Allergology and Immunology

Vernal Keratoconjunctivitis: an update focused on clinical grading system

Vernal keratoconjunctivitis (VKC) is a severe disease with a prevalence of < 1 case out of 10,000 in Europe, which occurs mainly in pediatric age and is characterized by a severe and often bilateral chronic in...

Authors: A. M. Zicari, G. Capata, M. Nebbioso, G. De Castro, F. Midulla, L. Leonardi, L. Loffredo, A. Spalice, L. Perri and M. Duse

The role of miR-29c/B7-H3/Th17 axis in children with Mycoplasma pneumoniae pneumonia

Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community-acquired pneumonia in children. Recent studies demonstrated that the incidence of severe or fatal M. pneumoniae was gradually in...

Authors: Qing-ling Li, Yin-yin Wu, Hui-ming Sun, Wen-jing Gu, Xin-xing Zhang, Mei-juan Wang, Yong-dong Yan, Chuang-li Hao, Wei Ji and Zheng-rong Chen

Clinical features and prognosis of patients with thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus: a review of 25 cases

To report the clinical features of patients with systemic lupus erythematosus (SLE) associated with thrombotic thrombocytopenic purpura (TTP). Their diagnosis, treatment, and prognosis were also discussed.

Authors: Ji Li, Jing-Jing Jiang, Chang-Yan Wang, Shan Jian, Yu Zhou, Ming-Sheng Ma, Xiao-Yan Tang, Lin Wang, Mei-Ying Quan, Yu Zhang, Juan Xiao, Yan-Yan He and Hong-Mei Song

Consensus communication strategies to improve doctor-patient relationship in paediatric severe asthma

Asthma is a chronic inflammatory disease that is very common among youth worldwide. The burden of this illness is very high not only considering financial costs but also on emotional and social functioning. Gu...

Authors: Antonietta Cappuccio, Filomena Bugliaro, Silvia Maria Elena Caimmi, Valeria Caldarelli, Lucia Caminiti, Enza D’Auria, Emanuela di Palmo, Marzia Duse, Alessandro Giovanni Fiocchi, Francesco Gesualdo, Ahmad Kantar, Enrico Lombardi, Anna Lucania, Margherita Marchiani, Maria Giulia Marini, Gianluigi Marseglia…

Analysis of the predicting factors of recurrent wheezing in infants

Clinically, asthma in children under 5 years old is under estimated because lack of diagnostic criteria. The current study was, therefore, designed to identify the predicting factors for recurrent wheezing in ...

Authors: Jia Zhai, Yingxue Zou, Jie Liu, Xingnan Jin, Cuian Ma, Jiao Li, Run Guo and Bing Huang

An association analysis to identify genetic variants linked to asthma and rhino-conjunctivitis in a cohort of Sicilian children

Asthma and rhino-conjunctivitis are common chronic diseases in childhood. In this cross-sectional study, we performed a gene association analysis with current asthma and rhino-conjunctivitis in a cohort of Sic...

Authors: Gianluca Sottile, Giuliana Ferrante, Marta Torregrossa, Fabio Cibella, Giovanna Cilluffo, Salvatore Fasola, Riccardo Alessandro, Gregorio Seidita, Giovanni Viegi and Stefania La Grutta

Omalizumab in children with severe allergic disease: a case series

Currently, severe allergic asthma and food allergy in children represent an important public health problem with medical, psychosocial and economic impacts. Omalizumab is a humanized monoclonal anti-IgE antibo...

Authors: Giuseppe Crisafulli, Lucia Caminiti, Fernanda Chiera, Stefania Arasi, Giuseppina Salzano, Ilenia Panasiti, Andrea Barbalace and Giovanni Battista Pajno

SIAIP position paper: provocation challenge to antibiotics and non-steroidal anti-inflammatory drugs in children

Drug hypersensitivity reactions (DHRs) in childhood are mainly caused by betalactam or non-betalactam antibiotics, and non-steroidal anti-inflammatory drugs (NSAIDs). Laboratory tests for identifying children ...

