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A Cricopharyngeal Bar as an Underrecognized Finding in an Adolescent with Eosinophilic Esophagitis. 嗜酸性粒细胞食管炎青少年患者中未被充分认识到的环咽横纹。
IF 0.9 4区 医学 Q4 ALLERGY Pub Date : 2024-09-01 DOI: 10.1089/ped.2024.0019
Russell J Hopp,Andrew Huang
A 16-year-old Caucasian male with previously diagnosed eosinophilic esophagitis (EoE) 4 years before his initial visit to an allergist-immunologist, scheduled due to severe dysphagia and recurrent food impaction. He had been off EoE therapy for 1 year. After resuming inhaled fluticasone and a proton pump inhibitor (PPI), esophagogastroduodenoscopy (EGD) was immediately scheduled. The dates of the original EGD procedures with the histological summary and EoE therapy are reported in the Table 1. The fourth endoscopy revealed near normal histology, with rare candida staining (Table 1). He was continued on daily PPI and the fluticasone was discontinued. Three weeks of Fluconazole failed to resolve his dysphagia. A repeat barium swallow confirmed a pre-existing cricopharyngeal bar, and he was referred to an otolaryngology for further care. [Table: see text].
一名 16 岁的白种男性曾被诊断患有嗜酸性粒细胞食管炎(EoE),4 年前他因严重吞咽困难和反复食物嵌塞而被安排到过敏免疫科就诊。他已停止 EoE 治疗 1 年。在恢复吸入氟替卡松和质子泵抑制剂(PPI)后,他立即接受了食管胃十二指肠镜检查(EGD)。表 1 列出了最初进行食管胃十二指肠镜检查的日期、组织学摘要和 EoE 治疗方法。第四次内镜检查显示组织学近乎正常,只有罕见的念珠菌染色(表 1)。他继续每天服用 PPI,并停用了氟替卡松。氟康唑治疗三周后,他的吞咽困难仍未缓解。重复吞咽钡剂检查证实他以前就有环咽钡餐阻塞,于是他被转到耳鼻喉科接受进一步治疗。[表:见正文]。
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引用次数: 0
Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for Pediatric Allergy, Immunology, and Pulmonology. 罗莎琳德-富兰克林学会自豪地宣布 2023 年度儿科过敏、免疫和肺病奖获得者。
IF 0.9 4区 医学 Q4 ALLERGY Pub Date : 2024-09-01 DOI: 10.1089/ped.2024.43534.rfs2023
Jean-Marie Bruzzese
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引用次数: 0
Evolving Trends in Pediatric Allergic Diseases: A Cross-Sectional Study Over 20 Years in the Central Black Sea Region of Turkey. 小儿过敏性疾病的演变趋势:土耳其黑海中部地区 20 年来的横断面研究。
IF 0.9 4区 医学 Q4 ALLERGY Pub Date : 2024-09-01 DOI: 10.1089/ped.2024.0021
Sefika Ilknur Kokcu Karadag,Burak Sariaydin,Ayşegül Sariaydin,Recep Sancak
Background: In the past two decades, the prevalence of asthma, eczema, and allergic rhinitis has increased among school-aged children in the Central Black Sea region of Turkey. This increase is consistent with national and international data, reflecting the impact and temporal changes of allergic diseases on the community. A similar increasing trend is also observed worldwide. This study aims to contribute to the development of health policies related to allergic diseases among Turkish children in the Central Black Sea region. Materials and Methods: This study compares the results of two cross-sectional surveys conducted in schools in and around Samsun, Turkey, between the years 2006 and 2022, examining changes in the prevalence of specific allergic diseases such as asthma, allergic rhinitis, and atopic eczema. Utilizing the Turkish translation of the International Study of Asthma and Allergies in Childhood protocol, the research encompassed a total of 1,310 and 3,219 children, respectively. Results: In the recent study conducted in 2022, the prevalence of asthma and allergic bronchitis diagnosed by physicians was found to be 10.5% and 4.6%, respectively. In addition, the prevalence of allergic rhinitis was determined to be 3.1% and the prevalence of atopic dermatitis was 2.5%. Moreover, previously unidentified rates of food