E. Dibek Mısırlıoğlu, Merve Tanıdır, Betul BUYUKTIRYAKI3, Saliha Kanik Yuksek, N. Şahiner, H. Guvenir, D. Azkur, C. Kocabaş
The fashion for temporary “black henna tattoo” is becoming increasingly more common among young adults and teens. An adolescent case with itching, erythema, edema, and inflammatory discharge on the right forearm two days after a temporary tattoo application is presented in this report. To determine the contact sensitizer, a patch test was performed one month after the end of the treatment. A bullous strong positive reaction (3+) was observed against para-phenylenediamine at the 48th and 72nd hours of evaluation after the application. Despite the common belief that henna tattoo application is harmless, the ingredients used in henna tattoo especially para-phenylenediamine can lead to allergenic reactions that can even be severe.Keywords: Adolescent, contact dermatitis, para-phenylenediamine
{"title":"Allergic Contact Dermatitis to Temporary Black Henna Tattoo Due to Sensitization to Para-Phenylenediamine","authors":"E. Dibek Mısırlıoğlu, Merve Tanıdır, Betul BUYUKTIRYAKI3, Saliha Kanik Yuksek, N. Şahiner, H. Guvenir, D. Azkur, C. Kocabaş","doi":"10.21911/aai.595","DOIUrl":"https://doi.org/10.21911/aai.595","url":null,"abstract":"The fashion for temporary “black henna tattoo” is becoming increasingly more common among young adults and teens. An adolescent case with itching, erythema, edema, and inflammatory discharge on the right forearm two days after a temporary tattoo application is presented in this report. To determine the contact sensitizer, a patch test was performed one month after the end of the treatment. A bullous strong positive reaction (3+) was observed against para-phenylenediamine at the 48th and 72nd hours of evaluation after the application. Despite the common belief that henna tattoo application is harmless, the ingredients used in henna tattoo especially para-phenylenediamine can lead to allergenic reactions that can even be severe.Keywords: Adolescent, contact dermatitis, para-phenylenediamine","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43430645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eray Yıldız, Ş. Arslan, Fatih Çölkesen, F. Aykan, R. Evcen, Mehmet Kılınç
Objective: The aim of this study was to determine the clinical course and treatment outcomes of patients with hereditary angioedema (HAE) after infection with coronavirus disease 2019 (COVID-19). Materials and Methods: Thirty-nine patients with HAE were included in this study. These patients were regularly followed up over phone calls since the first COVID-19 case was seen in our country. Patients were asked to visit the hospital if there was a history of contact with a confirmed COVID-19 patient or if the patient developed clinical symptoms of COVID-19.Results: There were 21 (54%) patients with type I HAE, and 18 (46%) with type II HAE. All patients received treatment for angioedema attacks (C1-inhibitor [C1-INH], icatibant), and seven (20%) received long-term prophylaxis (danazol). Treatment for attacks was continued for all patients during the pandemic. Patients taking danazol were switched to long-term prophylaxis using the C1-INH concentrate. Eleven (28%) patients with HAE developed COVID-19 during this study. Only one patient had severe COVID-19. Six patients (54.5%) were diagnosed with type II HAE, and five (45.5%) were diagnosed with type I HAE. The most common COVID-19 symptoms were fever (7/11; 64%) and myalgia (6/11; 55%). Mild angioedema attacks were experienced by 36% (4/11) of the HAE patients diagnosed with COVID-19. Icatibant was used in all patients.Conclusion: Agents used for HAE block the kallikrein-kinin system and may be useful in the treatment of COVID-19. Considering their beneficial effects on COVID-19, it is recommended that HAE patients should continue the use of agents blocking the kallikrein-kinin system. Keywords: COVID-19, hereditary angioedema, kallikrein-kinin system, bradykinin, C1-INH
