allergy
[IgE-dependent allergy--the intensification factor of gastroesophageal reflux in children and youth]

[Article in Polish]

Janiszewska T, Czerwionka-Szaflarska M.

Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii, Akademia Medyczna, ul. M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.

THE AIM of the study was an attempt to determine the correlation between the incidence of IgE - dependent allergy and the severity of gastro-oesophageal reflux in children and youth. PATIENTS AND METHODS: 222 patients aged from 1 to 16 years with diagnosed acidic gastro-oesophageal reflux on the basis of all day ph observations were enrolled to the study. IgE - dependent allergy was diagnosed on the basis of the history, physical examination, evaluation of cIgE concentration in serum and the results of skin tests with chosen food and pollen allergens. RESULTS: IgE - dependent allergy was found in 48% of patients with gastro-oesophageal reflux. In analysis of main parameters of ph examination (percent of time in which ph was lower than 4.0 and the quantity of refluxes lasting over 5 min) in the group of patients with symptoms of IgE - dependent allergy there was a statistically significant higher incidence rate of considerable gastro-oesophageal reflux and lower incidence rate of small gastro-oesophageal reflux in comparison with patients without symptoms of allergy. It was also determined that in this group the oesophageal mucosa in patients with gastro-oesophageal reflux and IgE dependent allergy was statistically significant more subjected to harmful influence of acidic gastric contents in comparison to the group of patients with isolated gastro-oesophageal reflux. CONCLUSIONS: IgE - dependent allergy and coexistent gastro-oesophageal reflux in children and youth escalate the intensity of gastro-oesophageal reflux and more often oesophageal mucosa is subjected to harmful influence of gastric contents.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12878792&dopt=Abstract allergy medicine



allergy
[Prevalence of soya allergy in children with cow's milk allergy]

[Article in Polish]

Szaflarska-Szczepanik A, Gasiorowska J.

Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii, Akademia Medyczna, ul. M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.

Because of contradictory data about the prevalence of soya allergy in children recommendations for the use of the protein-based formulas are ambiguous. THE AIM of the study was to estimate the prevalence of soya allergy in children with IgE-associated cow's milk allergy. MATERIAL: Ninety seven patients aged from six months to four years with personal history suggestive of food allergy with specific IgE to cow's milk protein attending the Department of Pediatrics, Allergology and Gastroenterology between 2000-2002 were studied. In all patients specific IgE to soya protein were detected. RESULTS: In 45% children with IgE-associated cow's milk allergy specific IgE to soya protein were detected. Clinical manifestation in both groups of children with or without specific IgE to soya protein was similar. Gastrointestinal tract symptoms were observed more often in children with cow's milk and soya allergy than in children with cow's milk allergy (52 and 42% respectively) and atopic dermatitis was observed more often in children with cow's milk allergy than in children with cow's milk and soya allergy (81 and 74% respectively). The incidence of respiratory tract symptoms in both groups of children was similar. The differences were not statistically significant. CONCLUSION: It seems, that hydrolyzed formulas should be the preferred choice for children because of a high prevalence of soya protein allergy in children with IgE- associated cow's milk allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12878795&dopt=Abstract allergy medicine



allergy
[Immunological confirmation of allergy in children with hypoimmunoglobulinemia]

[Article in Polish]

Siwinska-Golebiowska H, Czerwinska-Kartowicz I, Markiewicz K, Derentowicz P, Golebiowska-Wawrzyniak M.

Zaklad Immunologii, Instytut Matki i Dziecka, ul. Kasprzaka 17a, 01-211 Warszawa, Poland. immunolog imid.med.pl

The recognition of allergy in children with hypoimmunoglobulinemia is very difficult because they have very low level or even lack of specific IgE antibodies. Our research hypothesis was the possibility of detecting the specific sensitization of lymphocytes T to food allergens in children with hypoimmunoglobulinemia and with clinical symptoms of allergy. MATERIAL: 32 children actually treated in our Immunology Outpatients Department due to immunodeficiency connected with hypoimmunoglobulinemia and with clinical suspicion of allergy. METHODS: IgE concentration in serum and IgE specific antibodies to food and pollens were examined by FEIA CAP-SYSTEM. Lymphocyte specific response to allergens (cow's milk, gluten) was examined by classical blast transformation test. Immunological profile of children was also evaluated. RESULTS: In the group of 32 children we recognised: 20 children with predominantly antibody deficiencies (2 - agammaglobulinemia; 8 - CVID; 5 - selective immunoglobulins deficiency; 5 - hypoimmunoglobulinemia of infants) and 12 children who had combined immunodeficiency with hypoimmunoglobulinemia ( 3 - AT; 8 - Nijmegen S; 1 - Di George). The children had atopic dermatitis and clinical symptoms of allergy in respiratory and digestive tracts. Concentration of IgE in serum of children was very low, even < 2KU/L, Pediatric Phadiatop was negative, f2 and f79 were absent. Using lymphocytes transformation test (culture stimulated with cow's milk and gluten antigens) we detected sensitivity to cow's milk in 24 children and additionally in 4 of them sensitivity to gluten. CONCLUSIONS: 1) Laboratory difficulties in allergy diagnosis in children with hypoimmunoglobulinemia by evaluation of specific IgE concentration in serum may by caused by defect in biosynthesis of mentioned antibodies. 2) In children with hypoimmunoglobulinemia the lymphocyte blastic transformation test with specific allergens in cultures has a diagnostic value indicating lymphocytes specific response to allergens.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12878799&dopt=Abstract allergy medicine



allergy
Assessment of medication errors that involved drug allergies at a university hospital.

Jones TA, Como JA.

