Pediatric Allergy Immunology and Pulmonology最新文献

Background: Biological agents are considered important therapies and are increasingly used in the treatment of a range of rheumatological and inflammatory diseases. Nevertheless, the prevalent use of these treatments has been associated with increased incidence of drug-induced hypersensitivity reactions (HSR). Case Presentation: A 15-year-old patient with enthesitis-related arthritis developed late HSR after the use of adalimumab. Consequently, etanercept was used as an alternative treatment. Etanercept was administered subcutaneously through a single dose without any reaction upon examination using skin tests (skin prick test, intradermal test, and patch test) against likely cross-reactions given that both adalimumab and etanercept were anti-tumor necrosis factor (TNF) agents. Conclusions: Currently, TNF-α inhibitors find widespread use. Caution is required against HSR reactions, including systemic or local injection site reactions, although they are generally considered safe to use.

Introduction: Iron deficiency (ID) has been intricately linked with various inflammatory diseases. Chronic rhinitis stands as one of most common respiratory inflammation disorders in children. This study aimed to investigate the prevalence of ID among preschool children with chronic rhinitis and to explore the association between ID and chronic rhinitis in this population. Methods: This cross-sectional study included children aged 3 to 7 years diagnosed with chronic rhinitis. ID was defined as transferrin saturation <20%, with absolute ID being defined as ferritin <15 ng/mL. Logistic regression analyses were performed to identify factors associated with ID. Results: A total of 72 children with chronic rhinitis were included, revealing a prevalence of ID of 47.2%. Only 5.9% children with ID exhibited absolute ID. Multivariate analysis revealed that neutrophils (odds ratio [OR] = 1.205, 95% confidence interval [CI] = 1.013-1.433, P = 0.035) and monocytes (OR = 1.803, 95% CI = 1.198-2.713, P = 0.005) were independently and significantly associated with ID. Conclusion: This study revealed a notable prevalence of ID in the preschool children with chronic rhinitis. The significant association between neutrophils and monocytes with ID implied an intricate involvement of innate immunity in the manifestation of ID.

Background: This study aims to evaluate systemic immune inflammation index, systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and follistatin-like protein-1 (FSTL-1) levels in children with pneumonia and healthy controls. Methods: The study was carried out at the Seydisehir State Hospital between February 1, 2024 and June 1, 2024. The patient group included 44 children diagnosed with pneumonia and the control group included 45 healthy children without any disease. Index values obtained from hemogram data. Enzyme-linked immunosorbent assay was used to measure FSTL-1 levels. Results: A total of 89 participants, 44 in the patient group and 45 in the healthy control group, were included in the study. White blood cells, monocyte, eosinophil, neutrophil, c-reactive protein, SIRI, and AISI levels were significantly higher in the patient group than in the control group. FSTL-1 levels were higher in the patient group, but did not differ statistically significant. The patient and control groups were compared in the receiver operating characteristics analysis, we found the highest area under curve (AUC) in the SIRI (AUC: 0.754) and AISI (AUC: 0.713) parameters. Conclusion: In conclusion, compared to healthy controls, SIRI and AISI levels were significantly higher in the patient group, and the highest AUC values belonged to these indices. Therefore, we believe that SIRI and AISI indices, which are inexpensive and simple tests, are useful for early diagnosis and treatment of pneumonia.

Introduction: Poikiloderma with neutropenia (PN) is a rare autosomal recessive hereditary disease caused by biallelic mutations of the USB1 gene. It is characterized by poikiloderma, chronic noncyclic neutropenia, and recurrent sinopulmonary infections with bronchiectasis. Here we report a case with homozygous c.531delA mutation in USB1 gene. Case: An 15-month-old boy was admitted to our clinic with skin hyperpigmentation, growth retardation, and recurrent lower respiratory tract infections. The medical history revealed that he was hospitalized 6 times due to pneumonia since the age of 3 months. His physical examination showed facial dysmorphism with triangular face, depressed nasal bridge, and frontal bossing. He also had poikiloderma in the whole body. Skin biopsy was performed and showed only hyperkeratosis. His weight and height were below the 3 percentile. He is the first child of his consangenius parents. In the laboratuary findings; he has mild neutropenia (1,100/mm³), hypogammaglobulinemia (serum IgG: 351 mg/dL, IgA: 17 mg/dL, IgM: 20 mg/dL) and, peripheral lymphocyte subset analysis was normal. Neutropenia was also observed in previous examinations (980-560-840/mm³). Immunoglobulin replacement therapy and antibiotic prophylaxis were started. Exome sequence analysis showed the presence of known homozygous variant (c.351delA) in USB1 gene. Conclusion: Poikiloderma with neutropenia mainly affects the myeloid lineage. Unlike other patients in the literature, we observed hypogammaglobulinemia in addition to neutropenia in our patient. This case illustrated that it is important to monitor serum immunoglobulin levels in symptomatic patients with recurrent infections.

Objective: Mitigation of household allergens is associated with the reduction of asthma exacerbations in those with allergic asthma and is recommended in recent asthma guidelines. However, we need to better understand patient knowledge of aeroallergens in their homes prior to integrating direct allergen measurement methods into standard asthma care. Methods: We conducted a mixed-methods sequential pilot study consisting of a survey and virtual interview with caregivers of children aged 3 to 15 with asthma diagnosis (any severity) about asthma control, household environment, mitigation knowledge and strategies, and knowledge of allergens and asthma. Results: A total of 21 participants responded and 13 completed the virtual interview. Less than half identified mice (43%), rats (29%), and cockroaches (43%) as sources of allergens on the online survey, and no individuals mentioned these in discussions. Only 23% were able to define the term "allergen," but 69% could list examples. There was a poor correlation between perceived asthma control (57% stated asthma control was good or excellent) compared to asthma that was classified as well controlled per Expert Panel Report 3 (EPR-3) guidelines (33% based on albuterol use and asthma symptoms). Finally, visual identification of mouse infestation was associated with active steps taken to mitigate mouse exposure (P = 0.007). Conclusion: Implementation of new Asthma Management Guidelines: Focused Updates 2020 by the National Institutes of Health will require additional aeroallergen education for individuals with asthma who do not recognize that cockroaches, rats, and mice can cause asthma symptoms, do not know the definition of an allergen, and do not correctly perceive asthma control status. Environmental assessment with education addressing these could hopefully decrease additional pharmaceutical needs.