{"title":"Management of Patients with Hereditary Angioedema During the COVID-19 Pandemic","authors":"Eray Yıldız, Ş. Arslan, Fatih Çölkesen, F. Aykan, R. Evcen, Mehmet Kılınç","doi":"10.21911/aai.661","DOIUrl":"https://doi.org/10.21911/aai.661","url":null,"abstract":"Objective: The aim of this study was to determine the clinical course and treatment outcomes of patients with hereditary angioedema (HAE) after infection with coronavirus disease 2019 (COVID-19). Materials and Methods: Thirty-nine patients with HAE were included in this study. These patients were regularly followed up over phone calls since the first COVID-19 case was seen in our country. Patients were asked to visit the hospital if there was a history of contact with a confirmed COVID-19 patient or if the patient developed clinical symptoms of COVID-19.Results: There were 21 (54%) patients with type I HAE, and 18 (46%) with type II HAE. All patients received treatment for angioedema attacks (C1-inhibitor [C1-INH], icatibant), and seven (20%) received long-term prophylaxis (danazol). Treatment for attacks was continued for all patients during the pandemic. Patients taking danazol were switched to long-term prophylaxis using the C1-INH concentrate. Eleven (28%) patients with HAE developed COVID-19 during this study. Only one patient had severe COVID-19. Six patients (54.5%) were diagnosed with type II HAE, and five (45.5%) were diagnosed with type I HAE. The most common COVID-19 symptoms were fever (7/11; 64%) and myalgia (6/11; 55%). Mild angioedema attacks were experienced by 36% (4/11) of the HAE patients diagnosed with COVID-19. Icatibant was used in all patients.Conclusion: Agents used for HAE block the kallikrein-kinin system and may be useful in the treatment of COVID-19. Considering their beneficial effects on COVID-19, it is recommended that HAE patients should continue the use of agents blocking the kallikrein-kinin system. Keywords: COVID-19, hereditary angioedema, kallikrein-kinin system, bradykinin, C1-INH","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47125114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Anaphylaxis is a serious reaction that needs rapid intervention. However, some healthcare professionals may have inadequate knowledge about anaphylaxis to manage this situation. The aim of this study was to evaluate the level of knowledge about anaphylaxis in dentistry students (DS) in comparison with medical school ones (MS). Materials and Methods: Students were recruited from the Dentistry (n=81) and Medical (n=144) Faculties of the University Hospital. The level of knowledge about anaphylaxis was evaluated by using a questionnaire with 26 items that was used previously. Results: The overall response rate was 89.9%. One tenth of the study group had ever encountered a case with anaphylaxis, but 2.8% of them stated that they had involved in the treatment by themselves. Almost all of the participants stated that allergy might be a life-threatening reaction. Additionally, 43.3% reported that they had epinephrine in their department. DS knew less than MS about the primary use of epinephrine after assessing the airway, breathing and circulation in the treatment of anaphylaxis, and even in suspicious cases (59.3% vs. 98.6%, and 42% vs. 94.4%, all p<0.001). DS had significantly less knowledge about anaphylaxis treatment and epinephrine application than medical ones (all p <0.001). Furthermore, the information of that “the minimum duration for re-administration of epinephrine as 10 minutes” was known by the half of MS, and one fourth of DS (p<0.001). The appropriate follow-up duration of patients with anaphylaxis was unknown in half of DS, and one fifth of MS (p<0.001). Even though MS had a higher rate of knowledge about the responsible and closest department dealing with anaphylaxis than dental students (p=0.02), DS were more aware of referring the patient with anaphylaxis to an allergy clinic (77.8% vs. 62.9%, p<0.001). Almost all MS had heard about the epinephrine auto-injector, in contrast to one third of the DS (p<0.001). Most of the participants, but mainly the MS knew that anaphylaxis could be diagnosed clinically. The case questions about diagnosis of anaphylaxis related to local anesthetic and beta-lactam antibiotic use were answered correctly in a higher rate in MS than DS (p=0.01 and p<0.001), whereas the rate of correct diagnosis of anaphylaxis following a bee sting was similar between the groups. Conclusion: This study showed the gaps about the diagnosis and management of anaphylaxis not only in MS, but also in dentistry ones. It is possible to encounter a case of anaphylaxis for every student during clinical practice in the future. Thus, education about anaphylaxis should be included in the national dentistry core education programme and be improved in the medical school as well. Keywords: Anaphylaxis, epinephrine, student, medical, denta