Authors: Carlo Caffarelli, Fabrizio Franceschini, Davide Caimmi, Francesca Mori, Lucia Diaferio, Dora Di Mauro, Carla Mastrorilli, Stefania Arasi, Simona Barni, Paolo Bottau, Silvia Caimmi, Fabio Cardinale, Pasquale Comberiati, Giuseppe Crisafulli, Lucia Liotti, Umberto Pelosi…

Anaphylactic shock with methylprednisolone, Kounis syndrome and hypersensitivity to corticosteroids: a clinical paradox

Corticosteroids are widely used for the treatment of allergic reactions but paradoxically themselves may induce acute, delayed, local or systemic allergic reactions and even anaphylaxis with Kounis syndrome. T...

Authors: Nicholas G. Kounis, Ioanna Koniari, George D. Soufras and Emmanouil Chourdakis

Anaphylaxis in atypical cold urticaria: case report and review of literature

Cold-induced urticaria is a kind of physical urticaria characterized by the appearance of wheals after exposure to cold. The atypical form is a rare sub-type characterized by appearance of hives even in areas ...

Authors: Elisa Benelli, Giorgio Longo, Egidio Barbi and Irene Berti

Evidence that a primary anti-viral stimulation of the immune response by OM-85 reduces susceptibility to a secondary respiratory bacterial infection in mice

Viral respiratory infections may promote bacterial super-infection decreasing the host immune response efficiency. However, using a mice model we recently demonstrated that preventive treatment with the bacter...

Authors: Giovanni A. Rossi, Wolfgang Bessler, Stefania Ballarini and Christian Pasquali

Malocclusion and rhinitis in children: an easy-going relationship or a yet to be resolved paradox? A systematic literature revision

The relation between nasal flow and malocclusion represents a practical concern to pediatricians, otorhinolaryngologists, orthodontists, allergists and speech therapists. If naso-respiratory function may influ...

Authors: Francesca Occasi, Ludovica Perri, Matteo Saccucci, Gabriele Di Carlo, Gaetano Ierardo, Valeria Luzzi, Giovanna De Castro, Giulia Brindisi, Lorenzo Loffredo, Marzia Duse, Antonella Polimeni and Anna Maria Zicari

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in two young children: the importance of an early diagnosis

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious life-treating condition characterized by skin eruption, fever, haematologic abnormalities, and multi-organ involvement that c...

Authors: Massimo Luca Castellazzi, Susanna Esposito, Laura Elisabetta Claut, Valeria Daccò and Carla Colombo

The future outlook on allergen immunotherapy in children: 2018 and beyond

Allergen immunotherapy (AIT) is the only currently available immune-modifying and aetiological treatment for patients suffering from IgE-mediated diseases. In childhood, it represents a suitable therapeutic op...

Authors: Stefania Arasi, Giovanni Corsello, Alberto Villani and Giovanni Battista Pajno

Egg introduction during complementary feeding according to allergic risk: not just for peanuts!

The relationship between the timing of introduction of complementary foods and later allergy is a topic of current discussion. Although the European Society for Pediatric Gastroenterology Hepatology and Nutrit...

Authors: Elvira Verduci, Annamaria Bianchi, Marta Brambilla and Mauro Calvani

The impact of nasal aspiration with an automatic device on upper and lower respiratory symptoms in wheezing children: a pilot case-control study

The impact of proper aspiration of nasal secretions during upper respiratory infection on the frequency and severity of symptoms of lower airways has never been investigated. The study was aimed at testing if ...

Authors: Antonio Pizzulli, Serena Perna, Anja Bennewiz, Holger Roeblitz, Salvatore Tripodi, Jakob Florack, Petra Wagner, Stephanie Hofmaier and Paolo Maria Matricardi

Metabolic acidosis as Food Protein Induced Enterocolitis Syndrome (FPIES) onset in a newborn

FPIES (Food Protein Induced Eneterolitis Syndrome) is a rare non IgE- mediated food allergy, usually affecting infants and children after first months of life. Clinical presentation is heterogeneous, usually c...

