Sleep disturbances and affecting factors in young children with food allergy and their mothers

ObjectiveTo examine sleep patterns and sleep disturbance of children with food allergy (FA) and their mothers.MethodsThe food allergy group included 71 children with mean age, 2.97 ± 1.52 years, and 58 control children were recruited the study. Mothers of children completed the Childhood Sleep Habits Questionnaire (CSHQ) and The Pittsburgh Sleep Quality Index (PSQI) in order to evaluate sleep disturbance in both children and themselves. Depressive symptomatology of mothers of children with or without food allergy was assessed with Beck-Depression Inventory II (BDI-II).ResultsThe mean total scores of CSHQ was 49.33 ± 7.93 (range = 31–68) in the FA and 42.39 ± 6.43 (range = 30–62) in controls. The total CSHQ scores were significantly higher in children with FA than in controls (p = 0.002). The total PSQI score was significantly higher in mothers of children with FA than in mothers of children without FA (7.09 ± 3.11 vs 5.15 ± 2.59, p < 0.001) indicating that the mothers of children with FA had worse sleep quality. The mothers of children with FA had more depressive symptoms than mothers of children without FA. The mean total scores of BDI-II were 10.10 ± 6.95 in mothers of children with FA and 7.78 ± 6.64 in mothers of children without FA (p = 0.005).ConclusionThe presence of a food allergy in a child may be associated with a deterioration in sleep quality in children and mothers as well as increased depressive symptoms in mothers.     

Is there any difference regarding atopy between children with familial Mediterranean fever and healthy controls?

IntroductionThere are only a few studies regarding the prevalence of atopy in Familial Mediterranean fever (FMF) patients, and their results are conflicting.MethodsIn this study children with the diagnosis of FMF were evaluated for the presence of atopy by comparing with controls. One hundred and eighteen children diagnosed as FMF and 50 healthy age and sex matched controls were enrolled. They were evaluated for the presence of rhinitis, atopic dermatitis, urticaria and asthma. Laboratory assessment was done by measuring IgA, IgM, IgG, IgE levels, total eosinophil count and by performing skin prick test (SPT) panels for common allergens to children with FMF and healthy controls.ResultsOne hundred and eighteen children (61girls and 57 boys) diagnosed as FMF with a median age of 120 ± 47 months (range 36–204 months) were compared with 50 healthy controls (31 girls and 19 boys) having a median age of 126 ± 37 (range 48–192 months). The mean percentage of total eosinophil count of patients was similar to that of the control group. The mean level of IgE was significantly higher in children with FMF than controls (136 ± 268, 87 ± 201, respectively; p values <0.05). The percentage of skin prick test positivity was similar for both patients and controls (13% and 8.2%, respectively; p > 0.05). The prevalences of atopic dermatitis, allergic rhinitis, and asthma in the patient group were 5.08%, 28.8%, and 15.25%, respectively, while the control group had the prevalences of 0%, 36%, and 14% respectively.ConclusionChildren with FMF did not show an increase of atopic dermatitis, allergic rhinitis and asthma with respect to controls.     

Practical interest of both skin prick test and specific IgE in the evaluation of tolerance acquisition in IgE mediated cow's milk allergy (CMA). A clinical retrospective study in a cohort of 184 children

BackgroundCow's milk protein allergy (CMPA) represents one of the leading causes of food allergy in infants and young children. The immune reaction may be IgE mediated, non-IgE mediated, or mixed. IgE-mediated cow's milk protein allergy is revealed by immediate and acute symptoms which can be severe. The aim of this study is to report a one centre experience in the real life of testing children with IgE-mediated CMPA and try to identify predictive factor for follow-up challenges.MethodRetrospective and monocentric study between September 1997 and February 2008. 178 infants diagnosed with IgE-mediated CMPA during breastfeeding weaning were included. Initial factors such as age, sex, skin prick tests (SPTs), specific IgE (sIgE), atopic dermatitis and types of reaction were noted. Between 12 and 24 months all infants have undergone at least one evaluation including SPT.ResultsAt the food challenge, 138 (75.8%) infants were found tolerant. Results of the skin prick test (SPT) were statistically different according to the food challenge result (2.2 mm vs. 5.1 mm, p < 0.0001). It was the same result for sIgE for CM 2.0 ku/l vs. 11.5 ku/l – p < 0.0001 and for casein 1.0 ku/l vs. 16.0 ku/l – p = 0.0014.ConclusionThis study confirms the practical interest of both SPT and sIgE in the evaluation of tolerance induction in IgE-mediated CMPA, but with no corresponding results. Sensitivity, specificity and probability curves of success for cow's milk challenge can be determined and have clinical utility.     

