Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology最新文献

{"title":"Considerable heterogeneity in the management approaches to beta-lactam allergies in real-life practice: Results of a nationwide survey from Turkey.","authors":"Tugba Arikoglu, Ilkay Koca, Ozge Can Bostan, Metin Keren, Ozlem Sancakli","doi":"10.1111/pai.70344","DOIUrl":"https://doi.org/10.1111/pai.70344","url":null,"abstract":"<p><strong>Background: </strong>Beta-lactams (BLs) are common elicitors of drug hypersensitivity reactions. This study evaluated current practices of allergists in the management of BL allergy and investigated differences in clinical approaches in Turkey.</p><p><strong>Methods: </strong>A web-based survey was used to assess how allergy specialists manage hypersensitivity reactions to BLs. Information was collected on diagnostic tests used for BL allergy, skin and drug provocation test (DPT) protocols, risk stratification, management approaches in specific clinical scenarios, and limitations in clinical practice.</p><p><strong>Results: </strong>A total of 172 allergy specialists (92 pediatric and 80 adult allergists) from 70 centres were enrolled. Only 50 (29.1%) respondents were able to perform skin tests using a complete panel including penicillin determinants, whereas 23.3% tested only with the causative drugs. Remarkable variations exist in DPT protocols regarding number of steps, target doses, and total duration. The severity (96.5%), morphology (69.8%), and chronology (58.7%) of the reaction, and time elapsed since the reaction (51.7%) were identified as key features for risk stratification. Clinical practices for specific cases with different risk profiles were quite heterogeneous. Pediatric allergists more frequently perform direct DPTs in low-risk BL reactions (p < .05). Adult allergists more often perform drug tests to provide safe alternatives, particularly in high-risk reactions (p < .05). 44.2% of allergists preferred to perform a retest after an initial negative workup. Participants emphasized the need for updated educational activities, access to skin test reagents, and the application of standardized protocols.</p><p><strong>Conclusion: </strong>This nationwide study revealed considerable variability in allergists' clinical practices regarding the management of BL allergy. The implementation of standardized algorithms improves consistency in real-life practice.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70344"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the prevalence of asthma by BMI groups among adolescents in South Korea, 2007-2024.","authors":"Gyeom Hwangbo, Hyunjee Kim, Ye Won Kim, Jaeyu Park, Hyeon Seok Hwang, Sunyoung Kim, Dong Keon Yon","doi":"10.1111/pai.70348","DOIUrl":"https://doi.org/10.1111/pai.70348","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70348"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of lactation-associated anaphylaxis.","authors":"James P Senter, Kris G McGrath","doi":"10.1111/pai.70362","DOIUrl":"10.1111/pai.70362","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70362"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One day versus five day drug provocation tests in mild delayed cutaneous beta lactam reactions in children: Negative predictive value and real-life reuse outcomes.","authors":"Sule Buyuk Yaytokgil, Gulay Irem Parlak Ozel, Mehmet Cihat Sifil, Yuksel Kavas Yıldız, Emine Vezir","doi":"10.1111/pai.70345","DOIUrl":"https://doi.org/10.1111/pai.70345","url":null,"abstract":"<p><strong>Background: </strong>Although drug provocation test (DPT) is the gold standard for diagnosing beta-lactam hypersensitivity (BLHS), its optimal duration in mild non-immediate cutaneous reactions remains uncertain. We compared the outcomes and negative predictive values (NPVs) of one-day versus five-day DPT protocols in children with suspected mild non-immediate cutaneous BLHS.</p><p><strong>Methods: </strong>We retrospectively reviewed patients (<18 years) evaluated between 2016 and 2023 for mild nonimmediate cutaneous BLHS. Our unit used a five-day extended DPT protocol in earlier years and subsequently adopted a one-day protocol as routine practice. Therefore, protocol assignment was period-based. Demographics, index reaction features, culprit drugs, DPT results, and real-life re-exposure outcomes were recorded. Repeat DPT, when performed, was used to adjudicate true allergy and estimate final NPV.</p><p><strong>Results: </strong>A total of 173 children (median age 7 years; IQR 4-10.5; 50.9% female) were included. DPT was performed a median of 11 months after the index reaction. One-day and five-day protocols were applied in 92 (53.2%) and 81 (46.8%) patients, respectively. Objective reactions during DPT occurred in 10/173 (5.8%) (positive DPT). Among 163 patients with negative DPT, 95 (58.3%) reported re-exposure; 10/95 (10.5%) experienced recurrent symptoms (6 one-day vs. 4 five-day; p = .768). Five underwent re-provocation, with one confirmed positive. Final NPVs were 93.1% for the one-day protocol and 98% for the five-day protocol (p = .333).</p><p><strong>Conclusion: </strong>In this period-based retrospective cohort of selected low-risk children with mild non-immediate cutaneous beta-lactam allergy, one-day and five-day DPT protocols yielded comparable NPVs. A single-day protocol appears feasible for appropriately selected patients, although prospective studies are warranted.