Authors: Antonella Peduto, Mario Rocca, Cinzia De Maio, Federica Gallarotti, Giulia Pomero and Paolo Gancia

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

Acute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department (ED) visit and hospitalization. Appropriate care is fundamental, considering both the high...

Authors: Luciana Indinnimeo, Elena Chiappini and Michele Miraglia del Giudice

Detection of IL10-producing B cell (B10) in adenoids of atopic children with adenoidal hypertrophy

Authors: Chiara Valsecchi, Sara Carlotta Tagliacarne, Ilaria Brambilla, Catherine Klersy, Marco Benazzo, Lorenza Montagna, Dimitri Poddighe, Giorgio Ciprandi, Gian Luigi Marseglia, Amelia Licari and Annamaria Castellazzi

Susceptibility to allergy in adoptive children: a cross-sectional study at “Bambino Gesù Children’s Hospital”

Prevalence of allergy has steeply increased during the past few decades, particularly in high-income countries. The development of atopy could present different characteristics in internationally adopted child...

Authors: Hyppolite K. Tchidjou, Maria Fenicia Vescio, Jessica Serafinelli, Rosaria Giampaolo, Alessandro Jenkner, Mathurin C. Tadonkeng, Luca Avellis, Alessandro Fiocchi, Patrizio Pezzotti, Giovanni Rezza and Paolo Rossi

Anaphylactic shock with methylprednisolone sodium succinate in a child with short bowel syndrome and cow’s milk allergy

Medications with methyl-prednisolone sodium succinate containing lactose, which potentially contains traces of cow’s milk proteins (CMP), could cause allergic reactions or compromise treatment of acute allergi...

Authors: Federica Porcaro, Maria Giovanna Paglietti, Antonella Diamanti, Francesca Petreschi, Alessandra Schiavino, Valentina Negro, Valentina Pecora, Alessandro Fiocchi and Renato Cutrera

Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow’s milk according to age: a systematic review

The diagnosis of IgE-mediated cow’s milk allergy is often based on anamnesis, and on specific IgE (sIgE) levels and/or Skin Prick Tests (SPT), which have both a good sensitivity but a low specificity, often ca...

Authors: Barbara Cuomo, Giovanni Cosimo Indirli, Annamaria Bianchi, Stefania Arasi, Davide Caimmi, Arianna Dondi, Stefania La Grutta, Valentina Panetta, Maria Carmen Verga and Mauro Calvani

Efficacy and usability of a novel nebulizer targeting both upper and lower airways

Upper and lower airways diseases share in part their pathogenic mechanisms and frequently occur simultaneously as “United Airway Disease.” Local treatment with nebulizers delivers anti-symptomatic drugs in eit...

Authors: Daniela Posa, Antonio Pizzulli, Petra Wagner, Serena Perna, Stephanie Hofmaier, Paolo Maria Matricardi and Susanne Lau

Long-term treatment with low-dose medicine in chronic childhood eczema: a double-blind two-stage randomized control trial

The efficacy of low-dose medicine (LDM) in childhood mild/moderate eczema is not known. We conducted a double-blind, two-stage, randomized, placebo-controlled clinical trial, lasting 23 months, to address this...

Authors: R. Carello, L. Ricottini, V. Miranda, P. Panei, L. Rocchi, R. Arcieri and E. Galli

IOEASMA: an integrated clinical and educational pathway for managing asthma in children and adolescents

Due to the lack of real life clinical and educational studies, “Io e l’Asma” Centre performed this implementation research (IR).

