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1.
Allergy: European Journal of Allergy and Clinical Immunology ; 78(Supplement 111):600, 2023.
Artículo en Inglés | EMBASE | ID: covidwho-2304894

RESUMEN

Case report Dust is a known mixture and carrier of multiple allergens and an epidemiologic study demonstrated the presence of peanut proteins in school cafeterias and classrooms, suggesting that schools may play an important role in exposure to environmental food allergens. While inhalation of food allergens is a known trigger of IgE-mediate acute respiratory reaction as rhinitis and wheezing, little is known about persistent allergic asthma and/or rhinitis induced by chronic inhalation of food allergens. Here we report two cases of teenagers with nuts allergy presenting with persistent respiratory symptoms when exposed to closed and dusty environments. The first case concerns a 12-year-old boy allergic to walnut and hazelnut (specific IgE > 100 and 81.70 kU/l, respectively). For some years he has had a persistent mild asthma, frequent nasal occlusion and rhinorrhea, without any allergic sensitization to aeroallergens. Symptoms occurred exclusively during school period when he required maintenance therapy with inhaled and nasal steroids. He was asymptomatic and did not need any treatment during summer. During the lockdown period due to Covid-19 pandemic, he did not attend school for several months and he was able to discontinue inhaled corticosteroid therapy without recurrence of asthma and rhinitis symptoms. Asthma recurred after he returned to school, but with only mild intermittent symptoms, probably thanks to the use of masks and the frequent airing of the classrooms. On a single occasion he experienced nasal occlusion and rhinorrhea after that a parent had eaten hazelnut cream in the same room where he was. The second case deals with a 17-year-old boy with a history of several food allergies (milk, egg, wheat, banana, nuts, hazelnuts) and mild persistent asthma in absence of sensitization to aeroallergens. He successfully underwent oral desensitization for milk, egg and wheat in previous years. Asthma symptoms improved over the years together with progressive development of oral tolerance to food allergens for which oral immunotherapy had been done. On the other hand, he referred persistence of allergic rhinitis especially during the school year and his symptoms got worse in classroom. Exhaled nitric oxide was quite increased with evidence of eosinophils in nasal smears. In-vitro and in-vivo tests only detected food allergens sensitizations, in particolar to walnuts and hazelnuts (specific IgE were 61.00 and 55.50 kU/l respectively). These two clinical cases suggest that food allergens might be causative agents of allergic persistent asthma and/or rhinitis as aeroallergens do.

2.
Pediatric Rheumatology ; 19(SUPPL 1), 2021.
Artículo en Inglés | EMBASE | ID: covidwho-1571816

RESUMEN

Introduction: Chilblain-like lesions have become a common complaint among children and adolescent during COVID-19 pandemic. A clear and objective relationship between this skin manifestation and SARS-CoV-2 infection has not been fully established neither its potential triggering rheumatologic disorders. Objectives: To characterize a group of children and adolescents with chilblain-like lesions. Methods: Data from out-patients of two northeast Italian hospitals were collected between December 2020 and April 2021. Clinical evaluation, blood test, interferon score and capillaroscopy were recorded in an electronic database. Results: We collected data from 35 patients, almost all adolescents (mean age: 13.1 years, 7 male and 28 females), with evidence of chilblain-like lesions. 5/35 had a parent who presented with COVID-19- related symptoms and/or with a positive swab test for SARS-CoV2 in the previous months. Only 2/35 had a positive swab test respectively three and four months before clinical evidence of chilblain-like lesions and none of those tested had a positive IgG serology. The average duration of the skin lesions, which appeared to be mainly localized to the toes, at the time of the first visit was 13.4 weeks. Two patients presented with signs of arthritis and tenosynovitis of the ankles. No other physical complaints were reported by the other patients. The most common capillaroscopic pattern was characterized by mild pericapillary oedema without hemorrhages or capillary abnormalities. No alterations in whole blood count and inflammatory markers were noted. 3/35 showed antinuclear antibodies in low counts. Interferon score was positive in 7 patients with a maximum of 10.1. (n.v. < 2.4) A trial of oral prednisone was the most common therapeutic approach in 17/35 patients. Three patients received Nifedipine and a course of hydroxychloroquine was started in those with severe complaints and a positive interferon score. Conclusion: Chilblain-like lesions presented as a benign clinical entity without a clear and objective proof of SARS-CoV2 contact in almost of the cases. All the investigations performed did not show any evidence of underlying systemic inflammation except for an enhanced interferon mediated response in some cases. We believe a strict follow-up of these cases is strongly warranted.

4.
Medico e Bambino ; 40(4):211-212, 2021.
Artículo en Italiano | Scopus | ID: covidwho-1237083
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