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1.
Allergol. immunopatol ; 48(4): 323-331, jul.-ago. 2020. tab
Article in English | IBECS | ID: ibc-199716

ABSTRACT

INTRODUCTION AND OBJECTIVES: Since early 2000s, atopy patch test (APT) has been used to determine non-IgE and mixed-type food allergies. Previous studies have reported conflicting results about the diagnostic value of APT in food allergies, due to non-standardized methods. We aimed to determine the diagnostic efficacy of APT compared to open oral food challenge (OFC) in patients diagnosed with cow's milk allergy (CMA) and hen's egg allergy (HEA) manifesting as atopic dermatitis (AD) and gastrointestinal system symptoms. MATERIALS AND METHODS: In patients with suspected AD and/or gastrointestinal manifestations due to CMA and HEA, the results of OFC, APT, skin prick test (SPT) and specific IgE (sIgE) were reviewed. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sIgE, SPT, APT and SPT+APT were calculated. RESULTS: In total 133 patients with suspected CMA (80) and HEA (53) were included in the study. In patients with CMA presenting with gastrointestinal symptoms, APT had sensitivity of 9.1%, specificity of 100%, PPV of 100% and NPV of 48.7%. In atopic dermatitis patients, sensitivity of APT was 71.4%, specificity 90.6%, PPV 62.5% and NPV 93.6%. In patients diagnosed with HEA, the sensitivity, specificity, PPV and NPV values of APT were 72.0%, 78.6%, 47.2% and 75.0%, respectively. In patients diagnosed with HEA presenting with AD, sensitivity of APT was 87.5%, specificity 70.6%, PPV 73.7% and NPV 85.7%. Atopy patch test had lower sensitivity (44.4%) and higher specificity (90.9%) in patients diagnosed with HEA presenting with gastrointestinal symptoms than those presenting with AD. CONCLUSION: Our study showed that APT provided reliable diagnostic accuracy in atopic dermatitis patients. However, APT had low sensitivity in patients with gastrointestinal symptoms


No disponible


Subject(s)
Humans , Male , Female , Infant , Skin Tests , Egg Hypersensitivity/diagnosis , Milk Hypersensitivity/diagnosis , Sensitivity and Specificity
2.
Allergol Immunopathol (Madr) ; 48(4): 323-331, 2020.
Article in English | MEDLINE | ID: mdl-32402621

ABSTRACT

INTRODUCTION AND OBJECTIVES: Since early 2000s, atopy patch test (APT) has been used to determine non-IgE and mixed-type food allergies. Previous studies have reported conflicting results about the diagnostic value of APT in food allergies, due to non-standardized methods. We aimed to determine the diagnostic efficacy of APT compared to open oral food challenge (OFC) in patients diagnosed with cow's milk allergy (CMA) and hen's egg allergy (HEA) manifesting as atopic dermatitis (AD) and gastrointestinal system symptoms. MATERIALS AND METHODS: In patients with suspected AD and/or gastrointestinal manifestations due to CMA and HEA, the results of OFC, APT, skin prick test (SPT) and specific IgE (sIgE) were reviewed. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sIgE, SPT, APT and SPT+APT were calculated. RESULTS: In total 133 patients with suspected CMA (80) and HEA (53) were included in the study. In patients with CMA presenting with gastrointestinal symptoms, APT had sensitivity of 9.1%, specificity of 100%, PPV of 100% and NPV of 48.7%. In atopic dermatitis patients, sensitivity of APT was 71.4%, specificity 90.6%, PPV 62.5% and NPV 93.6%. In patients diagnosed with HEA, the sensitivity, specificity, PPV and NPV values of APT were 72.0%, 78.6%, 47.2% and 75.0%, respectively. In patients diagnosed with HEA presenting with AD, sensitivity of APT was 87.5%, specificity 70.6%, PPV 73.7% and NPV 85.7%. Atopy patch test had lower sensitivity (44.4%) and higher specificity (90.9%) in patients diagnosed with HEA presenting with gastrointestinal symptoms than those presenting with AD. CONCLUSION: Our study showed that APT provided reliable diagnostic accuracy in atopic dermatitis patients. However, APT had low sensitivity in patients with gastrointestinal symptoms.