Authors: Sebastiano Guarnaccia, Gaia Pecorelli, Marina Bianchi, Massimo Cartabia, Gianluigi Casadei, Ada Pluda, Cristina Quecchia, Valeria Gretter and Maurizio Bonati

ANCA-associated vasculitis in childhood: recent advances

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are rare systemic diseases that usually occur in adulthood. They comprise granulomatosis with polyangiitis (GPA, Wegener’s), microscopic poly...

Authors: Marta Calatroni, Elena Oliva, Davide Gianfreda, Gina Gregorini, Marco Allinovi, Giuseppe A. Ramirez, Enrica P. Bozzolo, Sara Monti, Claudia Bracaglia, Giulia Marucci, Monica Bodria, Renato A. Sinico, Federico Pieruzzi, Gabriella Moroni, Serena Pastore, Giacomo Emmi…

The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults

The basophil activation test (BAT), has been proposed as a possible assay for the diagnosis of immediate-type allergy to beta-lactams (BLs).

Authors: Simona Barni, Francesca Mori, Claudia Valleriani, Giusi Mangone, Sergio Testi, Francesca Saretta, Lucrezia Sarti, Neri Pucci, Maurizio de Martino, Chiara Azzari and Elio Novembre

Difficult diagnosis of atypical kawasaki disease in an infant younger than six months: a case report

Kawasaki disease (KD) is an acute inflammatory vasculitis of unknown origin.

Authors: L. Petrarca, R. Nenna, P. Versacci, A. Frassanito, G. Cangiano, A. Nicolai, F. Scalercio, L. Lo Russo, P. Papoff, C. Moretti and F. Midulla

Bifidobacterium mixture (B longum BB536, B infantis M-63, B breve M-16V) treatment in children with seasonal allergic rhinitis and intermittent asthma

Allergic rhinitis (AR) and allergic asthma are caused by an IgE-mediated inflammatory reaction. Probiotics may exert anti-inflammatory and immune-modulatory activity. Thus, this study aimed at investigating wh...

Authors: Michele Miraglia Del Giudice, Cristiana Indolfi, Michele Capasso, Nunzia Maiello, Fabio Decimo and Giorgio Ciprandi

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one cent...

Authors: Giovanni Battista Pajno, Roberto Bernardini, Diego Peroni, Stefania Arasi, Alberto Martelli, Massimo Landi, Giovanni Passalacqua, Antonella Muraro, Stefania La Grutta, Alessandro Fiocchi, Luciana Indinnimeo, Carlo Caffarelli, Elisabetta Calamelli, Pasquale Comberiati and Marzia Duse

Vitamin D deficiency and its impact on asthma severity in asthmatic children

Despite obtaining evidences on association between vitamin D and development of lung in fetus, little is known about vitamin D level and its impact on severity of asthma in children. The present study aimed to...

Authors: Nasrin Esfandiar, Fariba Alaei, Shahrzad Fallah, Delara Babaie and Niloofar Sedghi

Eosinophilic esophagitis after congenital diaphragmatic hernia

Eosinophilic esophagitis (EoE) is an increasingly diagnosed disease, especially in the western world. Although its pathogenesis remains poorly understood, there is strong evidence that the eosinophilic inflamm...

Authors: Amelia Licari, Riccardo Castagnoli and Gian Luigi Marseglia

Atopy and autoimmune thyroid diseases: melatonin can be useful?

Recently, there has been growing interest in the relationship between allergic and autoimmune diseases. Allergy and autoimmunity can be considered two potential outcomes of dysregulated immunity and analysis o...

Authors: Gabriella D’Angelo, Lucia Marseglia, Sara Manti, Laura Colavita, Caterina Cuppari, Pietro Impellizzeri, Salvatore Arena, Teresa Arrigo, Carmelo Salpietro and Eloisa Gitto

Kawasaki disease in Sicily: clinical description and markers of disease severity

Kawasaki disease (KD) is an acute systemic vasculitis of small and middle size arteries; 15-25 % of untreated patients and 5 % of patients treated with intravenous immunoglobulin (IVIG) develop coronary artery...