Prevalence of asthma and other allergic diseases in children born after in vitro fertilisation

BackgroundChildren born after in vitro fertilisation (IVF) are under greater risk of development of some health problems than those children born after spontaneous conception. Yet it is not exactly known what the prevalence of asthma and other allergic diseases among these children is.Aims of the studyTo investigate the prevalence of asthma, allergic rhinitis and atopic dermatitis in children born after IVF, and controls born after spontaneous pregnancy using questionnaires of International Study of Asthma and Allergies in Children (ISAAC).MethodsWe recruited 158 children (mean age: 4.60 ± 2.14 years) born after IVF pregnancies and 102 children (mean age: 5.27 ± 2.8 years) as control group to investigate the prevalences of asthma, atopic dermatitis and allergic rhinitis. The questions in the questionnaire were asked to the parents by telephone or face to face.ResultsWheezing ever has been reported in 19 % of the children born after IVF and in 17.6 % of the control group (p > 0.05). No significant differences were found between groups, in terms of use of any anti-asthma drugs, physician diagnosed asthma and admission to emergency room with wheezing (p > 0.05). In addition, prevalence of allergic rhinitis and atopic dermatitis were also comparable between two groups (p > 0.05).ConclusionsPrevalences of asthma, allergic rhinitis and atopic dermatitis are similar in children born after IVF and children born after spontaneous conception.     

Serum IgE and eosinophil count in allergic rhinitis-Analysis using a modified Bayes' theorem

BackgroundTo use probability theory to establish threshold values for total serum IgE and eosinophil counts that support a diagnosis of allergic rhinitis and to compare our results with previously published data.MethodsProspective study of rhinitis patients using a modified version of Bayes’ theorem. Study included 125 patients at the West Los Angeles VA Medical Center diagnosed with rhinitis who completed allergy consultation and immediate hypersensitivity skin testing.ResultsEighty-nine of 125 patients were atopic by prick and/or intradermal skin testing. Using a modified version of Bayes’ theorem and positive and negative probability weights, calculations for different thresholds of serum IgE and eosinophil counts were summated and a posttest probability for atopy was calculated. Calculated posttest probabilities varied according to the threshold used to determine a positive or negative test; however, IgE thresholds greater than 140 IU/ml and eosinophil counts greater that 80 cells/ml were found to have a high probability of predicting atopy in patients with rhinitis. Moreover, IgE had a greater influence than eosinophil count in determining posttest probability of allergy in this population. Considerable differences were noted in the IgE levels of atopic and non-atopic patients, including those with asthma or a history of smoking. However, these differences were not observed with eosinophil levels.ConclusionsUsing a modified version of Bayes’ theorem to determine posttest probability, IgE threshold levels greater than 140 IU/ml and eosinophil counts greater than 80 cells/ml in an individual with clinical signs and symptoms of rhinitis are likely to correlate with an atopic aetiology. This model of probability may be helpful in evaluating individuals for diagnostic skin testing and certain types of allergy-modifying treatment.     

Specific oral tolerance induction in paediatric patients with persistent egg allergy