allergy were determined to be 2.5%, and drug allergy was found to be 2.4%. Furthermore, a comparison with a cross-sectional study conducted in the same region 20 years ago revealed a statistically significant increase in the prevalence of physician-diagnosed asthma and allergic bronchitis (with P-values of 0.0375 and 0.0107, respectively). Discussion: The findings of this study suggest a similar trend of increasing prevalence of allergic diseases when compared with similar studies at national and global levels. Consistent with trends identified in the international literature, Turkey is also affected by the rising prevalence of allergic diseases.
背景:在过去二十年中,土耳其黑海中部地区学龄儿童中哮喘、湿疹和过敏性鼻炎的发病率有所上升。这一增长与国内和国际数据一致,反映了过敏性疾病对社区的影响和时间变化。全世界也观察到类似的增长趋势。本研究旨在为制定与中黑海地区土耳其儿童过敏性疾病相关的卫生政策做出贡献。材料和方法:本研究比较了 2006 年至 2022 年期间在土耳其萨姆松及其周边地区学校进行的两次横断面调查结果,研究了哮喘、过敏性鼻炎和特应性湿疹等特定过敏性疾病患病率的变化。研究采用了国际儿童哮喘和过敏症研究协议的土耳其语译文,分别涵盖了 1,310 名和 3,219 名儿童。研究结果最近在 2022 年进行的研究发现,由医生诊断的哮喘和过敏性支气管炎的发病率分别为 10.5% 和 4.6%。此外,过敏性鼻炎的发病率为 3.1%,特应性皮炎的发病率为 2.5%。此外,食物过敏的发病率为 2.5%,药物过敏的发病率为 2.4%。此外,与 20 年前在同一地区进行的横断面研究相比,医生诊断的哮喘和过敏性支气管炎的发病率有了显著增加(P 值分别为 0.0375 和 0.0107)。讨论:本研究结果表明,与国家和全球层面的类似研究相比,过敏性疾病的患病率呈上升趋势。与国际文献中发现的趋势一致,土耳其也受到过敏性疾病发病率上升的影响。
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引用次数: 0
Asthma and Adolescence: Unique Opportunities for Fostering Asthma Self-Management and Asthma Control. 哮喘与青少年:促进哮喘自我管理和哮喘控制的独特机遇。
IF 0.9 4区 医学 Q4 ALLERGY Pub Date : 2024-09-01 DOI: 10.1089/ped.2024.0094
Jean-Marie Bruzzese
Asthma is a significant worldwide concern among adolescents. Adolescents experience key cognitive and psychosocial developmental changes that they must negotiate as they transition from children to adults. Several of these changes have implications for their ability to effectively manage their asthma. When health care professionals (HCPs) understand these pivotal changes and their role in asthma management, they are better able to work with adolescents and help them become effective asthma self-managers. Therefore, this article reviews the cognitive changes that render adolescents ready to care for their asthma, as well as the following psychosocial changes that may hinder or facilitate self-management: independence from caregivers, reliance on peers, identity development, the role of social media in adolescents' lives, and risk-taking behaviors. Each developmental task is discussed in terms of asthma self-management and offers suggestions for HCPs that may help them work more effectively with adolescents with asthma.
哮喘是全世界青少年关注的一个重要问题。青少年在从儿童向成人过渡的过程中,必须经历认知和社会心理发展方面的重要变化。其中一些变化会影响到他们有效控制哮喘的能力。当医疗保健专业人员(HCPs)了解了这些关键变化及其在哮喘管理中的作用后,他们就能更好地与青少年合作,帮助他们成为有效的哮喘自我管理者。因此,本文回顾了使青少年做好护理哮喘准备的认知变化,以及可能阻碍或促进自我管理的以下社会心理变化:独立于照顾者、依赖同伴、身份发展、社交媒体在青少年生活中的作用以及冒险行为。每项发展任务都会从哮喘自我管理的角度进行讨论,并为保健医生提供建议,帮助他们更有效地与患有哮喘的青少年合作。
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引用次数: 0
Pharmaceutical Therapies for Pediatric Respiratory Disease: Setbacks and Progress in 2024. 治疗小儿呼吸系统疾病的药物疗法:2024 年的挫折与进步。
IF 0.9 4区 医学 Q4 ALLERGY Pub Date : 2024-09-01 DOI: 10.1089/ped.2024.0099
Scott Bickel,Ronald Morton
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引用次数: 0
First Reported Case of Anaphylaxis to Nebulized Tranexamic Acid in a Pediatric Patient: A Rare but Critical Event. 首例报告的小儿雾化氨甲环酸过敏性休克病例:罕见但危急的事件
IF 1.1 4区 医学 Q4 ALLERGY Pub Date : 2024-07-31 DOI: 10.1089/ped.2024.0035
Doğukan Mustafa Keskin, Mehmet Kocaoğlu, Alper Yıldırım, Ender Sayan, Muhammed Yusuf Ozan Avcı