Authors: Maria Cristina Maggio, Giovanni Corsello, Eugenia Prinzi and Rolando Cimaz

Brain damage resembling acute necrotizing encephalopathy as a specific manifestation of haemophagocytic lymphohistiocytosis - induced by hypersensitivity

Both haemophagocytic lymphohistiocytosis and acute necrotizing encephalopathy are life-threatening condition. It presents major diagnostic difficulties, since it may have a diversity in clinical picture and wi...

Authors: Dongling Dai, Feiqiu Wen, Sixi Liu and Shaoming Zhou

The B-cell compartment in antibody-deficient infants and young children – developing common variable immunodeficiency or transient immune maturation?

Hypogammaglobulinemia in early childhood is a common feature characterized by distinct intrinsic and extrinsic factors leading to disturbed peripheral blood lymphocyte homeostasis. Detailed flow cytometric imm...

Authors: Aleksandra Szczawinska-Poplonyk, Katarzyna Tapolska-Jozwiak and Husam Samara

Shared genetic variants between serum levels of high-density lipoprotein cholesterol and wheezing in a cohort of children from Cyprus

In a cohort of children in Cyprus, we recently reported low levels of high density lipoprotein cholesterol (HDL-C) to be associated with asthma. We examined whether genetic polymorphisms that were previously l...

Authors: Panayiotis K. Yiallouros, Panayiotis Kouis, Ourania Kolokotroni, Sonia Youhanna, Savvas C. Savva, Kleanthi Dima, Aikaterini Zerva, Danielle Platt, Nicos Middleton and Pierre Zalloua

Enuresis Nocturna in children with asthma: prevalence and associated risk factors

Enuresis Nocturna (EN) is a common disorders in childhood. Although many different underlying pathophysiological mechanisms have been proposed to explain EN, its etiology is multifactorial. Some reports demons...

Authors: Emin Ozkaya, Seren Calıs Aydın, Mebrure Yazıcı and Rusen Dundaröz

Pulmonary manifestation of immunoglobulin G4-related disease in a 7-year-old immunodeficient boy with Epstein-Barr virus infection: a case report

Immunoglobulin G4-related disease (IgG4-RD) is a multiorgan fibroinflammatory condition with lymphoplasmacytic infiltrates containing abundant IgG4-positive plasma cells. The immunopathogenesis of the disease ...

Authors: Aleksandra Szczawinska-Poplonyk, Irena Wojsyk-Banaszak, Katarzyna Jonczyk-Potoczna and Anna Breborowicz

Beyond the “Choosing wisely”: a possible attempt

Since the fundamental principles of the medical profession were clearly defined in a physician charter in 2002, special considerations have been expressed about the adequate distribution of health care resourc...

Authors: Roberto Bernardini, Giampaolo Ricci, Francesca Cipriani, Flavio Civitelli, Luciana Indinnimeo, Domenico Minasi, Luigi Terracciano and Marzia Duse

Omalizumab therapy in a 13-year-old boy with severe persistent asthma and concomitant eosinophilic esophagitis

Eosinophilic esophagitis (EoE) has been defined as “asthma of the esophagus” for the large number of similarities between the two diseases. Omalizumab is an anti-Immunoglobulin E (IgE) antibody currently appro...

Authors: Stefania Arasi, Stefano Costa, Giuseppe Magazzù, Antonio Ieni, Giuseppe Crisafulli, Lucia Caminiti, Fernanda Chiera, Mario Vaccaro, Michele Miraglia Del Giudice and Giovanni Battista Pajno

Consensus Conference on Clinical Management of pediatric Atopic Dermatitis

The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managi...