{"title":"Evaluation of Knowledge About Anaphylaxis in Dentistry and Medical Faculty Students; Need for More Training","authors":"A. Baccioglu, A. F. Kalpaklioglu, Dilek Çimşir","doi":"10.21911/aai.621","DOIUrl":"https://doi.org/10.21911/aai.621","url":null,"abstract":"Objective: Anaphylaxis is a serious reaction that needs rapid intervention. However, some healthcare professionals may have inadequate knowledge about anaphylaxis to manage this situation. The aim of this study was to evaluate the level of knowledge about anaphylaxis in dentistry students (DS) in comparison with medical school ones (MS). Materials and Methods: Students were recruited from the Dentistry (n=81) and Medical (n=144) Faculties of the University Hospital. The level of knowledge about anaphylaxis was evaluated by using a questionnaire with 26 items that was used previously. Results: The overall response rate was 89.9%. One tenth of the study group had ever encountered a case with anaphylaxis, but 2.8% of them stated that they had involved in the treatment by themselves. Almost all of the participants stated that allergy might be a life-threatening reaction. Additionally, 43.3% reported that they had epinephrine in their department. DS knew less than MS about the primary use of epinephrine after assessing the airway, breathing and circulation in the treatment of anaphylaxis, and even in suspicious cases (59.3% vs. 98.6%, and 42% vs. 94.4%, all p<0.001). DS had significantly less knowledge about anaphylaxis treatment and epinephrine application than medical ones (all p <0.001). Furthermore, the information of that “the minimum duration for re-administration of epinephrine as 10 minutes” was known by the half of MS, and one fourth of DS (p<0.001). The appropriate follow-up duration of patients with anaphylaxis was unknown in half of DS, and one fifth of MS (p<0.001). Even though MS had a higher rate of knowledge about the responsible and closest department dealing with anaphylaxis than dental students (p=0.02), DS were more aware of referring the patient with anaphylaxis to an allergy clinic (77.8% vs. 62.9%, p<0.001). Almost all MS had heard about the epinephrine auto-injector, in contrast to one third of the DS (p<0.001). Most of the participants, but mainly the MS knew that anaphylaxis could be diagnosed clinically. The case questions about diagnosis of anaphylaxis related to local anesthetic and beta-lactam antibiotic use were answered correctly in a higher rate in MS than DS (p=0.01 and p<0.001), whereas the rate of correct diagnosis of anaphylaxis following a bee sting was similar between the groups. Conclusion: This study showed the gaps about the diagnosis and management of anaphylaxis not only in MS, but also in dentistry ones. It is possible to encounter a case of anaphylaxis for every student during clinical practice in the future. Thus, education about anaphylaxis should be included in the national dentistry core education programme and be improved in the medical school as well. Keywords: Anaphylaxis, epinephrine, student, medical, denta","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46640160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ozge Can Bostan, M. Çakmak, S. B. Kaya, E. Damadoğlu, G. Karakaya, A. Kalyoncu
ABSTRACT Objective: Controversies continue over the diagnostic approach, prediction, and premedication in radiocontrast media (RCM) hypersensitivity. One of the most important problems encountered in daily clinical practice is that patients do not recall which contrast agent has been used in previous exposures. Also, in most cases, the details of the reaction have not been recorded. Therefore, difficulties are experienced in decision-making about skin testing and premedication in patients who are suspected of RCM hypersensitivity. To assess the clinical value of skin tests and premedication in RCM hypersensitivity. Materials and Methods: A retrospective evaluation was made of the medical records of patients between October 2014 and December 2019. The skin tests were performed with the culprit agent if it was known, otherwise, with iohexol, one of the most commonly used RCM in Turkey. As premedication, oral methylprednisolone 40 mg 13-7-1 hours before the procedure and oral pheniramine 22.7 mg 1 hour before the procedure were prescribed. Results: A total of 41 patients were evaluated (32 females and 9 males). Of the reactions, 35 (85.4%) were immediate and 6 (14.6%) were non-immediate. Three (7.3%) had a positive intradermal test result. It was determined that 20 patients (17 immediate, 3 non- immediate), required imaging with RCM again. Of these, 18 received premedication and two did not, although it was recommended. Of the patients who received premedication, one (5.5%) had an urticarial reaction of the same grade, while both patients (100%) who did not receive premedication developed an immediate allergic reaction that was of a similar grade to that of the previous reaction. Conclusion: Skin test positivity for RCM was observed at low rates. In cases with negative skin tests and when the culprit drug cannot be identified, re-exposure to alternative RCM under premedication may reduce the risk of the reaction. Keywords: Allergy, iodinated contrast media, iobitridol, iohexol, premedication
