; Pacharn, Punchama, MD; Visitsunthorn, Nualanong, MD ...
Journal of allergy and clinical immunology,
02/2017, Letnik:
139, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Methods Patients who were diagnosed as having shrimp allergy by positive oral food challenge (OFC) to Penaeus monodon (Pm) and Macrobrachium rosenbergii (Mr) were recruited.
Specific IgEs from their sera were analyzed to aeroallergens consisting of D. pteronyssinus, D. farinae, American cockroaches, cat dander, Bermuda and Johnson grass, and to common food allergens ...consisting of cow's milk, egg white and wheat by Euroline Allergy® and ImmunoCAP® concomitantly.
Recurrent acute rhinosinusitis (RARS) is characterized by multiple episodes of acute rhinosinusitis between which symptoms and signs resolve completely. The role of antibiotic prophylaxis to prevent ...RARS in children with nonallergic rhinitis (NAR) has not been investigated.
To evaluate the effect of azithromycin to prevent RARS in children with NAR.
A randomized, double-blind, placebo-controlled study was conducted in NAR children (5-15 years) with RARS. Azithromycin (5 mg/kg/d) 3 d/wk for 12 months or placebo was assigned to the study group and the control group, respectively. Patients with allergic rhinitis were excluded. Number of rhinosinusitis episodes in 12 months, visual analog scale score of nasal symptoms, and adjunctive medication score were recorded.
Forty patients were enrolled and 20 patients were assigned randomly to the azithromycin and placebo groups. IgG subclass and specific antibody deficiencies were found in 83% and 2.5% of patients, respectively. After 12 months, the number of rhinosinusitis episodes/y in the azithromycin group reduced significantly from 5 to 0.5 (P < .001) in contrast to the placebo group. Number needed to treat using azithromycin prophylaxis to prevent 1 patient from having RARS was 2. The average visual analog scale score and the average adjunctive medication score in the azithromycin (but not in the placebo) group reduced significantly compared with baseline (2.2 ± 1.4 vs 5.4 ± 1.8) and (3.9 ± 1.7 vs 5.4 ± 1.1), respectively (P < .001).
Azithromycin prophylaxis can reduce the number of rhinosinusitis episodes and medication score, and improve nasal symptoms in NAR children with RARS.
Predicting Factors for Asthma Remission in Children Siripattarasopon, Natcha, MD; Pacharn, Punchama, MD; Jirapongsananuruk, Orathai, MD ...
Journal of allergy and clinical immunology,
02/2016, Letnik:
137, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Predicting factors for asthma remission were age at onset of wheezing > 5 years (adjusted odds ratio OR 3.87; 95% CI 1.25-12.02), and sensitization to house dust mites (HDM) (adjusted OR 0.44; 95% CI ...0.20-0.97).
Methods Forty-three medical records of 22q11.2 deletion syndrome patients were reviewed . Kaplan-Meier survival curves were generated to depict the resolution of immune defect.
Rationale Local allergic rhinitis (LAR) is characterized by local specific IgE (sIgE) production, a nasal Th2 pattern during natural exposure to aeroallergen and a positive response to nasal allergen ...provocation test (NAPT).
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