IntroductionDesensitisation or specific oral tolerance induction (SOTI) to food is a new topical-therapeutic approach of food allergy for those children who have not achieved tolerance spontaneously. The objective of this study is to induce clinical tolerance in children with persistent allergy using an oral desensitisation protocol with powdered pasteurised egg.MethodsSeventy-two patients with egg allergy confirmed by open oral challenge test were randomly assigned to SOTI or elimination diet as a control group. Forty children (5–15 years) underwent a SOTI beginning with 1 mg and increasing the dosage weekly until a dose of 10 g, equivalent to an egg. The control group included 32 patients (4–15 years).ResultsThe procedure's average duration was 10 weeks (range 4–28 weeks). Three patients were withdrawn from the protocol for persistent gastrointestinal symptoms. During SOTI, 21 children (52.5%) presented symptoms. In eight the symptoms were mild and required no treatment. In the other 13 (61.90%), the reactions were more severe. Seventeen children finished the treatment over a year ago and 20 in the past 6–12 months. Thirty-seven patients (92.5%) in the active group achieved tolerance to egg, versus 21.8% in the control group. We only found statistically significant differences (p < 0.05) for skin prick tests with powdered egg at various dilutions and IgG levels with egg white after SOTI. Specific IgE concentration did not change significantly.ConclusionsOur SOTI protocol is a safe, effective treatment for food allergy and of reasonable duration, confirming that tolerance can be induced in children who have not achieved it spontaneously.     

Prevalence and factors associated to peanut allergy in Mexican school children

BackgroundIn our country, the prevalence and the factors associated to peanut allergy are unknown, a health problem that has been emerging worldwide.ObjectiveTo establish the prevalence and the factors that are associated to peanut allergy amongst school children.MethodsThis is a population-based cross-sectional study. We included 756 children aged 6–7 years. The children's parents were questioned about their peanut intake habits. A structured questionnaire was applied, it included questions regarding peanut intake; family and personal history of asthma; rhinitis; and atopic dermatitis. Allergic reactions to peanuts were registered as: probable, convincing and systematic. The statistical analyses included logistical regression models to look for associated factors.ResultsMales were 356/756 (47.1%). Peanut allergy prevalence: probable reaction: 14/756 (1.8%), convincing reaction: 8/756 (1.1%) and systemic reaction: 3/756 (0.4%). Through multivariate analysis, the presence of symptoms of allergic rhinitis (OR = 4.2 95% CI 1.3–13.2) and atopic dermatitis (OR = 5.2; 95% CI 1.4–19.5) during the previous year, showed significant association to probable peanut reaction. The former year, the presence of atopic dermatitis was the only variable that was substantially associated to a convincing reaction (OR = 7.5; 95% CI 1.4–38.4) and to a systematic reaction (OR = 45.1; 95% CI 4.0–510.0), respectively.ConclusionsThe reported prevalence of peanut allergy was consistent with that found in previous studies; symptoms of allergic rhinitis and atopic dermatitis were identified as associated factors to peanut allergy.     

Prevalence and risk factors for wheezing and allergic diseases in preschool children: A perspective from the Mediterranean coast of Turkey

ObjectivesThe aim of the present study was to determine the prevalence and risk factors of allergic diseases in preschool children from one of the biggest cities in the Mediterranean Region of Turkey.MethodsThe study population included 396 preschool children attending to urban daycare centres in Mersin. In the first stage, a comprehensive standardised questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC) was employed. In the second stage, serum food and inhalant specific IgE, and skin tests were performed in 45 children with frequent wheezing and 28 children with no wheezing.ResultsThe prevalence of ever wheezing, current wheezing, physician-diagnosed asthma, allergic rhinitis and eczema were 53% (210), 33.3% (132), 27.3% (108), 13.4% (53) and 8.3% (33), respectively. A family history of atopy (OR = 2.5, 95% CI: 1.3–4.7, p = 0.004), dampness at home (OR = 2.4, 95% CI: 1.2–4.8, p = 0.008), a history of intestinal parasites (OR = 4.3, 95% CI: 1.7–10.9, p = 0.002), previous history of pneumonia (OR = 6.9, 95% CI: 1.9–25.9, p = 0.004), initiation of complementary foods before the age of three months (OR = 6.1, 95%CI: 1.4–26.9, p = 0.02) and presence of food allergy (OR = 3.1, 95% CI: 1.1–9.2, p = 0.03) were found to be significant risk factors for physician-diagnosed asthma. The risk factors for frequent wheezing were maternal smoking during pregnancy (OR = 5.2, 95% CI: 0.9–28.7, p = 0.05) and high serum IgE levels (OR = 2.9, 95% CI: 0.9–9.0, p = 0.05) at borderline significance.ConclusionOur study was the first epidemiological study in preschool children in the Mediterranean region of Turkey and demonstrated a high prevalence of asthma and allergic diseases, probably related to humid climatic properties in addition to other environmental and genetic factors.     