{"title":"The Role of Skin Tests and Premedication in Radiocontrast Media Hypersensitivity: A Clinical Dilemma","authors":"Ozge Can Bostan, M. Çakmak, S. B. Kaya, E. Damadoğlu, G. Karakaya, A. Kalyoncu","doi":"10.21911/aai.606","DOIUrl":"https://doi.org/10.21911/aai.606","url":null,"abstract":"ABSTRACT Objective: Controversies continue over the diagnostic approach, prediction, and premedication in radiocontrast media (RCM) hypersensitivity. One of the most important problems encountered in daily clinical practice is that patients do not recall which contrast agent has been used in previous exposures. Also, in most cases, the details of the reaction have not been recorded. Therefore, difficulties are experienced in decision-making about skin testing and premedication in patients who are suspected of RCM hypersensitivity. To assess the clinical value of skin tests and premedication in RCM hypersensitivity. Materials and Methods: A retrospective evaluation was made of the medical records of patients between October 2014 and December 2019. The skin tests were performed with the culprit agent if it was known, otherwise, with iohexol, one of the most commonly used RCM in Turkey. As premedication, oral methylprednisolone 40 mg 13-7-1 hours before the procedure and oral pheniramine 22.7 mg 1 hour before the procedure were prescribed. Results: A total of 41 patients were evaluated (32 females and 9 males). Of the reactions, 35 (85.4%) were immediate and 6 (14.6%) were non-immediate. Three (7.3%) had a positive intradermal test result. It was determined that 20 patients (17 immediate, 3 non- immediate), required imaging with RCM again. Of these, 18 received premedication and two did not, although it was recommended. Of the patients who received premedication, one (5.5%) had an urticarial reaction of the same grade, while both patients (100%) who did not receive premedication developed an immediate allergic reaction that was of a similar grade to that of the previous reaction. Conclusion: Skin test positivity for RCM was observed at low rates. In cases with negative skin tests and when the culprit drug cannot be identified, re-exposure to alternative RCM under premedication may reduce the risk of the reaction. Keywords: Allergy, iodinated contrast media, iobitridol, iohexol, premedication","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45741656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Kisakurek, Sadi Can Sönmez, E. Osmanbaşoğlu, E. Öztürk, A. Öztürk
ABSTRACT Patients with angioedema can present to the internal medicine, emergency medicine, dermatology, or ear nose throat clinics. Physicians may need to assess the patients whose angioedema is unresponsive to antihistamines systematically in collaboration with other subspecialties including hematology, rheumatology, allergy, and immunology. We aimed to provide a concise review of the diagnosis and multi-disciplinary management of acquired angioedema through a case presentation. A 61-year-old woman presented with recurrent angioedema of 4 episodes within one year. She was evaluated by various disciplines such as dermatology and emergency medicine. Antihistamines and steroids were not effective. The complete blood count (CBC) results indicated lymphocytosis (lymphocyte count=9100 k/μL) and further evaluation of the lymphocytosis with flow cytometry immunophenotyping confirmed a diagnosis of chronic lymphocytic leukemia. Since the acquired angioedema diagnosis was confirmed with low C4, C1q, and C1 esterase inhibitor levels, Rituximab 375 mg/m2 was administered once a week for 4 weeks. The frequency of attacks decreased after rituximab therapy and none of them were life-threatening. In conclusion, when the effective treatment is initiated for the primary diagnosis in acquired angioedema, the numerous emergency department visits, hospitalizations, and the mortality due to life-threatening angioedema episodes can be avoided. Keywords: Angioedema, larynx angioedema, emergency, chronic lymphocytic leukemia, life-threatening angioedema