Subject(s)
Egg Hypersensitivity/diagnosis , Milk Hypersensitivity/diagnosis , Patch Tests/methods , Animals , Female , Humans , Infant , Male , Retrospective Studies , Sensitivity and Specificity
3.
Allergol. immunopatol ; 47(3): 265-271, mayo-jun. 2019. tab
Article in English | IBECS | ID: ibc-186488

ABSTRACT

Introduction and objectives: Symptom-based score (SBS) quantifies the number and severity of suspected cow's milk-related symptoms. In this study, we aimed to evaluate the efficiency of SBS in patients diagnosed with cow's milk protein (CMPA) and hen's egg allergy (HEA). Materials and methods: A single-center study was conducted between June 2015 and August 2017. Infants who were diagnosed with CMPA and HEA or both were enrolled in the study. SBS was applied at baseline and at one month during an elimination diet. Results: One hundred and twelve patients were enrolled in the study. Of these, 56 (50%) were female. Forty-nine (43.8%) patients were diagnosed with CMPA, 39 (34.8%) patients were diagnosed with HEA and 24 (21.4%) patients were diagnosed with cow's milk protein and hen's egg allergy (CMPHEA). In the analysis of SBS, median Bristol scale and initial total symptom-based scores were significantly lower in the HEA group than others (p = 0.002; p = 0.025). After the elimination diet, mean SBS decrease in the CMPHEA group (11.3 ± 4.7) was found to be higher than CMPA (8.8 ± 3.7) and HEA (8.0 ± 4.0) groups (p = 0.009). In 41 (83.7%) patients with CMPA, 33 (84.6%) patients with HEA and 21 (87.5%) patients with CMPHEA, a ≥ 50% decrease in SBS was observed after the elimination diet. Conclusion: We may conclude that the present study suggests that SBS can be useful in monitoring the response to elimination diet in infants diagnosed with cow's milk protein and hen's egg allergy


No disponible


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Cats , Egg Hypersensitivity/diagnosis , Milk Hypersensitivity/diagnosis , Research Design , Allergens/immunology , Brazil/epidemiology , Cross-Sectional Studies , Egg Hypersensitivity/diet therapy , Egg Hypersensitivity/epidemiology , Egg Proteins/immunology , Milk Hypersensitivity/diet therapy , Milk Hypersensitivity/epidemiology , Milk Proteins/immunology , Prevalence , Severity of Illness Index
4.
Allergol Immunopathol (Madr) ; 47(3): 265-271, 2019.
Article in English | MEDLINE | ID: mdl-30501905

ABSTRACT

INTRODUCTION AND OBJECTIVES: Symptom-based score (SBS) quantifies the number and severity of suspected cow's milk-related symptoms. In this study, we aimed to evaluate the efficiency of SBS in patients diagnosed with cow's milk protein (CMPA) and hen's egg allergy (HEA). MATERIALS AND METHODS: A single-center study was conducted between June 2015 and August 2017. Infants who were diagnosed with CMPA and HEA or both were enrolled in the study. SBS was applied at baseline and at one month during an elimination diet. RESULTS: One hundred and twelve patients were enrolled in the study. Of these, 56 (50%) were female. Forty-nine (43.8%) patients were diagnosed with CMPA, 39 (34.8%) patients were diagnosed with HEA and 24 (21.4%) patients were diagnosed with cow's milk protein and hen's egg allergy (CMPHEA). In the analysis of SBS, median Bristol scale and initial total symptom-based scores were significantly lower in the HEA group than others (p=0.002; p=0.025). After the elimination diet, mean SBS decrease in the CMPHEA group (11.3±4.7) was found to be higher than CMPA (8.8±3.7) and HEA (8.0±4.0) groups (p=0.009). In 41 (83.7%) patients with CMPA, 33 (84.6%) patients with HEA and 21 (87.5%) patients with CMPHEA, a ≥50% decrease in SBS was observed after the elimination diet. CONCLUSION: We may conclude that the present study suggests that SBS can be useful in monitoring the response to elimination diet in infants diagnosed with cow's milk protein and hen's egg allergy.