Similar prevalence,different spectrum: IgE-mediated food allergy among Turkish adolescents

BackgroundScarcity of reliable data on food allergy prevalence exists in Turkey. We aimed to assess reported and confirmed IgE-mediated food allergy prevalence, and define the spectrum of allergenic food.MethodsWe prospectively evaluated the ISAAC Phase II study population for food allergy. Participants that reported experiencing food allergy symptom in the last year and/or were skin prick test positive for a predefined list of food allergens, were interviewed via telephone, and those considered as having food allergy were invited to undergo clinical investigation, including challenge tests.ResultsA total of 6963 questionnaires were available. Parental reported food allergy prevalence and skin prick sensitisation rate were 20.2 ± 0.9% and 5.9 ± 0.6%. According to the above-defined criteria, 1162 children (symptom positive n = 909, skin prick test positive n = 301, both positive n = 48) were selected and 813 (70.0%) were interviewed via telephone. Out of 152 adolescents reporting a current complaint, 87 accepted clinical investigation. There were 12 food allergies diagnosed in nine adolescents, with food allergy prevalence of 0.16 ± 0.11%. The most common foods involved in allergic reactions were walnut (n = 3) and beef meat (n = 2), followed by hen's egg (n = 1), peanut (n = 1), spinach (n = 1), kiwi (n = 1), cheese (n = 1), hazelnut (n = 1) and peach (n = 1).ConclusionsWhile parental reported food allergy prevalence was within the range reported previously, confirmed IgE-mediated food allergy prevalence among adolescents was at least 0.16%, and the spectrum of foods involved in allergy differed from Western countries, implying environmental factors may play a role.     

Effectiveness of immunotherapy in children depends on place of living – A pilot study

BackgroundIt is considered that farm areas protect young patients from allergy and asthma due to high exposure to endotoxins. Allergen immunotherapy (AIT) is the only treatment of allergy modifying the immune response with the potential to change the natural history of allergic diseases. It seems that studies evaluating the efficacy of immunotherapy in large cohorts of allergic patients living in farm areas are needed to understand the influence of environment on immune response during AIT.Aim. To compare the clinical effectiveness of immunotherapy between children living in farm versus urban areas.Materials and methodsThis was a retrospective analysis of 87 children living in farm area (n = 42) and city area (n = 45), aged 8–16, who completed three years of subcutaneous immunotherapy due to allergic rhinitis/asthma. An AIT efficacy questionnaire has been designed to be filled in by the allergy specialist during a regular immunotherapy visit before and after AIT.ResultsWe observed significantly higher improvement in total score among children from farm area compared to children from city area (p < 0.001). Between-group differences in symptoms and drug scores did not reached the level of significance. Multivariate logistic regression analysis (adjustment for the effect of gender and type of allergy) showed that living in farm areas was independently associated with significant improvement in total score after immunotherapy (OR: 10.9; 95%CI: 3.7–32.2).ConclusionThe current analysis of the better AIT effectiveness in the farm population has shown the protective influence of environmental exposures on asthma and allergic rhinitis in our children.     

Diagnostic values for egg white specific IgE levels with the skin prick test in Turkish children with egg white allergy

BackgroundThe diagnostic values for the skin prick test (SPT) diameters and egg white-specific IgE (EW-sIgE) levels that will allow us to predict the result of the oral food challenge test (OFC) in the diagnosis of egg white allergy vary by the community where the study is carried out.ObjectiveThis study aimed to determine the diagnostic values of SPT and EW-sIgE levels in the diagnosis of egg white allergy.Methods59 patients followed with the diagnosis of egg allergy September 2013 to September 2015 were included in our retrospective cross-sectional study. The patients were investigated in terms of egg and anaphylaxis history or the requirement of the OFC positivity. The demographic, clinical and laboratory findings of the cases were recorded, and they were compared with the patients with the suspected egg allergy but negative OFC (n = 47).ResultsIn the study, for all age groups, the value of 5 mm in SPT was found to be significant at 96.4% positive predictive value (PPV) and 97.8% specificity and the value of 5.27 kU/L for EW-sIgE was found to be significant at 76% PPV and 86.6% specificity for egg white. The diagnostic power of the SPT for egg white (AUC: 72.2%) was determined to be significantly higher compared to the diagnostic power of the EW-sIgE (AUC: 52.3%) (p < 0.05).ConclusionAlong with the determination of the diagnostic values of communities, the rapid and accurate diagnosis of the children with a food allergy will be ensured, and the patient follow-up will be made easier.     