{"title":"Larynx Angioedema as a Signal in Chronic Lymphocytic Leukemia: A Case-based Guide for Acquired Angioedema in the Setting of Lymphoproliferative Disorders","authors":"Z. Kisakurek, Sadi Can Sönmez, E. Osmanbaşoğlu, E. Öztürk, A. Öztürk","doi":"10.21911/aai.614","DOIUrl":"https://doi.org/10.21911/aai.614","url":null,"abstract":"ABSTRACT Patients with angioedema can present to the internal medicine, emergency medicine, dermatology, or ear nose throat clinics. Physicians may need to assess the patients whose angioedema is unresponsive to antihistamines systematically in collaboration with other subspecialties including hematology, rheumatology, allergy, and immunology. We aimed to provide a concise review of the diagnosis and multi-disciplinary management of acquired angioedema through a case presentation. A 61-year-old woman presented with recurrent angioedema of 4 episodes within one year. She was evaluated by various disciplines such as dermatology and emergency medicine. Antihistamines and steroids were not effective. The complete blood count (CBC) results indicated lymphocytosis (lymphocyte count=9100 k/μL) and further evaluation of the lymphocytosis with flow cytometry immunophenotyping confirmed a diagnosis of chronic lymphocytic leukemia. Since the acquired angioedema diagnosis was confirmed with low C4, C1q, and C1 esterase inhibitor levels, Rituximab 375 mg/m2 was administered once a week for 4 weeks. The frequency of attacks decreased after rituximab therapy and none of them were life-threatening. In conclusion, when the effective treatment is initiated for the primary diagnosis in acquired angioedema, the numerous emergency department visits, hospitalizations, and the mortality due to life-threatening angioedema episodes can be avoided. Keywords: Angioedema, larynx angioedema, emergency, chronic lymphocytic leukemia, life-threatening angioedema","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46132369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Şule Büyük Yaytokgil, I. T. Yagmur, E. Misirlioglu
{"title":"Anaphylaxis Due to Horses in Two Children with Pollen Allergy","authors":"Şule Büyük Yaytokgil, I. T. Yagmur, E. Misirlioglu","doi":"10.21911/aai.609","DOIUrl":"https://doi.org/10.21911/aai.609","url":null,"abstract":"","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41445356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. U. Kahraman, Mebrure Yazıcı, N. Büyükpınarbaşılı, Nihal Soylu, A. Iscan, E. Ozkaya
ABSTRACT Objective: Although there is no consensus regarding the etiology of paranasal mucous retention cysts (MRCs) in the literature, several studies suggest an allergic etiology. This study aimed to investigate a potential association between paranasal MRCs diagnosed with MRI scans and allergic sensitization in the pediatric population. Materials and Methods: A total of 4559 MRI scans were retrospectively evaluated for MRC in patients who presented to the pediatric neurology outpatient clinic with headache complaints. Fifty children with MRI findings conclusive for paranasal MRC and 50 children without such findings were included in the study. All study and control patients were invited for atopy/allergy evaluation. Total IgE measurements, blood eosinophil levels, nasal smear and skin prick tests were performed to evaluate the allergic status of the children. In addition, an allergic rhinitis symptom questionnaire was administered. Results: The mean age was 13.0±2.8 years (median 14 y, range 6-18 y) with a female-to-male ratio of 1.4:1 in the study group. The prevalence of MRC was found to be 1.1% (50 in 4559). The two groups did not differ with regard to the frequency of blood eosinophilia, nasal eosinophilia, serum IgE levels, and allergic rhinitis symptom severity (p>0.05). Positive skin test for at least one of the allergens tested was more common in the MRC group than the controls (40% vs. 16%, p=0.007). Multivariate analysis identified that a positive skin prick test for at least one allergen was a significant independent predictor of MRC (OR, 4.6; 95% CI 1.2-17.0, p=0.023). Conclusion: Our study showed that paranasal MRCs were significantly more frequent in atopic children compared to controls. Additionally, MRCs were found to be strongly associated with allergic sensitization. Keywords: Cysts, allergic rhinitis, children, diagnostic tests, signs and symptoms
