Food-induced anaphylaxis and cofactors - data from the anaphylaxis registry.

Food allergens are frequent causes of anaphylaxis. In particular in children and adolescents they are the most frequent elicitors of severe allergic reactions, and in adults food allergens rank third behind insect venom and drugs. Since July 2006 severe allergic reactions from Germany, Austria, and Switzerland are collected in the anaphylaxis registry. Currently 78 hospitals and private practises are connected. From July 2006 until February 2009 1,156 severe allergic reactions were registered. Among children and adolescents (n = 187, age range from 3 months to 17 years) food allergens were the most frequent triggers, comprising 58% of cases. In the adult group (n = 968, 18 - 85 years) food allergens were in the third position (16.3%) behind insect venom and drugs. In children legumes (31%) and in particular peanuts were frequently responsible food allergens, followed by tree nuts (25%) with hazelnut being the most frequent elicitor. In adults fruits (13.4%) most often induced severe food-dependent anaphylaxis, but also animal products (12.2%); among these most frequently crustaceans and molluscs. Cofactors were often suspected in food-dependent anaphylaxis, namely in 39% of the adult group and in 14% of the pediatric group. In adults drugs (22%) and physical activity (10%) were reported to be the most frequent cofactors, in children physical activity was suspected in 8.7% and drugs in 2.6%. Concomitant diseases like atopic dermatitis, allergic asthma, or allergic rhinoconjunctivitis were reported in 78% of children and adolescents and in 67% of the adults. In conclusion, food-induced anaphylaxis, its cofactors and concomitant diseases are age-dependent. The data offers to identify risk factors of anaphylaxis.

Asymptomatic pulmonary involvement in 2 children with Niemann-Pick disease type B.

We present 2 cases of children with Niemann-Pick disease type B, and surprisingly with reticular lung infiltrations, although otherwise healthy in terms of pulmonary manifestation. Finding such reticular infiltrations should lead one to think of the possibility of metabolic storage disease.

Clinical and immunological response to oral and subcutaneous immunotherapy with grass pollen extracts. A prospective study.

Forty children allergic to grass pollen were divided into two groups, and matched by their serum IgE antibody concentrations to grasses. For two preseasonal treatment periods one group received immunotherapy with an alum adsorbed grass pollen extract, while the second group was treated orally with an aqueous extract of the same allergens. The patients' postseasonal self evaluation as well as the mean symptom scores calculated from symptom diaries indicate, that oral treatment is significantly less effective in controlling seasonal allergic symptoms than subcutaneous immunotherapy. During oral treatment neither an increase of specific serum IgG antibodies, nor a suppression of the seasonal increase in specific serum IgE antibodies could be demonstrated.

[Modern x-ray apparatus for pediatric radiology (Pädiatrix) (author's transl)]. / Ein modernes Röntgen-Untersuchungsgerät für die Kinderradiologie (Pädiatrix).

First experiences with the new apparatus "Pädiatrix" in pediatric radiology are reported. The apparatus is especially constructed for babies and children. X-ray pictures can be taken close-up and in distance with the tube above the table. Fluoroscopy can be performed with image intensivier. X-ray pictures with Bucky-diaphragm by the technique of middle and normal size and oblique or horizontal direction are to be made. Tomography and zonography can be done. The apparatus has proven useful for clinical radiological diagnostics after three years of experience.

IgE mediated hypersensitivity in children with idiopathic nephrotic syndrome.

Sixty children with idiopathic nephrotic syndrome (NS) and 30 unselected controls were studied for IgE mediated hypersensitivity by skin-test, total serum IgE and specific IgE antibodies to various allergens. In 42 patients the NS was steroid-responsive and associated with minimal glomerular changes (MC); in 18 patients it was steroid-resistant and associated with focal-segmental glomerulosclerosis (FSS). A history of allergy was found in 17% of MC, 6% of FSS and 10% of control children. Neither serum IgE concentration nor the incidence of allergen specific IgE antibodies were significantly different between the 3 groups. In the presence of steroid-dependency the prevalence of atopy appeared to be higher. However, our data do not support the hypothesis that for the pathogenesis of NS IgE mediated hypersensitivity plays a general role.

[Beclomethasone dipropionate seasonal allergic rhinitis treatment of children. A double blind cross over study (author's transl)]. / Beclometason dipropionat bei Rhinitis pollinosa im Kindesalter. Eine gekreuzte Doppelblindstudie.

In a double-blind cross over study on 25 children with seasonal allergic rhinitis treatment with Beclomethasone dipropionate (BDP)-Aerosol was found more effective than placebo. 17 children preferred BDP, two the placebo-aerosol, while 6 had no preferrence. During a period with very high pollen concentrations in the air the effect of BDP-therapy was no longer sufficient.

[CT in the diagnosis, treatment planning and follow-up in craniopharyngeoma (author's transl)]. / Computertomographische Diagnostik, Therapieplanung und Verlaufskontrolle beim Kraniopharyngeom.

The axial computed tomography of the skull has become an important part of the neuroradiologic diagnostics. The intracranial CT diagnosis is completed by the coronal sections which is used in particular in case of processes in the posterior cranial fossa and its differentiation of the supra- and infratentorial dimensions and in order to localize tumors in the sella region. The accurate determination of the tumor volume and the para-, supra-, and retrosellar dimensions makes possible an exact operation and irradiation planning. Solid, cystic and calcified tissues of the craniopharyngioma can be delimited. The quantitative evaluation by means of a computed tomogram of a tumor reduction obtained by surgery and irradiation with ultrahard X-rays (42 MV) with a target volume dose of about 5000 rd is illustrated by two examples. Under the above mentioned radiotherapeutic conditions, one partially resected craniopharyngioma with cystic, calcified and solid tissues showed a diminuation of the tumor volume of 60%, whereas the volume of a craniopharyngioma consisting of solid and calcified parts which had not been operated upon was reduced by about 40% two weeks after the end of the radiotherapy.

Determination of glomerular function in advanced renal failure.

In 15 children with advanced chronic renal failure, glomerular filtration rate was determined by different methods. Inulin clearance correlated well with the mean of creatinine and urea clearance, and also with 51-chromium edetic acid (EDTA) clearance measured over 24 hours. The absolute values of creatinine clearance and of 51Cr-EDTA clearance measured up to 8 hours were higher than inulin clearance. In advanced renal failure both the 51Cr-EDTA clearance measured over 24 hours, and the mean of creatinine and urea clearance, provide acceptable estimates of true glomerular filtration rate.