Laboratorial characteristics of patients with diarrhoea suffering from egg white allergy

BackgroundEgg allergy is associated with diarrhoeal symptoms. However, the mechanism underlying allergic diarrhoea remains unclear.ObjectiveTo determine whether egg white-specific IgE antibodies coexist with egg white-specific IgG antibodies in patients with egg allergy featuring diarrhoeal symptoms, and whether there is any relationship between these two antibody types.MethodsA total of 89 patients with egg allergy featuring diarrhoeal symptoms (average age, 23.2 years; range, 1–78 years), all of whom tested positive for egg white-specific IgG, were enrolled in this study. The concentration of total IgE, egg white-specific IgE and number of eosinophils in the serum were determined.ResultsAmong the 89 egg white allergic patients tested, 49 (55.1%) patients showed high reactivity to egg white-specific IgG, 48 (53.9%) patients had elevated serum total IgE levels, and 25 (28.1%) patients had elevated absolute eosinophil numbers. Out of the 89 egg white allergic patients, 25 showed elevated egg white-specific IgE antibody levels. Of the 25 patients who were positive for egg white-specific IgE antibody, 21 presented high sensitive reaction to egg white-specific IgG, three presented moderate sensitive reaction to egg white-specific IgG, and one presented mild sensitive reaction to egg white-specific IgG. A moderate correlation between egg white-specific IgG and egg white-specific IgE, egg white-specific IgG and absolute eosinophil number was found in the egg white allergic patients (r = 0.438, P = 0.000; r = 0.322, P = 0.002). Egg white-specific IgE levels varied in different age groups; the egg white-specific IgE concentration of younger patients (age ≤ 18 years, mean rank 54.29) was significantly higher than that of the adult patients (age > 18 years, mean rank 34.61) (Z = −3.629, P = 0.000).ConclusionEgg white-specific IgE antibody could coexist with egg white-specific IgG antibody in patients suffering from egg white allergy. Aberrant changes in the concentration of egg white-specific IgE antibody were associated with the presence of egg white-specific IgG antibody.     

The utility of TNF-α, IL-6 and IL-10 in the diagnosis and/or follow-up food allergy

BackgroundSeveral pro-inflammatory and anti-inflammatory mediators play a role in the immunopathogenesis of food allergy (FA). The aim of this study was to investigate the utility of serum biomarkers like interleukin (IL)-10, TNF-α, and IL-6 in the diagnosis and/or follow-up of FA.MethodsSixty (25 females, 41.6%) newly diagnosed FA patients [IgE mediated (group-1, n = 37), non-IgE (group-2, n = 23)] with a median age of nine (1–33) months were enrolled. Twenty-four healthy children with a median age of eight (1–36) months constituted the control group (CG). In all the subjects, serum TNF-α, IL-6 and IL-10 levels were evaluated at the time of diagnosis and reassessed four weeks after therapeutic elimination diet (TED).ResultsThe mean white blood cell count and median absolute eosinophile count of the CG were significantly lower than group-1 (p values were 0.019 and 0.006, respectively). The mean absolute neutrophile count and the median IL-6 were significantly higher in group-1 when compared with group-2 (p values were 0.005 and 0.032, respectively. Median TNF-α and IL-6 levels were significantly higher in the pre-TED among all patients (p values were 0.005 and 0.018, respectively). In group-1, median TNF-α and IL-6 levels decreased significantly after TED (p values were 0.01 and 0.029, respectively).ConclusionsOur findings support the role of inflammation in the pathogenesis of FA. Serum TNF-α and IL-6 levels may be useful markers for follow-up in FA, especially among IgE-mediated FA patients. Evaluation of IL-10 results was not sufficient for an interpretation of clinical tolerance.     

