[Bird-egg syndrome in children]. / Síndrome ave-huevo en niños.

Allergy to egg is highly frequent in childhood. In general, children allergic to egg react principally to the ingestion of egg white. Egg yolk contains various proteins but the major allergens are contained in egg white. The principal allergens are ovalbumin, ovomucoid, ovotransferrin, and lysozyme. These proteins have been sequenced. In some cases, a relationship between type I hypersensitivity with respiratory symptoms due to bird antigens and allergy to egg yolk has been described. This association is known as bird-egg syndrome, which is caused by sensitization to chicken serum albumin (alpha -livetin) and is characterized by the development of respiratory and gastrointestinal symptoms after egg intake or after contact with bird antigens. The initial symptoms are usually asthma with or without rhinoconjunctivitis due to contact with birds. Individuals first become sensitized to bird proteins (feathers, excrement, serum and meat) and subsequently develop egg allergy. Although bird-egg syndrome has been described principally in adults, especially in women, it can also affect children in whom the syndrome presents certain differentiating characteristics in relation to the more common sensitization to egg white. Gastrointestinal and respiratory symptoms are more common than cutaneous symptoms and sensitization to egg yolk is more frequent than that to egg white. In children with allergy to birds and egg, egg allergy is usually more persistent; tolerance is not always achieved and develops later. Sensitization to other aeroallergens is also greater in individuals with allergy to birds and egg. Sensitization to egg sometimes precedes respiratory sensitization to bird proteins, a process known as bird-egg syndrome. By way of example, the case of a child who clinically presented bird-egg syndrome is presented at the end of this review.

Primula dermatitis.

We report the cases of 2 patients diagnosed as having primula dermatitis. Both patients were housewives who had been exposed to primula plants. Although only one related her clinical manifestations with looking after plants, the symptoms of both remitted when contact with primula was avoided. The diagnosis was carried out with a patch test concentration of 0.01% primin pet. As primula dermatitis has variable clinical manifestations that can not easily be related to contact allergy, we emphasize the need to include synthetic primin in our standard patch test series.

Síndrome ave-huevo en niños / Bird-egg syndrome in children

La alergia al huevo es muy frecuente en la infancia. En general, los alérgicos al huevo reaccionan principalmente a la ingesta de la clara. La yema de huevo tiene diversas proteínas pero la clara contiene los alergenos mayores. Los alergenos principales son: ovoalbúmina, ovomucoide, ovotransferrina y lisozima. Estas proteínas han podido ser secuenciadas. Se ha descrito, en algunos casos, una relación entre la hipersensibilidad tipo I con síntomas respiratorios por antígenos de aves y la alergia alimentaria a yema de huevo. A esta asociación se la conoce como síndrome ave-huevo. Este síndrome es causado por sensibilización a la albúmina sérica de pollo ( -livetina) y se caracteriza por el desarrollo de síntomas respiratorios y digestivos tras la ingestión de huevos o tras el contacto con antígenos de aves.. Los síntomas iniciales suelen ser de asma con o sin rinocon- juntivitis por contacto con aves. Primero se sensibilizan a proteínas aviares (plumas, excrementos, suero y carne) y, posteriormente, desarrollan hipersensibilidad alimentaria a huevo. A pesar de que el síndrome ave-huevo se ha descrito sobre todo en adultos con predominio en mujeres, también puede afectar a niños y en ellos se presentan unas características diferenciales respecto a la sensibilización a la clara de huevo más habitual. Predominan los síntomas digestivos y respiratorios sobre los cutáneos y la sensibilización a yema es mayor que la de la clara. En los niños con alergia a aves y huevo, la alergia al huevo suele ser más persistente; no siempre se consigue una tolerancia y en todo caso esta aparece más tarde. La sensibilización a otros neumoalergenos también es superior en el grupo de alérgicos a aves y huevo. A veces, la sensibilización a huevo precede a la sensibilización inhalatoria a proteínas aviares y entonces se habla de síndrome huevo-ave. Al final de la revisión se presenta a modo de ejemplo el caso clínico de un niño que clínicamente presenta un síndrome huevo-ave (AU)

Allergy to egg is highly frequent in childhood. In general, children allergic to egg react principally to the ingestion of egg white. Egg yolk contains various proteins but the major allergens are contained in egg white. The principal allergens are ovalbumin, ovomucoid, ovotransferrin, and lysozyme. These proteins have been sequenced. In some cases, a relationship between type I hypersensitivity with respiratory symptoms due to bird antigens and allergy to egg yolk has been described. This association is known as bird-egg syndrome, which is caused by sensitization to chicken serum albumin (α -livetin) and is characterized by the development of respiratory and gastrointestinal symptoms after egg intake or after contact with bird antigens. The initial symptoms are usually asthma with or without rhinoconjunctivitis due to contact with birds. Individuals first become sensitized to bird proteins (feathers, excrement, serum and meat) and subsequently develop egg allergy.Although bird-egg syndrome has been described principally in adults, especially in women, it can also affect children in whom the syndrome presents certain differentiating characteristics in relation to the more common sensitization to egg white. Gastrointestinal and respiratory symptoms are more common than cutaneous symptoms and sensitization to egg yolk is more frequent than that to egg white. In children with allergy to birds and egg, egg allergy is usually more persistent; tolerance is not always achieved and develops later. Sensitization to other aeroallergens is also greater in individuals with allergy to birds and egg. Sensitization to egg sometimes precedes respiratory sensitization to bird proteins, a process known as bird-egg syndrome. By way of example, the case of a child who clinically presented bird-egg syndrome is presented at the end of this review (AU)