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70345"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-term pulmonary outcomes (<6 months) after pediatric COVID-19 infection evaluated using impulse oscillometry and spirometry.","authors":"Simge Atar Bese, Adnan Mercan, Zeynep Gülec Koksal, Soner Sertan Kara, Güneş Ozcolpan, Pinar Uysal, Duygu Erge","doi":"10.1111/pai.70347","DOIUrl":"https://doi.org/10.1111/pai.70347","url":null,"abstract":"<p><strong>Objective: </strong>Although coronavirus disease 2019 (COVID-19) usually exhibits a mild clinical course in children, concerns remain regarding persistent airway dysfunction after recovery. This study aimed to evaluate pulmonary function tests (PFTs) in children following mild COVID-19 infection and to compare the findings with those of healthy controls.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, children aged 6-18 years with polymerase chain reaction-confirmed COVID-19 infection were identified retrospectively from February 2022 and evaluated prospectively between June and December 2022. Fifty-eight post-COVID-19 patients and 56 age- and sex-matched healthy controls were included, and their demographic and clinical characteristics were recorded. PFTs were assessed using impulse oscillometry (IOS) followed by spirometry.</p><p><strong>Results: </strong>There were no significant differences in demographic and anthropometric measurements between the post-COVID-19 group and the healthy controls. In terms of IOS measurements, zR5 and R5-20 (reflecting airway resistance) were higher and zX5 and zX20 (reflecting airway reactance) were lower in the post-COVID-19 group (p = .006, p = .002, p < .001, and p = .001, respectively). No significant differences were observed in spirometric parameters, including zFEV1, zFVC, zFEV1/FVC, and zFEF25-75. Notably, three patients exhibited persistent cough and dyspnea after COVID-19, had FEV1 values <90% predicted, positive bronchodilator reversibility, and inhalant allergen sensitization despite having no prior history of asthma or allergic rhinitis.</p><p><strong>Conclusion: </strong>Children recovering from mild COVID-19 infection may exhibit persistent airway dysfunction detectable by IOS despite normal spirometric findings. IOS appears to be a sensitive tool for identifying subclinical airway involvement in children following COVID-19.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70347"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on socioeconomic deprivation performs equally to race in the Pediatric Asthma Risk Score.","authors":"Mark Kačar, Ayobami Akenroye, Sophia Tsabouri","doi":"10.1111/pai.70359","DOIUrl":"https://doi.org/10.1111/pai.70359","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70359"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on \"Italian pediatric experts\" consensus statement on diagnosis and management of primary atopic disorders'.","authors":"Maryam Vaseghi-Shanjani, Philippe Eigenmann, Carmen Riggioni, Stuart E Turvey","doi":"10.1111/pai.70356","DOIUrl":"https://doi.org/10.1111/pai.70356","url":null,"abstract":"<p><p>\"Primary Atopic Disorders (PAD) are a recently recognized group of inborn errors of immunity characterized by severe allergic manifestations. Due to their overlapping features with common atopic diseases, PAD diagnosis is often delayed. This consensus provides a standardized work-up and a core set of clinical and laboratory red flags to differentiate PAD from polygenic multifactorial allergic conditions.\"</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70356"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excessive gestational weight gain and risk of asthma, rhinitis and allergic sensitization: Results from a Portuguese birth cohort.","authors":"Mónica Rodrigues, Susana Santos, Francisca Castro Mendes, Pedro Moreira, André Moreira","doi":"10.1111/pai.70357","DOIUrl":"10.1111/pai.70357","url":null,"abstract":"<p><strong>Background: </strong>Maternal body mass index (BMI) before pregnancy and gestational weight gain (GWG) have been implicated in offspring health, yet their specific impact on the development of allergic diseases remains unclear. We aimed to evaluate associations between pre-pregnancy BMI and GWG with asthma, rhinitis, eczema, food allergy, anaphylaxis, and allergic sensitization during childhood and adolescence.</p><p><strong>Methods: </strong>We analyzed 7280 mother-child pairs from Generation XXI, a Portuguese population-based birth cohort. Maternal BMI was categorized per World Health Organization criteria and grouped into underweight/normal weight vs. overweight/obesity. GWG was considered using Institute of Medicine (IOM) guidelines and GWG z-scores. Allergic outcomes were assessed via parent-reported physician diagnosis at 4, 7, 10, and 13 years, and allergic sensitization was determined at 10 years using ImmunoCAP. Associations were analyzed using logistic regression models adjusted for confounders.