Department of Pharmacy, University of Alabama Hospital, Birmingham, Alabama, USA. tjones uabmc.edu

OBJECTIVES: To determine the reporting accuracy of true patient-related allergies to drugs in a large teaching institution (908 licensed beds), and to identify factors contributing to medication errors that involved drug allergies. Of particular interest was the accuracy of allergy information in the medical record and the occurrence of medication errors that involved penicillin antibiotics. METHODS: From a sample population of 340 patients, 50 adult patients admitted to our university-affiliated hospital who met criteria and had an allergy to selected drugs that was documented in the hospitalwide computer system were randomly selected and interviewed to determine the timing, nature, and extent of the reaction. Furthermore, data were collected from identified Medication Error Reports when an agent was prescribed for a patient with a reported allergy to that agent or class. Prospective data collection was conducted from November 2000-February 2001. Using the information obtained by the patient interview and chart documentation, we assessed the reported allergy. In addition, contributing factors for medication errors that involved drug allergies were identified. RESULTS: Of the sample population, 133 patients (39%) reported allergies to at least one drug. Allergies to beta-lactams, sulfonamides, and opioid narcotics were reported in 12.6% (43 patients), 9.1% (31), and 14.4% (49) of the sample population, respectively. Most agents involved in medication errors were beta-lactam antibiotics, with an overwhelming number of these errors due to piperacillin-tazobactam (51.4%, 36 errors). Other drugs involved were ampicillin (10%, 7 errors), other beta-lactams (24.3%, 17 errors), opioid narcotics (10%, 7 errors), and sulfonamides (4.3%, 3 errors). Most contributing factors were classified as "MD [prescribing physician] not aware of allergy." CONCLUSION: These results suggest a need for ensuring that prescribers review each patient's allergy profile before order entry.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12885098&dopt=Abstract allergy medicine



allergy
The role of food allergy in otitis media with effusion.

Aydogan B, Kiroglu M, Altintas D, Yilmaz M, Yorgancilar E, Tuncer U.

Department of Otolaryngology, Cukurova University Medical Faculty, Adana, Turkey.

OBJECTIVE: To detect the relationship between food allergy and otitis media with effusion (OME). MATERIALS AND METHODS: This study was performed on three different groups. The patient group was made up of 56 patients with OME (group I). There were 28 patients with food allergy in group II and these patients were investigated for OME. The control group consisted of 28 patients without any complaints concerning food allergy or OME (group III). RESULTS: Food allergy was detected in 25 patients with OME (44.6%) (group I). In patients with food allergy (group II), OME was detected in 7 patients (25%). In the control group (group III) food allergy was diagnosed in 5 patients (18%) and OME in 1 patient (3%). The incidence of food allergy in OME group was statistically significant when compared to the normal group (P > 0.05). CONCLUSIONS: This study demonstrates that food allergy may play a role in the etiopathogenesis of OME.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15195062&dopt=Abstract allergy medicine



allergy
Latex allergy: a life-threatening epidemic for scientists, healthcare personnel, and their patients.

Edlich RF, Woodard CR, Hill LG, Heather CL.

University of Virginia, Charlottesville, Virginia, USA. redlich9 attbi.com

Latex allergy has become a global epidemic, affecting patients, healthcare workers, and scientific personnel. Today, the incidence of latex allergy in healthcare and scientific personnel varies from 17-36%, costing billions of dollars annually to treat. Consequently, it is the purpose of this special report to describe the etiology, immunology, diagnosis, management, prevention, and litigation of cases of latex allergy. The latex allergy epidemic has been attributed to the dramatic increase in glove usage following the establishment of Universal Precautions by the Centers for Disease Control and Prevention. Because of the latex allergy epidemic, every hospital and scientific research facility should institute a comprehensive emergency treatment program for latex allergic patients, latex-safe areas in their facilities, and a prevention program that includes the wide use of latex-free gloves and the absence of powdered gloves throughout these facilities.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12825745&dopt=Abstract allergy medicine



allergy
Atopic dermatits in infants and children in Israel: clinical presentation, allergies and outcome.

Rottem M, Darawsha J, Zarfin J.

Allergy and Immunology Service, HaEmek Medical Center, Afula, Israel. menachem rottem.net

BACKGROUND: Atopic dermatitis is a common disease in infants and children and the incidence appears to be rising. OBJECTIVES: To determine the presentation, allergies, and outcome among Israeli infants and children. METHODS: Children with atopic dermatitis referred to the allergy clinic at a regional pediatric center were evaluated for their medical history and their allergy. The allergic assessment was determined by utilizing skin prick tests and/or serum specific immunoglobulin E concentrations. The children were reexamined again for all parameters at the end of the follow-up period. RESULTS: Forty-six children with atopic dermatitis were studied, 27 males (58.7%) and 19 females (41.3%). A family history of allergy was found in 19 (41.3%). The median age at presentation was 17 months. Of the 46 children 33 (71.7%) revealed an allergy to one or more of the allergens. The most common combination was allergy to food and house-dust mites. The mean follow-up time was 64 months. By the age of 8 years full recovery was seen in 16 patients, half of whom recovered within 3.3 years from the date of presentation. The probability of complete remission was 58%, and for either complete or partial remission 76%. Upon reevaluation at the end of the follow-up period some patients lost their sensitivities, while others, who had been allergic to foods, became sensitive to house-dust mites and/or pollens. CONCLUSIONS: Atopic dermatitis is an allergic problem in the northem region of Israel, as it is in other parts of the world. Food allergy and house-dust mites are major contributors to the evolution of eczema.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15115258&dopt=Abstract allergy medicine