{"title":"The Association Between Paranasal Mucous Retention Cysts and Allergic Sensitization","authors":"F. U. Kahraman, Mebrure Yazıcı, N. Büyükpınarbaşılı, Nihal Soylu, A. Iscan, E. Ozkaya","doi":"10.21911/aai.608","DOIUrl":"https://doi.org/10.21911/aai.608","url":null,"abstract":"ABSTRACT Objective: Although there is no consensus regarding the etiology of paranasal mucous retention cysts (MRCs) in the literature, several studies suggest an allergic etiology. This study aimed to investigate a potential association between paranasal MRCs diagnosed with MRI scans and allergic sensitization in the pediatric population. Materials and Methods: A total of 4559 MRI scans were retrospectively evaluated for MRC in patients who presented to the pediatric neurology outpatient clinic with headache complaints. Fifty children with MRI findings conclusive for paranasal MRC and 50 children without such findings were included in the study. All study and control patients were invited for atopy/allergy evaluation. Total IgE measurements, blood eosinophil levels, nasal smear and skin prick tests were performed to evaluate the allergic status of the children. In addition, an allergic rhinitis symptom questionnaire was administered. Results: The mean age was 13.0±2.8 years (median 14 y, range 6-18 y) with a female-to-male ratio of 1.4:1 in the study group. The prevalence of MRC was found to be 1.1% (50 in 4559). The two groups did not differ with regard to the frequency of blood eosinophilia, nasal eosinophilia, serum IgE levels, and allergic rhinitis symptom severity (p>0.05). Positive skin test for at least one of the allergens tested was more common in the MRC group than the controls (40% vs. 16%, p=0.007). Multivariate analysis identified that a positive skin prick test for at least one allergen was a significant independent predictor of MRC (OR, 4.6; 95% CI 1.2-17.0, p=0.023). Conclusion: Our study showed that paranasal MRCs were significantly more frequent in atopic children compared to controls. Additionally, MRCs were found to be strongly associated with allergic sensitization. Keywords: Cysts, allergic rhinitis, children, diagnostic tests, signs and symptoms","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42535482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Objective: Diagnostic delay is one of the major problems for patients with predominantly antibody deficiencies (PAD) that can lead to anxiety and depression disorders, like in other chronic diseases. We aimed to detect the frequencies of anxiety and depression in PAD patients. The second aim was to determine the influence of diagnosis delay on the patients’ anxiety and depression. Materials and Methods: In this prospective study, 40 patients and 50 healthy controls answered the Hospital Anxiety and Depression Scale (HADS). We compared the anxiety, depression, and the total scores of the patients and the healthy controls. We divided the patients into two groups as delayed and early diagnosed patients according to median diagnostic delay year and compared the HADS scores of the two groups. Results: The anxiety, depression and the total scores of PAD patients were significantly higher compared to the healthy controls; (p=0.001, p=0.001, p=0.001), respectively. The HADS scores were significantly higher in the delayed diagnosis patient group than the early diagnosed patient group (p=0.001, p=0.003, p=0.001), respectively. We also confirmed this positive relationship between delayed diagnosis and the HADS scores with Spearman’s correlation analysis. Conclusion: We demonstrated that psychiatric disorders such as anxiety and depression are common in PAD patients, and delayed diagnosis strongly affects their anxiety and depression. Collaboration with psychologists and psychiatrists during the management of these patients may improve the quality of their life. Keywords: Predominantly antibody deficiencies, early diagnosis, anxiety, depression
{"title":"Anxiety and Depression Among Patients with Predominantly Antibody Deficiencies and the Importance of Early Diagnosis","authors":"S. Yeşillik, F. Demirel","doi":"10.21911/aai.612","DOIUrl":"https://doi.org/10.21911/aai.612","url":null,"abstract":"ABSTRACT Objective: Diagnostic delay is one of the major problems for patients with predominantly antibody deficiencies (PAD) that can lead to anxiety and depression disorders, like in other chronic diseases. We aimed to detect the frequencies of anxiety and depression in PAD patients. The second aim was to determine the influence of diagnosis delay on the patients’ anxiety and depression. Materials and Methods: In this prospective study, 40 patients and 50 healthy controls answered the Hospital Anxiety and Depression Scale (HADS). We compared the anxiety, depression, and the total scores of the patients and the healthy controls. We divided the patients into two groups as delayed and early diagnosed patients according to median diagnostic