Impact of autoimmune gastritis on chronic urticaria in paediatric patients - pathophysiological point of views.

We would like to provide an updated comprehensive perspective and identify the components linked to chronic spontaneous urticaria (CSU) without specific triggers in autoimmune atrophic gastritis (AAG). AAG is an organ-specific autoimmune disease that affects the corpus-fundus gastric mucosa. Although we lack a unified explanation of the underlying pathways, when considering all paediatric patients reported in the literature, alterations result in gastric neuroendocrine enterochromaffin-like (ECL) cell proliferation and paracrine release of histamine. Several mechanisms have been proposed for the pathogenesis of CSU, with much evidence pointing towards AAG and ECL cell responses, which may be implicated as potential factors contributing to CSU. The excessive production/release of histamine into the bloodstream could cause or trigger exacerbations of CSU in AAG, independent of Helicobacter pylori; thus, the release of histamine from ECL cells may be the primary modulator. CONCLUSION: Considering the understanding of these interactions, recognising the respective roles of AAG in the pathogenesis of CSU may strongly impact the diagnostic workup and management of unexplained/refractory CSU and may inform future research and interventions in the paediatric population. WHAT IS KNOWN: • Autoimmune atrophic gastritis is a chronic immune-mediated inflammatory disease characterised by the destruction of the oxyntic mucosa in the gastric body and fundus, mucosal atrophy, and metaplastic changes. • Autoimmune atrophic gastritis in paediatric patients is important because of the poor outcome and risk of malignancy and possibly underestimated entities primarily reported in single-case reports. WHAT IS NEW: • Upper gastrointestinal inflammatory disorders, independent of H. pylori, have been implicated as potential inducing factors in the development of chronic spontaneous urticaria. • If a paediatric patient presents with symptoms such as anaemia, reduced vitamin B12 levels, recurrent urticaria with no other detectable aetiology, positive anti-parietal cell antibodies, and elevated gastrin levels, autoimmune atrophic gastritis should be considered a possible cause of chronic urticaria.

[Autoimmune enteropathy with onset in early infancy: clinico-morphologic and immunologic manifestations]. / Autoimunní enteropatie se zacátkem v casném kojeneckém veku: klinicko-morfologické a imunologické projevy.

This paper describes a severely affected male infant with serious protracted diarrhoea caused by a rare autoimmune enteropathy. The disease began at 6 weeks of age of the child and it was associated with small bowel villous atrophy and the presence of circulating antienterocyte antibodies. The child was treated with steroids and with parenteral and special enteral nutrition. The patient showed clinical improvement as documented by decreased stool output and possibility to terminate the parenteral nutrition. The small biopsy samples showed a return to normal. Antienterocyte antibodies were negative after the treatment. The patient has been followed up for at least 18 months and was in a clinical remission. We recommend that autoantibodies tests should be performed in all infants with unexplained protracted diarrhoea. The use of potent immunosuppressive drugs and the increasing experience with parenteral and enteral nutrition can improve the perspective of these previously fatal disorders.

[A comparative evaluation of the sensitivity of the vector of tick-borne relapsing fever to pesticides by using the standard test paper]. / Sravnitel'naia otsenka chuvstvitel'nosti perenoschika kleshchevogo vozvratnogo tifa k pestitsidam s pomoshch'iu standartnoi test-bumagi.

Standard test paper, recommended by the WHO for the assessment of the arthropod sensitivity, was used to assess the sensitivity of Ornithodoros papillipes, the agent of tick-borne relapsing fever, to a number of pesticides widely used in or holding good promise for the agent control. Poor sensitivity of the tick to dieldrin, malathion, propoxur, bendiocarb (less than 40% of the ticks died after 1 h exposure), satisfactory sensitivity to DDT, and permetrin (60% of the ticks died), and very high sensitivity to deltametrin (100% death of the ticks) were revealed. The authors believe that the ticks will be similarly sensitive to other cyan-containing pyretroids.

[The action of carbon dioxide gas in high concentrations on ixodid ticks]. / Deistvie uglekislogo gaza v vysokikh kontsentratsiiakh na iksodovykh kleshchei.

The ticks Ixodes persulcatus, Dermacentor reticulatus, D. marginatus were affected by 50, 70, 80 and 90% CO2 at 18 to 26 degrees. The higher the gas concentration and the lower the temperature, the quicker and the deeper was anesthesia. Additional tests have shown that response to CO2 depends on the water balance level determining the position of atrial valves. The response of some individuals to CO2 can change depending on the tick state during the experiment.