</p><p><strong>Results: </strong>Children of mothers with excessive GWG had increased odds of asthma at ages 7 and 13 (aOR = 1.30; 95% CI 1.01-1.66 and aOR = 1.29; 95% CI 1.01-1.65, respectively), and rhinitis at 4 (OR = 1.48; 95% CI 1.10-1.98). Higher GWG z-score group was associated with increased odds of asthma (aOR = 1.33; 95% CI 1.03-1.72), rhinitis (aOR = 1.54; 95% CI 1.13-2.09), and sensitization (aOR = 1.44; 95% CI 1.05-1.97). Lower GWG z-score group was associated to higher eczema odds at 13, while higher reduced eczema odds at age 4. Maternal overweight/obesity was associated with lower odds of eczema at age 13 (aOR = 0.73; 95% CI 0.60-0.88). Apart from eczema, maternal BMI showed no significant associations with others allergic diseases.</p><p><strong>Conclusion: </strong>Higher GWG is associated with increased odds of childhood asthma, rhinitis, and sensitization. In contrast, maternal overweight/obesity is linked to lower odds of eczema, suggesting condition-specific effects of maternal weight on childhood allergy risk.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70357"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-based food allergy and anaphylaxis training for primary and middle school students.","authors":"Hande Yuksel Bulut, Hilal Demirkesen Bicak","doi":"10.1111/pai.70363","DOIUrl":"https://doi.org/10.1111/pai.70363","url":null,"abstract":"<p><strong>Background: </strong>Schools are critical environments for food allergy (FA) because the majority of allergic reactions occur in schools. This study aimed to evaluate both the immediate effect and the retention of knowledge after 2 weeks of a video-based training on FA and anaphylaxis awareness among primary and middle school students.</p><p><strong>Methods: </strong>In this prospective study, children aged 6 to 15 years watched a 17.5-min \"FA and Anaphylaxis Awareness\" video. The effectiveness was assessed using the \"FA and Anaphylaxis Awareness Form\" administered before, immediately after, and 2 weeks after the training.</p><p><strong>Results: </strong>A total of 1492 children were included in the study; 42.0% of the children were male and 52.9% were attending primary school. Before training, 41.8% did not recognize FA symptoms, 49.1% could not identify signs of anaphylaxis, and only 9.5% knew the term \"anaphylaxis.\" Posttraining, 72.5% had learned \"anaphylaxis\" and knowledge of symptoms increased significantly. At 2 weeks after training, 65.9% of students recalled the term \"anaphylaxis,\" and the proportion unable to identify signs of FA and anaphylaxis decreased to 18.8% and 19.6%, respectively. The percentage of students unaware of allergy-related recommendations decreased from 23.0% to 6.8%. Those reporting reading ingredient labels and sharing allergen-free foods increased from 60.5% to 75.4%. Initially, only 13.3% identified correct anaphylaxis positioning, improving to 54.4% at 2 weeks after training.</p><p><strong>Conclusion: </strong>This study suggests that training given to students is an effective way to increase FA and anaphylaxis awareness in schools, and that utilizing the effectiveness and practicality of video-based training is a viable strategy for children.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 5","pages":"e70363"},"PeriodicalIF":4.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of allergic disease trajectories from birth up to adolescence.","authors":"Miriam Leskien, Martin Scheerer, Elisabeth Thiering, Sara Kress, Claire Coffey, Dietrich Berdel, Andrea von Berg, Carl-Peter Bauer, Monika Gappa, Joachim Heinrich, Sibylle Koletzko, Tamara Schikowski, Berthold Koletzko, Annette Peters, Marie Standl","doi":"10.1111/pai.70341","DOIUrl":"10.1111/pai.70341","url":null,"abstract":"<p><strong>Background: </strong>Allergic diseases often develop jointly during early childhood. Potential disease trajectories and relevant early-life factors have been described, yet existing prediction approaches mostly focus on single allergic diseases cross-sectionally. Models addressing allergic multimorbidity and disease trajectories are lacking. We aim to predict allergic disease trajectories from birth up to adolescence using early-life factors.</p><p><strong>Methods: </strong>Preceding research using data from 4646 adolescents of the German birth cohorts GINIplus and LISA identified seven allergic disease trajectories up to the age of 15 years. A set of predictors comprising parental and perinatal factors, early allergic or respiratory symptoms, lifestyle and environmental factors was used with an XGBoost machine learning approach to perform multiclass classification. In a subsample (N = 2109), polygenic risk scores (PRS) for asthma, allergic rhinitis, atopic dermatitis, and any allergy were added to the predictor set.</p><p><strong>Results: </strong>Our approach revealed moderate classification success (multiclass area under the curve (AUC) = 0.69). A macro-averaged sensitivity of 0.26 and specificity of 0.89 were obtained. The most important predictors were early-life skin rash, respiratory symptoms, and air pollution. In the sub-analysis, the PRS were among the factors with high importance, but the prediction performance in external test data was not improved.</p><p><strong>Conclusions: </strong>Our prediction success was comparable to established prediction scores while accounting for multiple allergic disease trajectories and using solely early-life factors. This study cannot yet provide reliable individual-level prediction in a clinical setting but can inform development of future work on this.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"37 4","pages":"e70341"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}