Background: Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss due to certain medical conditions. It has a low side effect profile and is safe to administer in most instances. Anaphylaxis cases due to intravenous TXA have been reported in the literature. We report the first pediatric case of anaphylaxis due to the use of nebulized TXA. Case Presentation: A 2-year-old boy with cerebral palsy, epilepsy, and tracheostomy was hospitalized with pneumonia. On the fourth day of hospitalization, the patient started bleeding from the trachea. Nebulized TXA was started to reduce tracheal bleeding. Anaphylaxis developed 5 min after administration of nebulized TXA. Subsequently, the patient was successfully treated with adrenaline, intravenous fluids, antihistamines, and steroids. Conclusion: Nebulized TXA is increasingly used off-label. Although it has a safe profile, side effects such as anaphylaxis may occur rarely. It is essential to recognize the symptoms of anaphylaxis when using nebulized TXA.

背景:氨甲环酸(TXA氨甲环酸(TXA)是一种药物,用于治疗或预防某些疾病导致的失血过多。它的副作用较小,在大多数情况下用药安全。静脉注射 TXA 引起过敏性休克的病例已有文献报道。我们报告了首例因使用雾化 TXA 而导致过敏性休克的儿科病例。病例介绍:一名患有脑瘫、癫痫和气管切开术的 2 岁男孩因肺炎住院。住院第四天,患者气管开始出血。为减少气管出血,患者开始使用雾化 TXA。雾化 TXA 使用 5 分钟后出现过敏性休克。随后,患者成功接受了肾上腺素、静脉输液、抗组胺药和类固醇治疗。结论雾化 TXA 越来越多地被用于标签外。虽然它的安全性很高,但过敏性休克等副作用可能很少发生。在使用雾化 TXA 时,必须识别过敏性休克的症状。
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引用次数: 0
Shift from Cow's Milk Food Protein-Induced Enterocolitis Syndrome to IgE-Mediated Allergy: Case Series and Literature Review. 从牛奶食物蛋白诱发的小肠结肠炎综合征转变为 IgE 引起的过敏:病例系列和文献综述。
IF 1.1 4区 医学 Q4 ALLERGY Pub Date : 2024-06-01 DOI: 10.1089/ped.2024.0023
Simona Barni, Benedetta Pessina, Viktória Tóth, Lucrezia Sarti, Giulia Liccioli, Leonardo Tomei, Mattia Giovannini, Francesca Mori

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by gastrointestinal symptom onset within 1-4 hours from trigger food ingestion. In the literature, some authors have previously described the possibility that a patient with FPIES may develop an IgE-mediated allergy to the same trigger food, especially cow's milk (CM). Case Presentation: We reported five cases of CM-FPIES converting to IgE-mediated CM allergy presented at our tertiary pediatric Allergy Unit and performed a review of the literature, aiming to characterize the clinical features of patients who are at risk of developing such conversion. Conclusions: This phenomenon raises the question of whether IgE-mediated and non-IgE-mediated allergies represent a spectrum of the same disease and highlights the need for further investigation to understand the pathophysiological mechanisms of this process.

背景:食物蛋白诱发小肠结肠炎综合征(FPIES)是一种非 IgE 介导的食物过敏,其特征是在摄入诱发食物后 1-4 小时内出现胃肠道症状。在文献中,一些作者曾描述过 FPIES 患者可能会对同一种诱发食物(尤其是牛奶 (CM))产生 IgE 介导的过敏。病例介绍:我们报告了五例在本院三级儿科过敏科就诊的 CM-FPIES 转为 IgE 介导的 CM 过敏的病例,并对文献进行了综述,旨在了解有可能发生此类转归的患者的临床特征。结论:这一现象提出了一个问题,即免疫球蛋白是否会导致中药过敏?这一现象提出了一个问题:IgE介导的过敏和非 IgE 介导的过敏是否代表了同一种疾病的一个谱系,并强调了进一步研究以了解这一过程的病理生理机制的必要性。
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引用次数: 0
A Case Report and Pediatric Literature Review: Povidone as a Rare Cause of Anaphylaxis in Children. 病例报告和儿科文献综述:聚维酮是导致儿童过敏性休克的罕见原因。
IF 1.1 4区 医学 Q4 ALLERGY Pub Date : 2024-06-01 Epub Date: 2024-06-12 DOI: 10.1089/ped.2024.0036
Sumeyye Baysal, Hulya Anil, Koray Harmanci

