Doğukan Mustafa Keskin, Mehmet Kocaoğlu, Alper Yıldırım, Ender Sayan, Muhammed Yusuf Ozan Avcı
{"title":"First Reported Case of Anaphylaxis to Nebulized Tranexamic Acid in a Pediatric Patient: A Rare but Critical Event.","authors":"Doğukan Mustafa Keskin, Mehmet Kocaoğlu, Alper Yıldırım, Ender Sayan, Muhammed Yusuf Ozan Avcı","doi":"10.1089/ped.2024.0035","DOIUrl":"10.1089/ped.2024.0035","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss due to certain medical conditions. It has a low side effect profile and is safe to administer in most instances. Anaphylaxis cases due to intravenous TXA have been reported in the literature. We report the first pediatric case of anaphylaxis due to the use of nebulized TXA. <b><i>Case Presentation:</i></b> A 2-year-old boy with cerebral palsy, epilepsy, and tracheostomy was hospitalized with pneumonia. On the fourth day of hospitalization, the patient started bleeding from the trachea. Nebulized TXA was started to reduce tracheal bleeding. Anaphylaxis developed 5 min after administration of nebulized TXA. Subsequently, the patient was successfully treated with adrenaline, intravenous fluids, antihistamines, and steroids. <b><i>Conclusion:</i></b> Nebulized TXA is increasingly used off-label. Although it has a safe profile, side effects such as anaphylaxis may occur rarely. It is essential to recognize the symptoms of anaphylaxis when using nebulized TXA.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"29-31"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What Do We Know About the Harms of Electronic Cigarettes?","authors":"Harold J Farber","doi":"10.1089/ped.2024.0130","DOIUrl":"10.1089/ped.2024.0130","url":null,"abstract":"<p><p>Electronic cigarettes are commonly misperceived as safe, hence the importance of health care providers understanding the harms of these devices. To date, there is substantial evidence of impaired immune defenses leading to increased risk for severe infections. Electronic cigarette users have increased respiratory symptoms, including bronchitis, cough, and wheeze. There is evidence of emphysema from electronic cigarette use in both laboratory mouse studies and population health surveys. There is evidence of increased cardiovascular disease from electronic cigarettes in both laboratory mouse models and population health surveys. There have been many cases of acute severe lung disease leading to hospitalization and death in electronic cigarette users; although most cases reported were associated with vitamin E acetate in tetrahydrocannabinol-containing products, some cases report exclusive use of nicotine-containing electronic cigarettes. Recently, constrictive bronchiolitis has been found in lung biopsies of electronic cigarette users with dyspnea. There are multiple carcinogenic chemicals in electronic cigarette emissions. Mouse models demonstrate increased rates of lung cancer and carcinogenic chemicals accumulate in the urine of human users. Neurotoxicity has been demonstrated in laboratory mouse models. There is concern about nicotine exposure adversely impacting brain development and serving as a gateway drug for other harmful drug use. Dual use of electronic and combustible cigarettes appears to be more harmful than the use of combustible cigarettes alone. <b><i>Conclusion:</i></b> Electronic cigarettes have substantial harms and are not a safe alternative to combustible tobacco use. It is important for health care providers to know these harms and counsel their patients.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"1-6"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful Treatment Using Etanercept in a Patient with Enthesitis-Related Arthritis Who Had Late Allergic Reaction to Adalimumab.","authors":"Halime Yağmur, Damla Baysal Bakir, Gizem Kabadayi, Tuncay Aydin, Rüya Torun, Özge Atay, Nevin Uzuner","doi":"10.1089/ped.2025.0003","DOIUrl":"10.1089/ped.2025.0003","url":null,"abstract":"<p><p><b><i>Background:</i></b> Biological agents are considered important therapies and are increasingly used in the treatment of a range of rheumatological and inflammatory diseases. Nevertheless, the prevalent use of these treatments has been associated with increased incidence of drug-induced hypersensitivity reactions (HSR). <b><i>Case Presentation:</i></b> A 15-year-old patient with enthesitis-related arthritis developed late HSR after the use of adalimumab. Consequently, etanercept was used as an alternative treatment. Etanercept was administered subcutaneously through a single dose without any reaction upon examination using skin tests (skin prick test, intradermal test, and patch test) against likely cross-reactions given that both adalimumab and etanercept were anti-tumor necrosis factor (TNF) agents. <b><i>Conclusions:</i></b> Currently, TNF-α inhibitors find widespread use. Caution is required against HSR reactions, including systemic or local injection site reactions, although they are generally considered safe to use.