Oral desensitization in egg acute food protein-induced enterocolitis syndrome.

OBJECTIVE: Strict avoidance of trigger food is the primary management of food protein-induced enterocolitis syndrome (FPIES). No published data are available on active induction of tolerance with oral desensitization (OD) in FPIES. CASE REPORT: We carried out an OD in a 9 and a half years old boy with persistent acute egg FPIES. OD was performed with increasing doses of raw egg every week, starting with an initial dose of 0.2 ml. The boy presented mild and transient gastrointestinal adverse reactions when the 4 ml dose was reached. He could tolerate a whole raw egg in less than 14 months. CONCLUSIONS: Even though randomized controlled clinical trials on patients including various phenotypes of FPIES are needed, our experience is encouraging about the possible efficacy and safety of OD in this food allergy.

Disagreement between guidelines regarding the third step of asthma drug therapy for school-age children

With the help of a routine clinical case, we highlighted the difference between two of the best asthma guidelines available at the time regarding therapeutic suggestions for the so-called "third step" for school-age asthmatic children. We have analyzed the scientific evidence that each of the two guidelines brings to support their position. Finally, we have motivatedly solved the clinical scenario. However, the question of disagreement between two guidelines remains unresolved. This can lead to unjustified differences in the management of schoolchildren with persistent asthma

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Does delayed urticaria induced by drug allergy exist?

With the help of a routine clinical case about delayed urticaria induced by drug, we have analyzed the scientific societies reports published during the last 5 years on this topic. We highlighted the differences between the EAACI consensus and documents on drug allergy, commenting their positions and some of their definitions on delayed urticaria. However, the question of disagreement between definitions of delayed urticaria can generate confusion. It would be beneficial to have more and "official" clearness about this topic because of its important clinical application to our patients

No disponible

Does delayed urticaria induced by drug allergy exist?

With the help of a routine clinical case about delayed urticaria induced by drug, we have analyzed the scientific societies reports published during the last 5 years on this topic. We highlighted the differences between the EAACI consensus and documents on drug allergy, commenting their positions and some of their definitions on delayed urticaria. However, the question of disagreement between definitions of delayed urticaria can generate confusion. It would be beneficial to have more and "official" clearness about this topic because of its important clinical application to our patients.

Disagreement between guidelines regarding the third step of asthma drug therapy for school-age children.

With the help of a routine clinical case, we highlighted the difference between two of the best asthma guidelines available at the time regarding therapeutic suggestions for the so-called "third step" for school-age asthmatic children. We have analyzed the scientific evidence that each of the two guidelines brings to support their position. Finally, we have motivatedly solved the clinical scenario. However, the question of disagreement between two guidelines remains unresolved. This can lead to unjustified differences in the management of schoolchildren with persistent asthma.

[Usefulness of ultrasonography in the study of superficial lymph nodes. A case of cat scratch disease]. / Utilità dell'ecografia nello studio dei linfonodi superficiali. Considerazioni a propoito di un caso di linforeticulosi benigna.

Ultrasonography is a wide spread, non-invasive and repeatable imaging methodology. It is able to evidence any type of lesion and to describe its extent, its site and its content. The ultrasound role in the diagnosis of a case of cat scratch disease in a 44 year old man is described. Symptoms included intermittent fever, pain and palpable tumefactions in right armpit and elbow. The patient underwent routine and lymphoadenopathy specific laboratory data. Ultrasound examination and echo-guided fine-needle biopsy of the evident lesions were performed. These exams, related to pathological clinical presentation, have shown a chronic granulomatous lymphadenopathy like cat scratch disease. This case provides further evidence that ultrasound procedures might play an important role in differential diagnosis of palpable lesions.

[Changes in lymphocyte subsets in chronic inflammatory diseases and neoplasms in the elderly. I. Multivariate analysis of variance and factoral analysis]. / Variazioni delle sottoclassi linfocitarie nelle patologie infiammatorie croniche e neoplastiche dell'anziano. I. Analisi della varianza multivariata ed analisi fattoriale.

The variations of lymphocyte subsets have been studied both in neoplastic and chronic inflammatory elderly patients compared to a control group. The interpretation of the Multivariate Analysis of Variance (MANOVA) and of the Factorial Analysis has demonstrated the opposite role of TCD4 subset, mainly involved in the inflammatory process, and of TCD8 subset in regard of the neoplastic ones. We report the slight and yet significant increase of NK related to age. Independently from the disease pattern, factorial analysis permitted a comparison between the variations of lymphocyte subsets and the different grades of immunoresponse.

[Non-ketosic hyperosmolar hyperglycemic coma. Case reports and therapeutic consideration]. / Il coma iperglicemico iperosmolare non chetosico. Contributo casistico e considerazioni terapeutiche

Non-ketonic hyperosmolar hyperglycaemic coma (N.K.H.H.C.) is by no means uncommon in diabetes. Its picture includes sensorial depression, hyperglycaemia, hyperazotemia, marked dehydration and plasma hyperosmolarity. It is mostly found in elderly subjects with non-serious diabetes. Reference is made to 6 personal cases observed during a period of 14 months. The incidence of N.K.H.H.C. noted during this period was 2.2%; this was higher than that of ketoacidotic coma. Two patients died from hypovolaemic shock and one from septic complications. Three survived the episode. Treatment was based on three main points: high doses of insulin, though less than those employed for equal blood sugar levels in cases of ketoacidotic coma, hypotonic saline solutions, and correction of electrolyte imbalance. It is hoped that improved knowledge of the syndrome and, more particularly, earlier diagnosis and treatment, with lead to a reduction in the ta 50% mortality present associated with the disease.