1,721,012 research outputs found
Asthma and allergic rhinitis in childhood: what's new
No full textNovel approaches are currently offered for the diagnostic workup and therapeutic management of allergic rhinitis and asthma. New predictive biomarkers of allergy and asthma are available. Primary and secondary prevention, earlier intervention, and modification of the natural history of allergic rhinitis and asthma are being intensively investigated. This review highlights advances in the understanding of the etiology, diagnosis, and management of atopic airway diseases in childhood, as well as prenatal and early-life risk factors and strategies for prevention
Allergic reactions to cow's milk proteins in medications in childhood
No full textCow's milk is a frequent trigger of allergic reactions in childhood. Cow's milk proteins can be present in pharmaceutical excipients. METHODS: We have analyzed paediatric literature on allergic reactions to cow's milk proteins in medication, focusing on the different routes of administration (inhaled, parental and oral). RESULTS: Dry-powder inhalers may contain lactose as excipient. Lactose can be rarely contaminated with milk proteins and it may induce allergic reactions in patients with cow's milk allergy. Case reports have described immediate hypersensitivity reactions to methylprednisolone sodium succinate 40 mg injection, a formulation that contains lactose as excipient. Some cases of anaphylaxis after receiving diphteria-tetanus-pertussis vaccine injection in children allergic to milk have been reported. Cow's milk proteins can be detected also in oral polio vaccine, certain probiotics and lactulose syrup. CONCLUSIONS: We suggest caution in administration of pharmaceuticals containing milk allergens in children allergic to milk
Food allergy and atopic dermatitis: Prediction, progression, and prevention
No full textThe rising burden of allergic diseases in childhood requires a compelling need to identify individuals at risk for atopy very early in life or even predict the onset of food allergy and atopic dermatitis since pregnancy. The development and clinical phenotypes of atopic diseases in childhood depend on a complex interaction between genetic and environmental factors, such as allergen exposure, air pollution, and infections. Preventive strategies may include avoidance measures, diet supplements, and early complementary food introduction. Overall, the management of allergic diseases has been improving to date toward a patient's tailored approach. This review will cover the current understanding of risk factors, prediction, and management of food allergy and atopic dermatitis in childhood and discuss how these may contribute to the modification of the natural history of food allergy and atopic dermatitis
Use of Sublingual Immunotherapy for Aeroallergens in Children with Asthma
No full textAsthma is a heterogeneous disease that in children is often allergen-driven with a type 2 inflammation. Sublingual immunotherapy represents an important progress in the use of personalized medicine in children with allergic asthma. It is a viable option for house dust mite-driven asthma and in subjects with the asthma associated with allergic rhinitis. The use and indications for isolated asthma caused by other allergens are still controversial owing to heterogeneity of commercially available products and methodological limitations of studies in children. Nevertheless, most studies and meta-analyses found the efficacy of sublingual immunotherapy. Sublingual immunotherapy is safe but cannot be recommended in children with uncontrolled asthma
Allergy in children with functional constipation and irritable bowel syndrome
No full textContext: Functional constipation (FC) and irritable bowel syndrome (IBS) represent very common pediatric functional gastrointestinal disorders (FGIDs). Controversial results have suggested a potential role of food allergy as a trigger of functional bowel symptoms. Evidence Acquisition: This review summarizes the literature regarding the role of allergic diseases in children with FC and IBS and discusses the hypothesis of the pathogenesis of constipation due to cow’s milk protein allergy (CMPA). We searched systematic reviews, guidelines, or original data in PubMed, MEDLINE, and the Cochrane central register of controlled trials. Results: The pathogenesis of FGIDs remains elusive and is likely multifactorial. Among these factors, adverse reactions to food may play a pathogenic role. Some features, such as abnormal bowel motility, visceral hypersensitivity, and changes in mucus composition caused by inflammation of the gastrointestinal wall, have been found both in IBS or FC and in food allergy. Since 1978, an increasing number of reports have suggested a relationship between CMPA and FC. Two randomized controlled studies conducted in children showed that CMPA may induce chronic FC; one study indicated that fermentable oligosaccharide, disaccharide, and monosaccharide polyols (FODMAP) foods may play a role in triggering IBS. Conclusions: Food allergy in children with chronic constipation should be identified using an oral food challenge after being on a diet free of cow’s milk. A diet low in FODMAPs might also be recommended for children with IBS. This approach could be suggested for children with chronic FC and IBS, especially when they do not respond to standard treatment. However, it should also be considered that a minority of patients with FC or IBS could respond to an elimination diet. Further studies are needed to understand the complex pathogenic mechanisms of FGIDs; they also might be helpful to recognize markers for identifying children with IBS and FC caused by foods and to improve their management
Sindrome polline-alimenti, rinite allergica e asma stagionale in età pediatrica: una relazione complessa.
No full textNuove indicazioni allergologiche per lâalimentazione complementare
No full textThe prevalence of food allergy (FA) in children has been steadily increased, especially in developed countries, where it reaches 3-6%, with serious implications for patientsâ quality of life and significant burden on public health. However, food tolerance mechanisms remain largely unknown and the complex interactions between the immune system and environmental factors dare any preventive measures against allergic diseases. In the last decades, various strategies of complementary feeding have been proposed to prevent FA and international guidelines changed their schemes from a delayed introduction to an early weaning. Generally, all foods, including allergenic foods, should be introduced at 4-6 months of age and within the first year of life both in infants at risk for allergy and not at risk. In countries with high peanut consumption it is recommended to introduce peanut within 4-6 months in case of severe eczema and/or egg allergy, within 6 months in case of mild-moderate eczema, according to family habits
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