ABSTRACT
We describe a two year-old multiallergic boy who developed generalized urticaria after the third Di-Te-Pol vaccination. A Type I reaction to the vaccine was demonstrated by performing basophil histamine release to the complete vaccine. Further, we found that the reaction could be exclusively ascribed to Diphtheria-Toxoid whereas no release was observed by the Polio and Tetanus component. The latter result was confirmed since no specific IgE to Tetanus Toxoid could be demonstrated.
Subject(s)
Hypersensitivity, Immediate/etiology , Basophils/immunology , Basophils/metabolism , Child, Preschool , Diphtheria Toxoid/adverse effects , Diphtheria Toxoid/immunology , Histamine/immunology , Humans , Immunoglobulin E/immunology , MaleABSTRACT
The effect of inhaled beclomethasone dipropionate and budesonide on the adrenal function was studied in 30 children (aged 7 to 15 years) with mild bronchial asthma. The trial was designed as a prospective double-blind parallel study of the effect of stepwise increase of either beclomethasone dipropionate or budesonide from 200 micrograms through 400 micrograms, to 800 micrograms daily in three consecutive periods of 4 weeks. At the end of each period, the adrenal stress response was evaluated by measurements of serum cortisol and androstenedione during a short adrenocorticotropic hormone test. The unstimulated diurnal production of glucocorticosteroids was assessed by measurements of free cortisol in 24-hour urine samples. Free cortisol in urine was found a valid measure of the total diurnal excretion of cortisol metabolites, since it exhibited a good correlation to the fractional cortisol metabolites measured by gas chromatography. The adrenal response to adrenocorticotropic hormone stimulation was unaffected by treatment or dose. The unstimulated diurnal production of glucocorticosteroids demonstrated a highly significant dose-related suppression in response to the inhaled steroids. No significant difference was found between the two topical steroids (probability value 5.3%), and yet the suppression was apparent in the group of children treated with beclomethasone dipropionate but not in the group of children treated with budesonide. Further studies are desirable in order to ascertain whether budesonide offers an improved ratio between beneficial anti-inflammatory effect and unwanted systemic activity.
Subject(s)
Adrenal Cortex Function Tests , Asthma/physiopathology , Beclomethasone/therapeutic use , Pituitary-Adrenal Function Tests , Pregnenediones/therapeutic use , Adolescent , Androstenedione/blood , Asthma/drug therapy , Asthma/urine , Beclomethasone/adverse effects , Budesonide , Child , Circadian Rhythm/drug effects , Clinical Trials as Topic , Double-Blind Method , Drug Administration Schedule , Female , Humans , Hydrocortisone/blood , Hydrocortisone/urine , Male , Pregnenediones/adverse effects , Prospective Studies , Random AllocationABSTRACT
The efficacy of nebulised sodium cromoglycate (SCG) used as a prophylactic treatment of wheezy bronchitis in children aged 1 to 4 years was evaluated in a multicentre double-blind placebo controlled, group comparative study. Fifty-four patients completed the 10-week trial (29 treated with SCG and 25 treated with placebo), preceded by 4-8 weeks baseline. Nebulised SCG did not prove significantly superior to placebo in reducing day wheezing, day coughing, or sleep disturbance due to wheezing or coughing at night. Neither was there significant difference in the use of supportive medicine (beta 2-agonist and theophylline) between the groups. Extra doctor visits, hospital admissions, and parental preference did not show significant difference either.