Background: Povidone, a synthetic polymer commonly used in various products such as antiseptics, cosmetics, and medications, has been associated with allergic reactions, including anaphylaxis. Despite its widespread use, cases of povidone-induced anaphylaxis, especially in children, are under-recognized. This case report aims to highlight the importance of considering povidone allergy in pediatric patients presenting with anaphylaxis. Case Presentation: We describe a 3-year-old boy who experienced anaphylaxis following the application of povidone-iodine antiseptic solution to a leg wound. He presented with generalized urticaria, angioedema, dyspnea, and cough. Prompt diagnosis and management were initiated in the emergency department. He experienced the second anaphylaxis with povidone-containing eye drops prescribed during an ophthalmology visit. Conclusions: Povidone allergy should be considered in pediatric patients presenting with anaphylaxis, especially those with idiopathic reactions or multiple drug allergies. Clinicians should emphasize patient education on label reading and the provision of adrenaline autoinjectors to prevent life-threatening reactions associated with povidone exposure.

背景:聚维酮是一种合成聚合物,常用于消毒剂、化妆品和药物等各种产品中,与过敏反应(包括过敏性休克)有关。尽管聚维酮被广泛使用,但其诱发的过敏性休克病例,尤其是儿童过敏性休克病例,却未得到充分认识。本病例报告旨在强调在出现过敏性休克的儿童患者中考虑聚维酮过敏的重要性。病例介绍:我们描述了一名 3 岁男孩在腿部伤口涂抹聚维酮碘消毒液后出现过敏性休克。他出现全身性荨麻疹、血管性水肿、呼吸困难和咳嗽。急诊科对其进行了及时诊断和治疗。在眼科就诊时,医生给他开了含聚维酮的眼药水,这是他经历的第二次过敏性休克。结论:对于出现过敏性休克的儿童患者,尤其是特发性反应或对多种药物过敏的患者,应考虑聚维酮过敏。临床医生应重视对患者进行标签阅读教育,并提供肾上腺素自动注射器,以防止因接触聚维酮而发生危及生命的反应。
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引用次数: 0
Is It Possible to Use Inflammatory Markers as Potential Biomarkers for Chronic Urticaria? 将炎症标记物作为慢性荨麻疹的潜在生物标记物是否可行?
IF 1.1 4区 医学 Q4 ALLERGY Pub Date : 2024-06-01 Epub Date: 2024-06-12 DOI: 10.1089/ped.2024.0022
Gaye Kocatepe, Mehmet Akif Kaya, Aysen Bingol, Dilara Fatma Kocacik Uygun

Background: This study aimed to determine whether the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) at admission affect the transition of pediatric patients diagnosed with acute spontaneous urticaria to chronic urticaria. Methods: This study included 390 patients who presented to the Department of Pediatrics at Akdeniz University Hospital with acute spontaneous urticaria between January 2020 and December 2022. A statistical comparison was made between the hematological parameters of patients who developed chronic urticaria and those who did not. Neutrophil, lymphocyte, and platelet counts, as well as NLR, PLR, and SII ratios, were used for the comparison. Results: It was observed that acute urticaria progressed to chronic urticaria in 5.8% (n = 23) of the patients. No significant differences in lymphocyte, hemoglobin, and platelet counts were observed between the group progressing to chronic urticaria and the control group (P > 0.05). However, the chronic urticaria group had higher leukocyte and absolute neutrophil counts (P = 0.009 and P < 0.001, respectively). In addition, the NLR was significantly higher in the chronic urticaria group (P = 0.029), whereas no statistically significant difference was observed in the PLR (P = 0.180). The chronic urticaria group had a significantly higher SII than the control group (P = 0.011). Conclusion: Hematological parameters, particularly NLR and SII, may be useful indicators of the transition from acute to chronic urticaria in pediatric patients. The early identification of these markers could help monitor patients and guide treatment decisions. Further comprehensive studies are required to validate these findings.