Allergic rhinitis and allergy are risk factors for otitis media with effusion: A meta-analysis

Objective/HypothesisWe systematically reviewed the associations between allergic rhinitis or allergy and otitis media with effusion, by reference to published data.Study designA meta-analysis of case-controlled studies.Data sourceFive databases (Pubmed, Highwire, Medline, Wanfang, and China National Knowledge Infrastructure) were searched for relevant studies in the English language published prior to November 12, 2015.Studies chosenStudies with clearly defined experimental and control groups, in which the experimental groups had otitis media with effusion together with allergic rhinitis or allergy, were selected.MethodsWe performed a meta-analysis on data from the identified cross-sectional and case-controlled studies using fixed- or random-effects models (depending on heterogeneity). We used Reviewer Manager 5.3 software to this end.ResultsSeven studies met the inclusion criteria. The prevalence of allergic rhinitis in patients with otitis media with effusion and the control groups differed significantly in three studies (P < 0.00001), as did the prevalence of allergy (in six studies; P = 0.003).ConclusionAllergic rhinitis and allergy appear to be risk factors for otitis media with effusion.     

Prevalence of parent-reported immediate hypersensitivity food allergy in Chilean school-aged children

BackgroundFood allergies (FAs) affect 2–4% of school-aged children in developed countries and strongly impact their quality of life. The prevalence of FA in Chile remains unknown.MethodsCross-sectional survey study of 488 parents of school-aged children from Santiago who were asked to complete a FA screening questionnaire. Parents who reported symptoms suggestive of FA were contacted to answer a second in-depth questionnaire to determine immediate hypersensitivity FA prevalence and clinical characteristics of school-aged Chilean children.ResultsA total of 455 parents answered the screening questionnaire: 13% reported recurrent symptoms to a particular food and 6% reported FA. Forty-three screening questionnaires (9%) were found to be suggestive of FA. Parents of 40 children answered the second questionnaire; 25 were considered by authors to have FA. FA rate was 5.5% (95% CI: 3.6–7.9). Foods reported to frequently cause FA included walnut, peanut, egg, chocolate, avocado, and banana. Children with FA had more asthma (20% vs. 7%, P < 0.02) and atopic dermatitis (32% vs. 13%, P < 0.01) by report. The parents of children with FA did not report anaphylaxis, but 48% had history compatible with anaphylaxis. Of 13 children who sought medical attention, 70% were diagnosed with FA; none were advised to acquire an epinephrine autoinjector.ConclusionUp to 5.5% of school-aged Chilean children may suffer from FA, most frequently to walnut and peanut. It is critical to raise awareness in Chile regarding FA and recognition of anaphylaxis, and promote epinephrine autoinjectors in affected children.     

Food hypersensitivity in patients with seasonal rhinitis in Ankara

BackgroundFood hypersensitivity (FH) affects 1-2% of the adult population and is more common in atopic individuals. The aim of this study was to determine the frequency of FH and risk factors for its development in patients with seasonal rhinitis (SR) in our allergy clinic.MethodsWe performed a retrospective study based on the medical records of 774 patients out of 955 patients diagnosed with SR in an adult allergy clinic between 1 January 1991 and 31 December 2003.ResultsThe mean age of the patients was 29.1 ± 9.29 and 62.7 % were females. The most common major complaints were due to nasal symptoms in 82.3 %. The mean duration of SR was 6.8 ± 6.8 years. Patients were symptomatic for a mean of 3.5 ± 1.7 months per year. Skin prick tests (SPT) with common aeroallergens were positive in 685 patients (90.3 %), and the most common sensitivity was against timothy (85.1 %). The most common accompanying allergic disease was FH in 14%. FH according to history and the results of SPT performed with food allergens were discordant. The most common clinical manifestations of FH were oral allergy (49.1 %) and cutaneous symptoms (38.9 %). Risk factors for the development of FH in patients with SR were dermatological symptoms, rhinitis duration > 5 years, symptom duration > 3 months per year, SPT reactivity to Artemisia vulgaris, tree pollen allergens (Corylus avellena, Betula verrucosa), and bee allergy.ConclusionFH was the most common (14 %) accompanying allergic disease in patients with SR. SPT with food allergens have limited diagnostic value for food allergy and/or intolerance. Risk factors for developing FH in patients with SR in Turkey were dermatological symptoms, duration of rhinitis > 5 years, duration of rhinitis symptoms > 3 months per year, and SPT reactivity to Corylus avellena.     