Subject(s)
Egg Hypersensitivity/diagnosis , Milk Hypersensitivity/diagnosis , Research Design , Allergens/immunology , Animals , Brazil/epidemiology , Cattle , Child, Preschool , Cross-Sectional Studies , Egg Hypersensitivity/diet therapy , Egg Hypersensitivity/epidemiology , Egg Proteins/immunology , Female , Humans , Infant , Infant, Newborn , Male , Milk Hypersensitivity/diet therapy , Milk Hypersensitivity/epidemiology , Milk Proteins/immunology , Prevalence , Severity of Illness Index
6.
Pediatr Dermatol ; 25(3): 326-31, 2008.
Article in English | MEDLINE | ID: mdl-18577036

ABSTRACT

Dorfman-Chanarin syndrome is a rare, autosomal recessive inherited lipid storage disease with congenital ichthyotic erythroderma due to an acylglycerol recycling defect. It is characterized by accumulation of neutral lipids in different tissues. Liver, muscle, ear, eye, and central nervous system are generally involved, so we presented a patient with severe ichthyosis, lipid vacuoles in neutrophils, and multiorgan involvement including a very rare complication, renal involvement. A 7-month-old girl was presented with frequent respiratory infection, congenital ichthyotic erithroderma and suspicion for immune deficiency. On her physical examination hepatomegaly, developmental delay, palmar and plantar hyperkeratosis and increased deep tendon reflexes with clonus and high tonus were found. Laboratory investigations revealed elevation at transaminases levels, hypoalbuminemia, hypergammaglobulinemia, presence of autoantibodies and eosinophilia. Vacuolization in leukocytes confirmed Dorfman-Chanarin syndrome, whereas no mutation at RAG1-2 and ARTEMIS genes ruled-out immune deficient status of the patient. At the age of eight months the patient died from severe renal failure. Her necropsies demonstrated microvesicular lipid accumulation not only at the liver but also at the renal species. The variability of involvement of different systems in Dorfman-Chanarin syndrome is well described, however the renal findings has not been reported previously at the literature.


Subject(s)
Ichthyosiform Erythroderma, Congenital/complications , Lipidoses/diagnosis , Renal Insufficiency/etiology , DNA Mutational Analysis , Developmental Disabilities , Diagnosis, Differential , Fatal Outcome , Fatty Liver/etiology , Fatty Liver/pathology , Female , Humans , Ichthyosiform Erythroderma, Congenital/pathology , Infant , Leukocytes/pathology , Lipidoses/blood , Lipidoses/complications , Lipidoses/genetics , Nervous System Diseases , Renal Insufficiency/pathology , Syndrome , Vacuoles/pathology
7.
Pediatr Int ; 41(5): 557-60, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10530072

ABSTRACT

AIM: To clarify the role of maternal preeclampsia in jitteriness in preterm infants. METHODS: Sixteen premature infants of preeclamptic mothers were observed for occurrence of jitteriness and were compared with 32 premature infants born to normotensive women. RESULTS: Jitteriness was present in a significantly higher percentage (75 vs 6%) and persisted longer (4.5 +/- 5.6 vs 1.5 +/- 0.7 days) in the preterm infants of preeclamptic mothers. CONCLUSIONS: Maternal preeclampsia could be included among the pathological factors that cause jitteriness in preterm babies.


Subject(s)
Infant, Premature , Pre-Eclampsia/complications , Psychomotor Agitation/etiology , Adult , Case-Control Studies , Female , Humans , Infant, Newborn , Logistic Models , Male , Pregnancy , Prospective Studies , Psychomotor Agitation/epidemiology , Risk Factors , Turkey/epidemiology
9.
Ann Nucl Med ; 13(6): 415-8, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10656276

ABSTRACT

Landau-Kleffner syndrome (LKS) is a rare childhood disorder characterized by acquired aphasia with seizures and electroencephalogram (EEG) abnormalities. Tc-99m-HMPAO SPECT was performed in three right handed children with LKS. A relative decrease in perfusion was found in the left temporal cortex of all three patients and also in the left frontoparietal cortex of one patient with hyperkinetic behavior. Degree of regional cerebral perfusion impairment did not correlate with the severity of clinical and EEG abnormalities. Asymmetrical temporoparietal perfusion appears characteristic of LKS. SPECT findings in LKS were evaluated as useful in elucidating the pathogenic features of the disorder in the brain.