研究背景本研究旨在确定入院时中性粒细胞-淋巴细胞比率(NLR)、血小板-淋巴细胞比率(PLR)和全身免疫炎症指数(SII)是否会影响确诊为急性自发性荨麻疹的儿科患者向慢性荨麻疹的转变。研究方法本研究纳入了 390 名在 2020 年 1 月至 2022 年 12 月期间因急性自发性荨麻疹到阿克登尼兹大学医院儿科就诊的患者。对发展为慢性荨麻疹的患者和未发展为慢性荨麻疹的患者的血液学参数进行了统计比较。比较采用了中性粒细胞、淋巴细胞和血小板计数以及 NLR、PLR 和 SII 比率。结果观察发现,急性荨麻疹发展为慢性荨麻疹的患者占 5.8%(23 人)。慢性荨麻疹进展组与对照组的淋巴细胞、血红蛋白和血小板计数无明显差异(P > 0.05)。然而,慢性荨麻疹组的白细胞和绝对中性粒细胞计数更高(分别为 P = 0.009 和 P <0.001)。此外,慢性荨麻疹组的 NLR 明显更高(P = 0.029),而 PLR 则无统计学差异(P = 0.180)。慢性荨麻疹组的 SII 明显高于对照组(P = 0.011)。结论血液学参数,尤其是 NLR 和 SII,可能是儿童患者从急性荨麻疹转变为慢性荨麻疹的有用指标。早期识别这些指标有助于监测患者并指导治疗决策。要验证这些发现,还需要进一步的综合研究。
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引用次数: 0
Prevalence and Clinical Characteristics of Pediatric Lower Airway Malacia: Case Series from a Tertiary Center in Turkey. 小儿下气道麻痹症的发病率和临床特征:土耳其一家三级医疗中心的病例系列。
IF 1.1 4区 医学 Q4 ALLERGY Pub Date : 2024-06-01 Epub Date: 2024-06-05 DOI: 10.1089/ped.2023.0134
Fazılcan Zirek, Gizem Özcan, Merve Nur Tekin, Özlem Can Selvi, Nazan Çobanoğlu

Introduction: Lower airway malacia (LAM) is characterized by a reduction in the cross-sectional luminal area during quiet respiration. There is no gold standard diagnostic test; however, flexible fiberoptic bronchoscopy (FFB) is most frequently utilized. The exact prevalence and incidence of LAM are unknown. This study aimed to determine the prevalence rates of pediatric patients diagnosed with LAM, offer a detailed understanding of their demographic and clinical characteristics, and investigate distinctions between two specific types of LAM, namely, tracheomalacia (TM) and bronchomalacia (BM). Materials and Methods: Patients younger than 18 years diagnosed with LAM using FFB were included in this retrospective case series. Demographic and clinical characteristics and comorbid disorders were compared between patients with isolated BM and those with isolated TM or tracheobronchomalacia (TM/TBM). Results: Among 390 patients who underwent FFB, 65 (16.6%) were diagnosed with LAM, 16 (24.6%) with TM, and 56 (86.2%) with BM. The median age at diagnosis was 15 months. Among them, 59 (90.8%) had other comorbidities; gastrointestinal (GI) disorders were the most common (38.5%). The most common indications for bronchoscopy were recurrent/prolonged lower respiratory tract infections (LRTI) or wheezing (43.1%), while the most frequently observed respiratory physical examination finding was stridor (35.4%). Patients with TM/TBM had significantly higher frequencies of premature births, stridor, retraction, and GI disorders. Conclusion: Patients with stridor without typical laryngomalacia features or recurrent or prolonged LRTI should undergo prompt evaluation for LAM. The potential coexistence of GI disorders such as gastroesophageal reflux disease and swallowing dysfunction should also be considered.

简介下气道畸形(LAM)的特征是安静呼吸时管腔横截面积缩小。目前还没有金标准诊断测试,但最常用的是柔性纤维支气管镜(FFB)检查。LAM 的确切患病率和发病率尚不清楚。本研究旨在确定被诊断为 LAM 的儿科患者的患病率,详细了解他们的人口统计学和临床特征,并调查两种特定类型的 LAM(即气管畸形(TM)和支气管畸形(BM))之间的区别。材料和方法:本回顾性病例系列纳入了使用纤维支气管镜确诊为 LAM 的 18 岁以下患者。比较了孤立 BM 患者与孤立 TM 或气管支气管畸形(TM/TBM)患者的人口统计学特征、临床特征和合并症。结果在接受 FFB 的 390 名患者中,65 人(16.6%)被诊断为 LAM,16 人(24.6%)被诊断为 TM,56 人(86.2%)被诊断为 BM。确诊时的中位年龄为 15 个月。其中,59 人(90.8%)患有其他合并症;胃肠道疾病最为常见(38.5%)。支气管镜检查最常见的适应症是反复/长期的下呼吸道感染(LRTI)或喘息(43.1%),而最常见的呼吸道体检结果是呼吸困难(35.4%)。TM/TBM患者出现早产、喘鸣、回缩和消化道疾病的频率明显更高。结论出现无典型喉头水肿特征的喘鸣或反复发作或长期低喉头水肿的患者应及时进行 LAM 评估。还应考虑可能同时存在的消化道疾病,如胃食管反流病和吞咽功能障碍。
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引用次数: 0
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Pediatric Allergy Immunology and Pulmonology
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