Characteristics of patients with allergic rhinitis in an outpatient clinic: A retrospective study

BackgroundAllergic rhinitis affects a significant proportion of the European population. Few surveys have investigated this disorder in Greek adults. Our objective was to describe the characteristics of patients with allergic rhinitis in an adult outpatient clinic in Thessaloniki, Greece.MethodsWe studied the medical records of adult patients referred to a Clinical Immunology outpatient clinic from 2001 to 2007. The diagnostic procedure was not changed during the whole study period, including the same questionnaire used at the time of diagnosis, skin prick tests, and serum specific IgE.ResultsA total of 1851 patient files with diagnosed allergies were analysed and allergic rhinitis was confirmed in 711 subjects (38.4%). According to ARIA classification, persistent allergic rhinitis was more prevalent than intermittent (54.9% vs. 45.1%), while 60.8% of subjects suffered from moderate/severe disease. In multivariable analysis, factors associated with allergic rhinitis were age (for every 10 years increase, OR: 0.84, 95% CI: 0.77–0.91; p < 0.001); working in school environment (teachers or students) (OR: 1.46, 95% CI: 1.05–2.02; p = 0.023); parental history of respiratory allergy (OR: 2.41, 95% CI: 1.69–3.43; p < 0.001); smoking (OR: 0.71, 95% CI: 0.55–0.91; p = 0.007); presence of allergic conjunctivitis (OR: 6.16, 95% CI: 4.71–8.06; p < 0.001); and asthma (OR: 2.17, 95% CI: 1.57–3.01; p < 0.001). Analysis after multiple imputation corroborated the complete case analysis results.ConclusionsAllergic rhinitis was documented in 38.4% of studied patients and was frequently characterised by significant morbidity. Factors associated with allergic rhinitis provide insight into the epidemiology of this disorder in our region. Further studies on the general population would contribute to evaluating allergic rhinitis more comprehensively.     

Mold-specific IgE antibodies in relation to exposure and skin test data in schoolchildren

BackgroundThe purpose of the present study was to compare mold specific IgE results with skin test and exposure data, as well as in relation to asthma and other allergic manifestations.MethodsWe performed skin prick tests (SPT) to 13 molds in 341 children from six schools and studied the microbial status of all school buildings. Subsequently, mold specific IgE was measured by enzyme immunoassay (EIA) to 10 molds in 31 of those children with a positive (≥ 3 mm) or weak SPT reaction (1–2 mm) and in 62 age- and sex-matched controls with no such reactions.ResultsMold-specific IgE was elevated by EIA (> 0.35 lU/mL) to at least one of the 10 studied species in 12 children (39%) with and in two children (3%) without skin test reactions. The calculated prevalence of elevated mold-specific IgE was 5% in the non-selected and 10% in children selected by respiratory morbidity. Six children had IgE to the dampness-indicative mold Aspergillus fumigatus, five children had IgE to the common outdoor mold Cladosporium herbarum and four children had IgE to the uncommon, but highly allergenic, indoor mold Rhizopus nigricans. All 14 children who had elevated IgE to molds were boys, 13 had atopy by skin tests and 12 had either asthma or had wheezed. However, no species-specific association was found between IgE or SPT responses and exposure to molds.ConclusionsMold allergy, as assessed by IgE measurements or skin tests, is rare in children. School- aged asthmatic boys having exposed to indoor air dampness seem to form a susceptible group for mold allergy, being at risk for worsening of their asthma.     

Prevalence of oral allergy syndrome in children with allergic diseases

IntroductionThe oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem.ObjectiveIdentify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases.MethodsA cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression.Results267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1–13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR = 2.7, 95%CI 1.2–6.2).ConclusionsOAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome.