Natural Course of Cow's Milk Allergy in Children with Atopic Dermatitis

Cow's milk is one of the most common food allergens in children with atopic dermatitis (AD). This study was conducted to describe the natural course of cow's milk allergy in children with AD, and to identify factors predictive of outcome. To accomplish this, we reviewed the medical records of 115 children who were diagnosed with AD and cow's milk allergy before 24 months of age to evaluate their clinical characteristics and prognostic factors. During a follow-up period of 24 to114 months, the median age for tolerance to cow's milk was found to be 67 months. Multivariate analysis using the Cox proportional hazard model revealed that the peak cow's milk-specific IgE level within 24 months after birth was the most important factor for prediction of the outcome of cow's milk allergy. In conclusion, half of the children younger than 24 months of age with AD and cow's milk allergy could tolerate cow's milk at 67 months of age. The peak cow's milk-specific IgE level within the first 24 months of birth is useful to predict the prognosis of cow's milk allergy in children with AD.

Etiology of hemoptysis in children: a single institutional series of 40 cases

PURPOSE: The aim of this study was to determine the causes of hemoptysis in a pediatric age group. METHODS: We conducted a retrospective chart review of all patients who were admitted to Samsung Medical Center between 1996 and 2008 with a chief complaint of hemoptysis. Patients with trauma or underlying bleeding tendency such as leukemia were excluded. Patients were divided into three groups according to age (0 to 5 yr, 6 to 10 yr, and 11 to 18 yr). The amount of hemoptysis was classified as mild (100 mL/day). Causes and duration of hemoptysis, disease course, and mortality were also investigated. RESULTS: A total of 40 patients (18 males and 22 females) were identified. Their median age was 6.3 yr (range, 10 months to 18 yr). Twenty-five patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and six patients, respectively. Respiratory tract infection was the most common cause of hemoptysis. Other causes included congenital heart disease, Heiner syndrome, neoplasm in the airway, vasculitis syndrome, and bronchiectasis. In most patients (87.5%), hemoptysis disappeared during medical treatment that included antibiotics or transfusion. Hemoptysis recurred in 12 patients, and the overall mortality rate was 5%. CONCLUSIONS: The most common cause of hemoptysis in children was respiratory tract infection. Most cases had a benign course, but recurrence and mortality occurred in a minority of patients. An accurate diagnosis of the underlying etiology is essential for treatment.

Etiology of hemoptysis in children: a single institutional series of 40 cases

PURPOSE: The aim of this study was to determine the causes of hemoptysis in a pediatric age group. METHODS: We conducted a retrospective chart review of all patients who were admitted to Samsung Medical Center between 1996 and 2008 with a chief complaint of hemoptysis. Patients with trauma or underlying bleeding tendency such as leukemia were excluded. Patients were divided into three groups according to age (0 to 5 yr, 6 to 10 yr, and 11 to 18 yr). The amount of hemoptysis was classified as mild (100 mL/day). Causes and duration of hemoptysis, disease course, and mortality were also investigated. RESULTS: A total of 40 patients (18 males and 22 females) were identified. Their median age was 6.3 yr (range, 10 months to 18 yr). Twenty-five patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and six patients, respectively. Respiratory tract infection was the most common cause of hemoptysis. Other causes included congenital heart disease, Heiner syndrome, neoplasm in the airway, vasculitis syndrome, and bronchiectasis. In most patients (87.5%), hemoptysis disappeared during medical treatment that included antibiotics or transfusion. Hemoptysis recurred in 12 patients, and the overall mortality rate was 5%. CONCLUSIONS: The most common cause of hemoptysis in children was respiratory tract infection. Most cases had a benign course, but recurrence and mortality occurred in a minority of patients. An accurate diagnosis of the underlying etiology is essential for treatment.