Subject(s)
Anticonvulsants/therapeutic use , Brain/physiopathology , Electroencephalography , Landau-Kleffner Syndrome/diagnostic imaging , Landau-Kleffner Syndrome/physiopathology , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Brain/diagnostic imaging , Carbamazepine/therapeutic use , Cerebrovascular Circulation , Child, Preschool , Clonazepam/therapeutic use , Dexamethasone/therapeutic use , Evoked Potentials, Auditory, Brain Stem , Frontal Lobe/blood supply , Humans , Landau-Kleffner Syndrome/drug therapy , Male , Parietal Lobe/blood supply , Radiopharmaceuticals/pharmacokinetics , Technetium Tc 99m Exametazime/pharmacokinetics , Temporal Lobe/blood supply , Tomography, Emission-Computed, Single-Photon , Valproic Acid/therapeutic use
10.
Indian J Pediatr ; 65(5): 729-34, 1998.
Article in English | MEDLINE | ID: mdl-10773929

ABSTRACT

The study was planned to investigate the effectiveness of using leucocyte filters in neonates during exchange and erythrocyte transfusion in preventing the development of anti-HLA antibodies. Twenty-four newborn infants who were admitted to the Neonatology Unit and received either exchange or at least two erythrocyte transfusions were recruited. The study group comprised of 12 infants on whom leucocyte filters were used during transfusions. Control group included the remaining 12 infants who were transfused without using a leucocyte filter. Anti-HLA antibodies in the serum samples were studied using modified Amos technique. Presence of anti-HLA antibodies in post-transfusion sera was detected in 3 (25%) of 12 infants in the study (filter) group, while in 10 (83.33%) of 12 infants in the control (no-filter) group. The difference between two groups was statistically significant (p < 0.05). The study demonstrated that term and preterm neonates were capable of developing anti-HLA antibodies following exchange and erythrocyte transfusions, and use of leucocyte filters could efficiently prevent the formation of anti-HLA antibodies.


Subject(s)
Blood Group Incompatibility/prevention & control , Erythrocyte Transfusion , Exchange Transfusion, Whole Blood , HLA Antigens/blood , Isoantibodies/blood , Leukocytes/immunology , Female , Gestational Age , Humans , Infant, Newborn , Male , Risk Factors
11.
J Pediatr Endocrinol Metab ; 10(4): 391-4, 1997.
Article in English | MEDLINE | ID: mdl-9364365

ABSTRACT

MHC class I antigen expression was found to be low on the lymphocytes of patients with insulin dependent diabetes mellitus (IDDM). Thus, it has been proposed that the defective expression of MHC antigens could lead to faulty immunological responses with the eventual destruction of the pancreatic beta cells. The objective in this study was to compare MHC antigen expression in IDDM patients and their presently healthy siblings. Nineteen children (mean age 10.8 +/- 3.9 years) with diabetes and their 25 siblings (mean age 10.7 +/- 4.6 years) were enrolled in the study. Peripheral blood lymphocytes isolated from venous blood samples were incubated with FITC conjugated monoclonal antibody W6/32. The amount of antibody binding by cell surface MHC class I antigens was assessed by flow cytometry. MHC class I molecule expression did not differ significantly among IDDM patients and their siblings. It was concluded that MHC class I antigen expression did not appear to be indicative of a susceptibility to develop autoimmune diabetes.