delay year and compared the HADS scores of the two groups. Results: The anxiety, depression and the total scores of PAD patients were significantly higher compared to the healthy controls; (p=0.001, p=0.001, p=0.001), respectively. The HADS scores were significantly higher in the delayed diagnosis patient group than the early diagnosed patient group (p=0.001, p=0.003, p=0.001), respectively. We also confirmed this positive relationship between delayed diagnosis and the HADS scores with Spearman’s correlation analysis. Conclusion: We demonstrated that psychiatric disorders such as anxiety and depression are common in PAD patients, and delayed diagnosis strongly affects their anxiety and depression. Collaboration with psychologists and psychiatrists during the management of these patients may improve the quality of their life. Keywords: Predominantly antibody deficiencies, early diagnosis, anxiety, depression","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42806632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Aytekin, Sevda Tüten Dal, Hilal Ünsal, A. Akarsu, M. Ocak, Ü. Şahiner, O. Soyer, B. Sekerel
ABSTRACT Objective: The coronavirus disease 2019 (COVID-19) pandemic creates secondary problems for the health care system, and understanding specific issues can guide the management of the pandemic and its future consequences. We aimed to characterize the problems and related risk factors experienced with outpatient compliance and dietary compliance of children with food allergies during the COVID-19 pandemic. Materials and Methods: A cross-sectional survey was conducted on the mothers of children with ongoing food allergies, eight months after Turkey’s first confirmed case of COVID 19. Results: Of the 288 patients, 76.3% and 40.2% were non-adherent to their scheduled appointments and oral food challenge, respectively, during the pandemic. The group non-adherent to their scheduled visit was significantly older (p=0.005), had more frequent home food trials without the consent of their physicians (p<0.001), and had less usable epinephrine auto-injectors (EAI) available compared with the adherent group (p<0.001). Eighty-nine patients (30.9%) with home food trial experience had more essential food allergies (p<0.001) and experienced more allergic reactions (p=0.002), compared with patients who adhered to dietary elimination. Thirty parents (10.4%) eliminated some foods from their children’s diet because of the suspected reactions. Conclusion: The COVID-19 pandemic, significantly reduces adherence with scheduled appointments and OFC, and increases home food trials and food eliminations without physician approval. Keywords: The COVID-19 pandemic, food allergy, compliance, telemedicine, oral food challenge
{"title":"Food Allergy Management Has Been Negatively Impacted During the COVID-19 Pandemic","authors":"E. Aytekin, Sevda Tüten Dal, Hilal Ünsal, A. Akarsu, M. Ocak, Ü. Şahiner, O. Soyer, B. Sekerel","doi":"10.21911/aai.628","DOIUrl":"https://doi.org/10.21911/aai.628","url":null,"abstract":"ABSTRACT Objective: The coronavirus disease 2019 (COVID-19) pandemic creates secondary problems for the health care system, and understanding specific issues can guide the management of the pandemic and its future consequences. We aimed to characterize the problems and related risk factors experienced with outpatient compliance and dietary compliance of children with food allergies during the COVID-19 pandemic. Materials and Methods: A cross-sectional survey was conducted on the mothers of children with ongoing food allergies, eight months after Turkey’s first confirmed case of COVID 19. Results: Of the 288 patients, 76.3% and 40.2% were non-adherent to their scheduled appointments and oral food challenge, respectively, during the pandemic. The group non-adherent to their scheduled visit was significantly older (p=0.005), had more frequent home food trials without the consent of their physicians (p<0.001), and had less usable epinephrine auto-injectors (EAI) available compared with the adherent group (p<0.001). Eighty-nine patients (30.9%) with home food trial experience had more essential food allergies (p<0.001) and experienced more allergic reactions (p=0.002), compared with patients who adhered to dietary elimination. Thirty parents (10.4%) eliminated some foods from their children’s diet because of the suspected reactions. Conclusion: The COVID-19 pandemic, significantly reduces adherence with scheduled appointments and OFC, and increases home food trials and food eliminations without physician approval. Keywords: The COVID-19 pandemic, food allergy, compliance, telemedicine, oral food challenge","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42292885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Karaatmaca, Şule Büyük Yaytokgil, I. K. Celik, O. Y. Topal, E. Civelek, M. Toyran, E. Misirlioglu
