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.
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Nebulizers generate aerosols and may potentially transmit respiratory viral particles including SARS-CoV-2. There is a great concernabout the use of a nebulizer in the treatment of asthma exacerbations in the hospital or home setting during the COVID-19 pandemicand its use is not recommended unless essential. However, aerosol therapy should not be avoided in obligatory indications. Therefore,indications of nebulizer use during the pandemic should be evaluated on an individual basis in case of a severe asthma attack, andinfection control recommendations should be followed by clinicians while using nebulizers. In this article, we aimed to assess the safetyin addition to the “pro” and “con” sides of nebulizer treatment in asthma exacerbation during the COVID-19 pandemic.
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Objective: Food allergen sensitization patterns vary among patients with atopic dermatitis in different countries. Theaim of this study was to determine the food sensitization patterns of infants with food-triggered atopic dermatitis.Material and Methods: The study was a retrospective evaluation of atopic dermatitis patients who were followed atthe Pediatric Allergy and Immunology Clinic of our hospital. Among these patients, those who had both positive skinprick test and positive serum specific IgE to a food were included in the study. The diagnosis of food sensitization wasconfirmed upon improvement with an elimination dietResults: A total of 204(74.5% boys) atopic dermatitis patients less than 1 year of age were found to have food-trigerredatopic dermatitis. Median age at diagnosis was 3 months(interquartile range: 1-5.8). When skin prick test and serumspecific IgE results were analyzed, we found sensitivity to egg in 85.8%, milk in 35.5%, wheat in 3.9%, walnut in 1.5%,peanut in 2.5%, and fish in 2% of the patients. None of the patients showed sensitivity to soybean.Conclusion: Our findings indicated that a large portion of our patients were male, egg was the most common foodsensitivity, the prevalence of peanut sensitivity was less than other countries and none of the patients had soy sensitivity
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Objective: Children with food allergy need special care. Therefore, parents of food allergic children usually seek information on theinternet to improve their knowledge. However, the quality and accuracy of internet-based information may vary and misdirect parentsin their daily practices.Materials and Methods: We aimed to investigate the habits of internet usage in the families reporting cow’s milk protein allergy ormultiple food allergy in their children. This study was conducted by using a web-based questionnaire that can be completed on theInternet in Facebook groups of families who stated that their children had diagnosis of food allergy.Results: A total of 458 (96% female) individuals with a mean age of 32.03 ± 4.49 years participated in our survey. Three hundred fortythree (74.9%) participants reported that they have preferred the internet to get information associated with the complaints of theirchildren before seeing a physician. Two hundred ninty five (64.4%) participants reported that the information obtained on the internetand the information provided by the physicians were sometimes contradictory. As regards the contradicting information, 147 (49.8%)participants reported that they relied on the information provided by the physicians, whereas, 43 (14.9%) reported that they relied onthe information on the internet. In addition, 44.3% stated that they always or most of the time gave advice to other patients and theirfamilies on the internet.Conclusion: Considering that social media use is an unpreventable habit, online sources should include correct information forinformation-seeking parents and should possibly be supervised or be certified by health institutions and organizations.
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Background/aim: Ig level assessment is frequently used in the diagnosis and follow-up of immunodeficiency, as well as in studiesinvestigating the prevalence of low serum Ig level in specific diseases.Material and methods: Patients who underwent Ig testing in the inpatient and outpatient clinics of our hospital in the years 2010–2016were included. The Ig levels of the patients were assessed separately according to two reference systems commonly used in Turkey andanother reference system used in the USA.Results: A total of 20,138 patients (57.6% male) were included in the study. The median age of the patients was 55.7 months (interquartilerange: 23.1–96.7). According to the reference intervals determined by Tezcan et al., 30.6% of the patients were deficient in one or more Igvalues. This rate was 4 times higher than those based on the reference intervals determined by Aksu et al. (7.7%) and those in the NelsonTextbook of Pediatrics (6.8%). We also determined that the frequency of low Ig levels with three reference systems.Conclusion: In this study, we found that the rates of low Ig level in a group of pediatric patients differed significantly when evaluatedusing three different reference systems for age-related serum Ig levels
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Amaç: Vizing İngilizce kökenli bir kelimedir ve İngilizcenin anadilolmadığı ülkelerde aileler yakınmalarını farklı terminolojiler kullanarakanlatırlar. Bu anlatım farklılığı tanıda zorluklar yaşanmasınayol açabilmektedir. Çalışmada, halkın vizing sesini nasıl tarif ettiğisaptanmaya çalışılmıştır.Gereç ve Yöntem: ISAAC (International Study of Asthma andAllergies in Childhood) çalışma grubu tarafından video anketyöntemi için hazırlanan görüntü akıllı telefonlar yardımıyla gönüllükişilere izletildi. İlk aşamada gönüllülerden izledikleri görüntüdekisesi tarif etmeleri istendi, ikinci aşamada ise daha önceden belirlenmişolan seçenekler verilerek bu sese en yakın tanımın hangisi olduğusoruldu. Kişilerin tanımlayıcı bilgileri ve sosyoekonomik durumlarıkaydedildi.Bulgular: Çalışmaya ortalama yaşı 36.1±9.4 yıl olan 322 gönüllükatıldı. Katılımcıların %52.2’si erkek idi ve %66.1’i videoda dinletilensesi daha önce duymuştu. 322 katılımcının vizing sesi için 55 farklıtarif kullandığı saptandı. En çok kullanılan tarifler nefes darlığı sesi(%23.2), hırıltı (%15.8), boğulma sesi (%11.1) ve astımlı hasta krizsesi (%9.3) idi. Hışıltı tüm cevapların %1.2’sini oluşturmaktaydı.Katılımcıların cinsiyetine ve ailelerinde allerjik hastalık öyküsüolup olmamasına göre vizing sesine verdikleri cevaplar arasındaanlamlı farklılık saptandı (sırası ile p=0.005 ve p<0.001). Çalışmanınson kısmında katılımcılara daha önce hazırlanmış olan ankettenseçenekler verilerek (hırıltı, hışıltı, kedi miyavlaması, fokurtu, haşırtı)dinledikleri sese en yakın ifadenin hangisi olduğu sorulduğundaen çok verilen 3 cevabın hırıltı, hışıltı ve kedi miyavlaması olduğugörüldü.Sonuç: Katılımcı grubu tarafından vizing sesine çok farklı Türkçekarşılıklar verilmiştir. Vizing sorgulanırken hışıltı dışındakiseçeneklerin de sorulması klinikte öykünün daha kolay alınmasınayardımcı olabilir. Ayrıca halk tarafından doğru ve kolay anlaşılabilirbir karşılık bulunması gerek klinikte gerek saha çalışmalarındasemptomların daha kolay anlaşılmasına olanak sağlayabilir.
