Vitamin D deficiency in children and adolescents with food allergy: Association with number of allergens, sun exposure and nutritional status

Our objective was to describe the serum vitamin D concentrations of children and adolescents with food allergy (FA) and to verify the association between the number of food allergens involved, length of sun exposure, and nutritional status. Through a cross-sectional study, 79 patients with FA, from ages 2 to 15 years, were assessed and followed up in a reference outpatient clinic, in Sao Paulo, Brazil. Clinical and biochemical data were collected for analysis of 25(OH)D, calcium, phosphorus, phosphatase, parathyroid hormone (PTH), and high-sensitivity C-reactive protein (hs-CRP). The cut-off point used for vitamin D deficiency was 25(OH)D ≤ 20 ng/mL. Vitamin D deficiency was detected in 45.6% of patients with a median age of 6.9 years (Interquartile range [IQR] 4.7; 10.2). The median serum 25(OH)D concentration was 21.1 ng/mL (IQR 17.8; 26.0). Multivariate linear regression was performed considering serum vitamin D level as a dependent variable. Allergy to multiple foods (inverse) and length of sun exposure (direct), but not nutritional status, were independently associated with serum 25(OH)D levels (P = 0.034 and P = 0.014, respectively). Patients with cow’s milk allergy also showed lower vitamin D concentrations in comparison with other FA (19.1 ng/mL [IQR 16.6; 24.4] vs 22.2 ng/mL [IQR 18.1; 27.1] [P = 0.056]). Vitamin D deficiency affected about half of individuals with FA. Multiple food allergy was associated with lower vitamin D concentrations, reinforcing the importance of monitoring vitamin D status in patients with FA (AU)

Body Mass Index and skin reactivity to histamine and Dermatophagoides pteronyssinus in children and adolescents followed in a pediatric allergy service.

SUMMARY: Rationale. Recent data suggest that the nutritional status assessed by body mass index (BMI) is positively associated with skin reactivity to histamine in children. Objective. To study the relation between BMI and skin reactivity to histamine and Dermatophagoides pteronyssinus in allergic children and adolescents. Methods. The medical charts of patients attended in our outpatient clinic between 2013 and 2014 (n = 972) were evaluated. Only patients with asthma, allergic rhinitis or wheezing infants sensitized to at least one aeroallergen were selected: a total of 626 patients (6 months to 19 year-olds; 60.1% male) were enrolled. Weight (kg), height (m), BMI (weight/height2), and the mean diameter of the wheals induced by histamine (10 mg/ml) and Dermatophagoides pteronyssinus in skin prick tests (SPT) were obtained. Skin index (SI; ratio of allergen-induced wheal diameter and corresponding histamine diameter) was also analyzed. Results. All patients had shown a mean wheal diameter of histamine greater than 1 mm. There was no increased skin reactivity to histamine with increasing BMI Z score (ZBMI). However, a significant correlation between BMI and the mean wheal of histamine was observed in patients < -1 ZBMI. Similar results were observed with Dermatophagoides pteronyssinus, (even considering the SI). Conclusions. We did not document interference of nutritional status (ZBMI) on the skin reactivity to histamine or Dermatophagoiodes pteronyssinus in atopic patients. Further investigation is required.

Prevalence and associated factors for asthma in Brazilian and Japanese schoolchildren living in the city of São Paulo, Brazil.

OBJECTIVES: Ethnic background interferes on the prevalence of asthma among schoolchildren (4 to 9 years old, SC) born and living in São Paulo, Brazil. METHODS: International Study of Asthma and Allergy in Childhood (ISAAC)'s written standard and complementary questionnaires were applied to SC (similar socioeconomic status) living in the city of São Paulo: no-Japanese Brazilian (NJB, N = 306) and Japanese Brazilian (third generation, born in Brazil, from Japanese families with no miscegenation, JB, N = 258). RESULTS: The prevalence of current asthma was significantly higher among NJB in comparison to JB (22.2% vs 14.7%, respectively). To have rhinitis and to exercise less than once/week were risk factors for both groups of children. CONCLUSION: Although both groups were apparently exposed to the same environment, other cultural differences do not allow us to conclude about the ethnic component having greater influence than the environment in the development of asthma in these individuals.

Profile of latex sensitization and allergies in children and adolescents with myelomeningocele in São Paulo, Brazil.

