[Low salicylate diet in hypersensitivity to nonsteroidal anti-inflammatory drugs]. / Dieta ubogosalicylanowa w nadwrazliwosci na niesteroidowe leki przeciwzapalne.

The article below shows different forms, patomechanisms and diagnostics criteria of hypersensitivity to NSAIDs based on available literature as well as up to date outlook on implementing low salicylate diet as a treatment.

Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: a pilot crossover study.

OBJECTIVE: Aspirin exacerbated respiratory disease (AERD) is comprised of aspirin/acetylsalicylic acid (ASA) sensitivity, bronchial asthma, and nasal polyposis. Treatment of this condition is challenging and may include topical/systemic steroids, endoscopic sinus surgery, and/or aspirin desensitization. STUDY DESIGN: A prospective crossover pilot study (n = 10) was conducted in which patients were randomized into either of 2 groups with 6 weeks of regular diet (R) or 6 weeks of a low salicylate diet (LS). SETTING: The study was conducted in a tertiary otolaryngology clinic. SUBJECTS: Patients with AERD were enrolled in the study. METHODS: Subjective (Sino-nasal Outcome Test-22 [SNOT-22], Nasal Sinus Symptom Scale [NSSS], and the Asthma Control Questionnaire-7 [ACQ-7]) and objective outcome instruments (Peri-Operative Sinus Evaluation [POSE] and Lund-Kennedy Endoscopic Score [LKES]) were used to evaluate patients at baseline, 6 weeks (at crossover), and 12 weeks. RESULTS: Wilcoxon rank sum tests demonstrated that patients on the low salicylate diet had improved scores compared to their regular diet when evaluated by 4 of the 5 outcome measures (SNOT-22 pLS = 0.0059, NSSS pLS = 0.0195, LKES pLS = 0.0039, POSE pLS = 0.005). CONCLUSION: Results of the pilot study indicate that implementation of a low salicylate diet improves the nasal symptoms and nasal endoscopy findings of individuals with AERD. Further research is required to support these findings.

[Allergy to food colouring. A prospective study in ten children]. / Allergie aux colorants alimentaires chez l'enfant. Etude prospective chez dix enfants.

In order to know more about allergy to food colouring, we conducted a prospective open study over 8 months in a group of 10 atopic children with repeated urticaria. The mean age was 6.5 years (4.2 - 13.5 years). The diagnosis was based on oral challenge tests along with hisory taking there were 3 cases of allergy to food colourings. Clinical features were mainly skin symptoms, sometimes associated with GI manifestations which were not only rare (1 case in our series) but also non specific. Colourings-free diet was recommended in consequence. It resulted in the disappearance of the symptoms in a child (Red cochineal) and their regression in the two others (Red cochineal, Red beet) with a follow up of 8 months and 3 months respectively.

[Non-allergic rhinitis or intrinsic rhinitis? Unusual features of nickel allergy]. / Rhinite non allergique ou rhinite intrinseque? Aspects inhabituels de l'allergie au nickel.

The clinical expression of nickel is known for its great diversity, from classical contact eczema to rhinitis, including work-related allergy, and by secondary hyperthermia to a metallic heart valve. Very often, hypersensitivity which may be of type I or type IV is secondary to contact of the hapten with sensitive cells, however some authors have reported the possibility of reactivation of lesions, especially dermatological (urticaria-eczema) by tests of oral ingestion. However, review of the literature does not mention the possibility of O.R.L. problems of the rhinitis type, from rhinosinusitis following ingestion of nickel and the two clinical cases that we report that involve one child of 11 years and one patient of 59 years, both of whom presented a serious rhinitis with a tendency to surperinfection, developing to perennial, where a patch-test to nickel was strongly positive, and who have seen an improvement in their clinical problems with a strict diet without this hapten. This confirms that the need is eventually physiopathological and suggests the necessity to search systematically for a possibility of hypersensitivity to haptens by the patch test technique in rhinitis that is labelled "non-allergic", by a negative reaginic history to pneumoallergens and trophallergens.

Salicylate sensitivity in children reported to respond to salicylate exclusion.

Twelve children, aged six to 13 years, whose parents reported an improvement in behavioural problems with use of the Feingold (K-P) diet for an average period of 12 months, were challenge-tested with 40 mg of acetylsalicylic acid in a double-blind, cross-over trial with ascorbic acid as a placebo. The children were tested within three hours of ingestion of either the experimental or placebo tablet with a battery of psychological and neurological tests, and were rated by a parent on an enlarged Conners' Parent-Teacher Questionnaire for four days after the ingestion of the tablet. It was found that significance was reached in tests of general cognitive capacity, line walking and the "finger-to-nose" tests, as well as increased disturbance in sleep patterns in these children.