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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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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