BACKGROUND: Latex allergy is an important cause of occupational allergy. In many countries the prevalence of latex allergy is still high and the profile of latex sensitization is unknown. OBJECTIVES: To evaluate the frequency of sensitization and allergy to latex in children and adolescents with myelomeningocele and to identify associated risk factors. METHODS: The study included 55 children and adolescents with myelomeningocele followed at a specialized center. In addition to a standard questionnaire and skin prick tests (SPTs) to aeroallergens and total latex, the patients underwent determination of total and specific serum IgE to latex and recombinant allergens. RESULTS: We observed a prevalence of 25% for latex sensitization and of 20% for latex allergy. Twenty-four patients (43.6%) were atopic and the average age for the first reaction to latex was 44.5 months. Cutaneous reactions were the most frequently reported reactions (72.7%). Specific immunoglobulin (Ig) E to rHev b 1, rHev b 3, rHev b 5, rHev b 6.1, and rHev b 6.2 was detected in over 50% of patients allergic to latex. Multivariate analysis showed current asthma, atopy, and having undergone 4 or more operations to be risk factors for latex sensitization. CONCLUSIONS: Our study documented a high prevalence of sensitization and allergy to latex in patients with myelomeningocele. Specific IgE to rHev b 1, rHev b 3, rHev b 5, rHev b 6.1, and rHev b 6.2 was detected in over 50% of children and adolescents with myelomeningocele who are allergic to latex. A history of current asthma, atopy, and having undergone 4 or more operations were independent risk factors for latex allergy.

Profile of Latex Sensitization and Allergies in Children and Adolescents With Myelomeningocele in São Paulo, Brazil

Introducción: La alergia al látex constituye una causa importante de alergia ocupacional. En muchos países la prevalencia de alergia al látex es elevada y su perfil de sensibilización desconocido. Objetivos: El objetivo de este estudio fue evaluar la frecuencia de sensibilización y de alergia al látex en niños y adolescentes con mielomeningocele e identificar los factores de riesgo asociados. Métodos: Este estudio evaluó 55 niños y adolescentes afectos de mielomeningocele y monitorizados en un centro especializado. Se realizó un estudio de test cutáneos (prick) frente a aeroalérgenos y látex total. Así como un cuestionario y la determinación de IgE total y específica frente a látex y sus alérgenos recombinantes. Resultados: En los resultados encontramos un 25% de sensibilización y un 20% de alergia al látex. Un 43.6% de los pacientes eran atópicos y la edad media de comienzo de la sintomatología fue de 44.5 meses, siendo las reacciones cutáneas las más frecuentes (72.7%). La IgE específica frente a rHev b 1, 3, 5, 6.1 y 6.2 se detectó en más del 50% de los pacientes alérgicos al látex. El análisis multivariante mostró como significativas las siguientes variables: asma, atopia, y número de cirugías a las que había sido sometido el paciente. Conclusiones: Como conclusión este estudio documenta una elevada prevalencia de sensibilización y alergia al látex en pacientes con mielomeningocele. La IgE específica frente a rHev b 1, 3, 5, 6.1 y 6.2 se detecta en más del 50% de los alérgicos al látex en esta serie. Entre los factores independientes de riesgo para sufrir alergia a látex se encuentran el asma, la atopia y el haber estado sometido a más de cuatro cirugías (AU)

Background: Latex allergy is an important cause of occupational allergy. In many countries the prevalence of latex allergy is still high and the profile of latex sensitization is unknown. Objectives: To evaluate the frequency of sensitization and allergy to latex in children and adolescents with myelomeningocele and to identify associated risk factors. Methods: The study included 55 children and adolescents with myelomeningocele followed at a specialized center. In addition to a standard questionnaire and skin prick tests (SPTs) to aeroallergens and total latex, the patients underwent determination of total and specific serum IgE to latex and recombinant allergens. Results: We observed a prevalence of 25% for latex sensitization and of 20% for latex allergy. Twenty-four patients (43.6%) were atopic and the average age for the first reaction to latex was 44.5 months. Cutaneous reactions were the most frequently reported reactions (72.7%). Specific immunoglobulin (Ig) E to rHev b 1, rHev b 3, rHev b 5, rHev b 6.1, and rHev b 6.2 was detected in over 50% of patients allergic to latex. Multivariate analysis showed current asthma, atopy, and having undergone 4 or more operations to be risk factors for latex sensitization. Conclusions: Our study documented a high prevalence of sensitization and allergy to latex in patients with myelomeningocele. Specific IgE to rHev b 1, rHev b 3, rHev b 5, rHev b 6.1, and rHev b 6.2 was detected in over 50% of children and adolescents with myelomeningocele who are allergic to latex. A history of current asthma, atopy, and having undergone 4 or more operations were independent risk factors for latex allergy (AU)