Subject(s)
Diabetes Mellitus, Type 1/immunology , Histocompatibility Antigens Class I/blood , Adolescent , Antibodies, Monoclonal , Child , Diabetes Mellitus, Type 1/genetics , Female , Flow Cytometry , Fluorescein-5-isothiocyanate , Fluorescent Dyes , Humans , Lymphocytes/immunology , Male
12.
Acta Paediatr Jpn ; 39(2): 201-4, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9141254

ABSTRACT

Various changes in renal function caused by unconjugated hyperbilirubinemia in newborns have been suggested in previous reports. Disclosing an injury in renal tubulus epithelium is feasible by measurement of urinary enzymes. Thus, renal function tests and urinary enzymes in 25 terms newborns with unconjugated hyperbilirubinemia were evaluated before and after phototherapy. Ten healthy term newborns without hyperbilirubinemia formed the control group. Mean values of the variables obtained before and after phototherapy in the study group and in the controls were, respectively: urine osmolality (osm/kg H2O): 0.147 +/- 0.009, 0.174 +/- 0.011, and 0.153 +/- 0.018; endogenous creatinine clearance (mL/min per 1.73 m2): 45.7 +/- 2.15, 46.0 +/- 1.6 and 46.7 +/- 3.9; fractional excretion of sodium (%): 1.27 +/- 0.30, 0.79 +/- 0.19 and 1.24 +/- 0.07; tubular phosphorus reabsorption (%): 85.8 +/- 3.3, 87.8 +/- 2.8 and 86.6 +/- 1.7; urinary N-acetyl-beta-D glucosaminidase/creatinine (IU/mg): 0.617 +/- 0.226, 0.574 +/- 0.214 and 0.619 +/- 0.210; fractional excretion of alkaline phosphatase (%): 0.422 +/- 0.103, 1.001 +/- 0.374 and 0.596 +/- 0.201; fractional excretion of lactic dehydrogenase (LDH; %): 0.102 +/- 0.019, 0.121 +/- 0.023 and 0.119 +/- 0.041; fractional excretion of AST (%): 0.433 +/- 0.127, 0.530 +/- 0.113 and 0.502 +/- 0.074; fractional excretion of alanine aminotransferase (ALT; %) 0.856 +/- 0.413, 1.619 +/- 1.076 and 1.066 +/- 0.366. No significant difference was found between these values before and after phototherapy in the study group, or between the values before phototherapy in hyperbilirubinemic neonates and in the control group. In conclusion, unconjugated hyperbilirubinemia up to a serum level of 18.4 mg/dL in term neonates does not seem to result in injury of normal tubulus epithelium as shown by urinary enzyme levels.


Subject(s)
Jaundice, Neonatal/enzymology , Kidney Tubules/physiopathology , Alanine Transaminase/urine , Alkaline Phosphatase/urine , Aspartate Aminotransferases/urine , Hexosaminidases/urine , Humans , Infant, Newborn , Jaundice, Neonatal/physiopathology , Jaundice, Neonatal/therapy , Jaundice, Neonatal/urine , Kidney Function Tests , L-Lactate Dehydrogenase/urine , Osmolar Concentration , Phototherapy
13.
Acta Paediatr Jpn ; 38(2): 118-20, 1996 Apr.
Article in English | MEDLINE | ID: mdl-8677785

ABSTRACT

Postictal serum prolactin and cortisol levels were measured in 37 children having either epilepsy, febrile seizure or syncopal attack and in 37 normal controls. Blood samples were obtained within 1.5 h following the seizure episode. All serum levels were compared between each group and the control groups. Significantly higher (P < 0.005) prolactin levels (56.64 +/- 34.78 ng/mL) were found in the epileptic group, compared to the levels in children with febrile seizures (21.72 +/- 12.92 ng/mL), syncope attacks (13.88 +/- 5.27 ng/mL) and the control group (14.32 +/- 5.05 ng/mL). In contrast, serum cortisol levels were non-specifically elevated in children with epilepsy, febrile seizures and syncopal attacks. Cortisol secretion appears to be non-specifically elevated in all stressful events. Elevated prolactin levels may be helpful in differentiating epilepsy from febrile seizures and syncope.


Subject(s)
Hydrocortisone/blood , Prolactin/blood , Seizures/blood , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Epilepsy/complications , Epilepsy/diagnosis , Humans , Infant , Seizures/etiology , Seizures, Febrile/complications , Seizures, Febrile/diagnosis , Syncope/complications , Syncope/diagnosis
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