ABSTRACT Objective: Macrolide allergy is rarely reported, and there is limited knowledge of hypersensitivity reactions (HRs) in children. The negative predictive value (NPV) of drug provocation tests (DPTs) for macrolides is unresolved. We aim to evaluate the clinical features of macrolide allergy in children, and determine the NPV of macrolide DPTs. Materials and Methods: Pediatric patients who were referred to our allergy department with a suspicion of macrolide allergy were evaluated by DPTs with or without prior skin tests between 2011 and 2020. Characteristics of the HRs and patients, the results of skin and DPTs were recorded. At least three months after evaluation of the patients with allergy work up, telephone interviews were performed. Patients were asked whether they had reused the suspected macrolide or not. Patients who reported HR during subsequent drug intake were invited for reevaluation. Results: A total of 160 children (161 reactions) (55.6% male) with a suspicion of macrolide allergy were enrolled for the study, and all children had a mild index reaction. The median age was 48 (18-102) months, and the median time between the suspected allergic reaction and allergy work-up was 3 (2-8) months. The most frequently reported suspected agent was clarithromycin, in 151 patients (94.4%). Macrolide allergy was confirmed in 8 (5%) patients. Only one patient reported skin eruptions upon reuse despite a negative DPT and he was invited to be reevaluated. A second DPT was performed resulting in urticarial lesions. The NPV was found to be 97.4% for negative DPT with macrolides. Conclusion: Confirmed macrolide allergy is rare in children, and DPTs are the gold standard to assess suspected macrolide allergy. The NPV of macrolide provocation tests seems to be high in children. Keywords: Children, drug hypersensitivity, drug provocation test, macrolide, negative predictive value
{"title":"Macrolide Allergy in Children and the Negative Predictive Value of Drug Provocation Tests in Mild Index Reactions","authors":"B. Karaatmaca, Şule Büyük Yaytokgil, I. K. Celik, O. Y. Topal, E. Civelek, M. Toyran, E. Misirlioglu","doi":"10.21911/aai.655","DOIUrl":"https://doi.org/10.21911/aai.655","url":null,"abstract":"ABSTRACT Objective: Macrolide allergy is rarely reported, and there is limited knowledge of hypersensitivity reactions (HRs) in children. The negative predictive value (NPV) of drug provocation tests (DPTs) for macrolides is unresolved. We aim to evaluate the clinical features of macrolide allergy in children, and determine the NPV of macrolide DPTs. Materials and Methods: Pediatric patients who were referred to our allergy department with a suspicion of macrolide allergy were evaluated by DPTs with or without prior skin tests between 2011 and 2020. Characteristics of the HRs and patients, the results of skin and DPTs were recorded. At least three months after evaluation of the patients with allergy work up, telephone interviews were performed. Patients were asked whether they had reused the suspected macrolide or not. Patients who reported HR during subsequent drug intake were invited for reevaluation. Results: A total of 160 children (161 reactions) (55.6% male) with a suspicion of macrolide allergy were enrolled for the study, and all children had a mild index reaction. The median age was 48 (18-102) months, and the median time between the suspected allergic reaction and allergy work-up was 3 (2-8) months. The most frequently reported suspected agent was clarithromycin, in 151 patients (94.4%). Macrolide allergy was confirmed in 8 (5%) patients. Only one patient reported skin eruptions upon reuse despite a negative DPT and he was invited to be reevaluated. A second DPT was performed resulting in urticarial lesions. The NPV was found to be 97.4% for negative DPT with macrolides. Conclusion: Confirmed macrolide allergy is rare in children, and DPTs are the gold standard to assess suspected macrolide allergy. The NPV of macrolide provocation tests seems to be high in children. Keywords: Children, drug hypersensitivity, drug provocation test, macrolide, negative predictive value","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49452861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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