Is Oral Food Challenge (OFC) test safe for preschool children?

BACKGROUND: Oral food challenges (OFCs) are performed for diagnosis of a food allergy in cases where the allergy is not supported by patient history, or when a newly developed tolerance level needs to be established. OBJECTIVE: We aimed to investigate the prevalence and severity of reactions during OFCs in preschool children. METHODS: A retrospective study was conducted on children younger than 5 years, for whom OFC had been performed with milk, egg white and egg yolk. All children had been admitted to the Department of Pediatric Allergy at Behçet Uz Children's Hospital between 1 January 2010 and 31 December 2014. Any symptoms developed during the OFC were classified and recorded. RESULTS: A total of 122 patients who underwent an OFC were included in this study. The patients included 85 males (69.7%), and 50.8% of patients (n = 62) had a history of IgE-mediated food allergy. Co-existing allergies were found for 57.4% (n = 70) of patients. Of the OFCs performed, tests for milk, egg white and egg yolk made up 46.5, 30.5 and 23.0%, respectively. Of these, 19% (n = 33) were mild and 4.5% (n = 7) were moderate allergies in terms of symptom development. It was determined that the skin prick test (SPT) wheal size and the food-specific IgE levels did not effect in determining whether the allergic reaction would develop by OFC if the SPT wheal size and the food-specific IgE levels were below the cut-off point of a 95% positive predictive value (p > 0.05). CONCLUSION: The severity of egg and milk allergy symptoms resulting from the frequently used OFC in preschool children are generally mild and easy to manage, particularly if the OFC is only conducted if serum-specific IgE or SPT wheal size is below the cut-off point.

Can mean platelet volume be used as a biomarker for asthma?

INTRODUCTION: Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. AIM: We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. MATERIAL AND METHODS: Our patient group consisted of 95 children with exacerbation of asthma who were admitted to our allergy clinic. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. Mean platelet volume values of the patient group obtained during exacerbation of asthma were compared to those of the same group during the asymptomatic period and with the control group. We investigated factors that can affect the MPV values of asthma patients, including infection, atopy, immunotherapy treatment, and severity of asthma exacerbation. RESULTS: The patient group consisted of 50 (52.6%) boys and 45 (47.4%) girls with a mean age of 125 ±38 months old. Mean MPV values in the exacerbation period, the healthy period, and in the control group were 8.1 ±0.8 fl, 8.1 ±1.06 fl, and 8.2 ±0.9 fl, respectively; there were no significant differences between groups (p > 0.05). The severity of asthma, severity of asthma exacerbation, immunotherapy, coinfection, eosinophil count, and IgE level also had no effect on MPV (p > 0.05). CONCLUSIONS: Although platelets play a role in the pathophysiology of asthma, MPV measurement is insufficient to detect inflammation through platelets.

Coexistence of hereditary angioedema in a case of familial Mediterranean fever with partial response to colchicine.

Hereditary angioedema (HAE) is a very rare and potentially life-threatening genetic disease characterised by episodes of edema in various parts of the body, including the extremities, face, and airway. The disease is usually associated with attacks of abdominal pain. On the other hand, familial Mediterranean fever (FMF) is an inherited condition characterised by recurrent episodes of painful inflammation in the abdomen, chest, or joints. In this report, we present a child with FMF and undiagnosed HAE, which made him a partial responder to colchicine treatment. Consequently, HAE must be considered in differential diagnosis of cases in which a partial response is obtained from FMF treatment, particularly in countries where FMF is frequently encountered, because early diagnosis of HAE can facilitate prevention of life-threatening complications, such as upper airway obstruction. To our knowledge, our patient is the first patient reported in the literature with the diagnosis of HAE and FMF together.