Authors: Elena Galli, Iria Neri, Giampaolo Ricci, Ermanno Baldo, Maurizio Barone, Anna Belloni Fortina, Roberto Bernardini, Irene Berti, Carlo Caffarelli, Elisabetta Calamelli, Lucetta Capra, Rossella Carello, Francesca Cipriani, Pasquale Comberiati, Andrea Diociaiuti, Maya El Hachem…

Severe asthma features in children: a case–control online survey

Very few studies have explored the distinguishing features of severe asthma in childhood in Europe, and only one study was conducted in Southern Europe. The aim of this study was to provide a detailed characte...

Authors: Silvia Montella, Eugenio Baraldi, Salvatore Cazzato, Raffaele Aralla, Mariangela Berardi, Luigia Maria Brunetti, Fabio Cardinale, Renato Cutrera, Fernando Maria de Benedictis, Emanuela di Palmo, Sabrina Di Pillo, Grazia Fenu, Stefania La Grutta, Enrico Lombardi, Giorgio Piacentini, Francesca Santamaria…

Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation

Data on specific IgE sensitization prevalence in children with allergy-like symptoms seen in the primary care setting are rare. Early diagnosis of allergic diseases is important to prevent clinical manifestati...

Authors: Alessandro Fiocchi, Valentina Pecora, Carl Johan Petersson, Lamia Dahdah, Magnus P. Borres, Maria J. Amengual, Johannes Huss-Marp, Oscar Mazzina and Francesco Di Girolamo

The evaluation of risk factors for recurrent hospitalizations resulting from wheezing attacks in preschool children

We aimed to evaluate the risk factors in preschool children admitted to inpatient services with a diagnosis of recurrent attacks of wheezing.

Authors: Sebnem Ozdogan, Burcu Tabakci, Ayse Sirin Demirel, Bilge Atli, Gulser Esen Besli and Gulsen Kose

Risk factors for celiac disease

Celiac Disease (CD) is an immune-mediated systemic disorder elicited by gluten and related prolamines in genetically susceptible individuals and it is the result of the interaction between genetic and environm...

Authors: Marco Sarno, Valentina Discepolo, Riccardo Troncone and Renata Auricchio

Food allergies in school: design and evaluation of a teacher-oriented training action

Food allergies are perceived as a significant problem in school environments; as a result, a teacher’s ability to recognise and deal with allergic reactions is of fundamental importance to protect children’s h...

Authors: Licia Ravarotto, Giulia Mascarello, Anna Pinto, Maria Rita Schiavo, Marina Bagni and Lucia Decastelli

Resveratrol plus carboxymethyl-β-glucan in children with recurrent respiratory infections: a preliminary and real-life experience

Recurrent respiratory infections (RRI), such as the presence of at least one of the following criteria: i) >6 RI per year; ii) >1 RI per month involving upper airways from September to April; iii) >3 RI involv...

Authors: Alfonso Maria Varricchio, Michele Capasso, Antonio della Volpe, Luigi Malafronte, Nicola Mansi, Attilio Varricchio and Giorgio Ciprandi

Severe congenital neutropenia due to G6PC3 deficiency: early and delayed phenotype in two patients with two novel mutations

Severe Congenital Neutropenia type 4 (SCN4, OMIM 612541) is a rare autosomal recessive disease due to mutations in the G6PC3 gene. The phenotype comprises neutropenia of variable severity and other anomalies incl...

Authors: Lucia Dora Notarangelo, Gianfranco Savoldi, Sara Cavagnini, Veronica Bennato, Sabrina Vasile, Alba Pilotta, Alessandro Plebani and Fulvio Porta

Late-onset of immunodysregulation, polyendocrinopathy, enteropathy, x-linked syndrome (IPEX) with intractable diarrhea

The syndrome of immune dysregulation, polyendocrinopathy, enteropathy, X linked (IPEX) is a rare disorder caused by mutations in the FOXP3 gene. Diarrhea, diabetes and dermatitis are the hallmark of the diseas...

Authors: Daniele Zama, Ilaria Cocchi, Riccardo Masetti, Fernando Specchia, Patrizia Alvisi, Eleonora Gambineri, Mario Lima and Andrea Pession