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Objective: Platelets play a role in the pathogenesis of inflammationbeside hemostasis. Mean platelet volume (MPV) is used as abiomarker of platelet activation. Although the platelet’s role in thepathogenesis of allergic diseases is well known, the MPV value isstill controversial in allergic diseases. The objective is to observethe changes of the MPV value in patients with allergic diseasesand patients receiving subcutaneous venom and aeroallergenimmunotherapy (SCIT).Materials and Methods: Patients who are followed by our pediatricallergy and immunology clinic were enrolled in the study. Thestudy group included patients with atopic dermatitis, food allergy,chronic urticaria, allergic rhinitis, asthma and obese asthmatics. Thecontrol group consisted of age- and gender-matched and otherwisehealthy children. The value of MPV was recorded and compared tothe control group’s value. The value of MPV was evaluated at thebeginning and at the second year of SCIT.Results: Study subgroups included patients with atopic dermatitis(n:132), food allergy (n:47), allergic rhinitis (n:48), chronic urticaria(n:102 ), asthma (n:22), and obese asthmatics (n:31). The valueof MPV was not statistically different between the patient andcontrol groups. The severity of atopic dermatitis, autoimmunityof chronic urticaria and presence of obesity in asthmatic patientsdid not influence the value of MPV. The beginning and the secondyear median (IQR) MPV levels of the patients receiving SCIT were 7.5 (7.1-8.1) fl and 8.6 (7.6-9.2) fl respectively in the aeroallergenimmunotherapy (IT) group, and 7.9 (7.2-8.4) fl and 8.8 (8.3-9.3) flrespectively in the venom immunotherapy (VIT) group (p<0.001).Conclusion: This study has shown that MPV changes significantlyover the years in SCIT.
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Amaç: Astım genetik ve çevresel faktörlerin etkisiyle ortaya çıkan kronik infl amatuvar bir hastalıktır. Deri testi, çeşitli alerjenlere karşı olan Tip 1 aşırı duyarlılık reaksiyonunu göstermektedir. Deri testleri ile alerjik tetikleyiciler ve spesifi k bir ajana karşı hassasiyetin derecesi saptanabilir. Çalışmada; astımlı çocuklarda yapılan deri testi sonuçları; aile öyküsü, eşlik eden alerjik rinit varlığı ve çeşitli faktörlere bağlı sonuçların değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya, 6-18 yaş grubunda kliniğimizde astım tanısı ile takip edilen eşlik eden alerjik rinit dışında kronik hastalığı olmayan hastalar alındı. Her hastaya standart veri toplama formu dolduruldu. Solunum fonksiyon testi yapıldı. Her hastaya deri testi uygulandı. Sonuçlar ailede atopi öyküsü ve tanı gruplarına (Astım/ Astım+ Alerjik Rinit) göre değerlendirildi.Bulgular: Çalışmaya toplam 236 astımlı hasta dahil edildi. Olguların 155'i (%65.7) erkek ve yaş ortalaması 7.9 (7.4-12.2) (IQR) yıldı. Astımlı hasta sayısı 163 iken; 73 hastada hem astım hem alerjik rinit mevcuttu. Deri testi sonuçlarına göre en az bir alerjene karşı duyarlılık sıklığı %42.6 bulundu. En fazla duyarlılık %23.6 ile genel polen duyarlılığıydı. Tanı gruplarına göre astımlı hastalarda atopi sıklığı %39 iken eşlik eden alerjik rinit varlığında bu oran %52.1 bulundu (p=0.061). Ailede atopi öyküsü olan grupta alerjen duyarlılığı %39.8 iken öykü vermeyen grupta %44.3 (p=0.496) bulundu.Sonuç: Çocukluk çağı astımında alerjen duyarlılığı önemli rol oynamaktadır. Astım tanısı konulan her hastada alerjen duyarlılığı araştırılmalıdır. Deri testi yapılan her hastanın sosyodemografi k özellikleri, aile öyküsü, eşlik eden diğer alerjik hastalıklar açısından dikkatle sorgulanması gerekmektedir. Çalışmamızda en çok genel polen duyarlılığı bulunması bölgemizde daha önce yapılan çalışmalarla benzerlik göstermektedir. Astım ve alerjik rinit birlikteliği olan grupta alerjen duyarlılığı sıklığı beklenildiği gibi daha fazla bulunmuştur. Aile öyküsü olan grupta daha fazla alerjen duyarlılığı olması beklenirken bizim çalışmamızda alerjen duyarlılığının daha düşük olduğu tespit edilmiştir.
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