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"36-39"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful Use of Anakinra in a Patient with IL-10R Beta Deficiency: A Case Report.","authors":"Selcuk Dogan, Ridvan Selen, Ferda Ozbay Hosnut, Semanur Ozdel, Figen Dogu, Aydan Ikinciogullari, Caner Aytekin","doi":"10.1089/ped.2024.0116","DOIUrl":"10.1089/ped.2024.0116","url":null,"abstract":"<p><p><b><i>Background:</i></b> Interleukin-10 (IL-10) is a crucial anti-inflammatory cytokine essential for maintaining immune homeostasis, particularly in the gastrointestinal system. Defects in the IL-10 signaling pathway, including mutations in interlaukin-10 receptor (IL-10R) beta, have been implicated in early-onset inflammatory bowel disease (IBD), often resistant to conventional treatments. <b><i>Case Presentation:</i></b> We report a 1.5-month-old male patient with IL-10R beta deficiency presenting with fever, vomiting, malnutrition, and sepsis. Despite normal initial evaluations, persistent fever and elevated inflammatory markers prompted the initiation of anakinra, an interleukin-1 receptor antagonist. Genetic testing confirmed a homozygous deletion in the <i>IL10RB</i> gene. Anakinra led to significant clinical improvement, including weight gain and symptom resolution. The patient was enrolled in an allogeneic hematopoietic stem cell transplantation (HSCT) program and successfully received HSCT from an HLA-matched related donor. <b><i>Discussion:</i></b> IL-10R beta deficiency presents with severe and early-onset symptoms, often unresponsive to standard IBD therapies. Anakinra has shown promise in bridging to HSCT by reducing inflammation and improving clinical outcomes in patients with IL-10 pathway defects. This case highlights the effectiveness of anakinra as a treatment strategy in severe, refractory IBD associated with IL-10R beta deficiency and underscores the importance of genetic testing for accurate diagnosis and treatment planning. <b><i>Conclusion:</i></b> Anakinra may provide significant clinical benefits in patients with IL-10R beta deficiency, serving as a bridge to definitive treatment with HSCT. Early genetic diagnosis and targeted therapy are crucial for managing this challenging condition.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"32-35"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stefano Miceli Sopo, Matteo Di Toro Mammarella, Francesco Mastellone, Marta Barbato, Mariannita Gelsomino, Giulia Bersani, Bruno Miceli Sopo
{"title":"Tailoring Component Resolved Diagnosis Through the Use of Likelihood Ratios: The Example of Cor a 14.","authors":"Stefano Miceli Sopo, Matteo Di Toro Mammarella, Francesco Mastellone, Marta Barbato, Mariannita Gelsomino, Giulia Bersani, Bruno Miceli Sopo","doi":"10.1089/ped.2024.0126","DOIUrl":"10.1089/ped.2024.0126","url":null,"abstract":"","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"7-10"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammed Fatih Erbay, Şefika Kökçü Karadağ, Tuğba Üstün, Nilay Çalışkan, Güler Yıldırım, Hamit Bologur, Hilal Güngör, Merve Karaca Şahin, Aslı Berivan Topçak, Deniz Ozceker
{"title":"Is Routine Skin Prick Testing Essential in Managing Pediatric Chronic Urticaria?","authors":"Muhammed Fatih Erbay, Şefika Kökçü Karadağ, Tuğba Üstün, Nilay Çalışkan, Güler Yıldırım, Hamit Bologur, Hilal Güngör, Merve Karaca Şahin, Aslı Berivan Topçak, Deniz Ozceker","doi":"10.1089/ped.2024.0070","DOIUrl":"https://doi.org/10.1089/ped.2024.0070","url":null,"abstract":"<p><p><b><i>Background:</i></b> Chronic urticaria (CU) in children, persisting beyond six weeks, is less common than acute urticaria, with a prevalence of 0.1%-0.3%. CU is classified into chronic idiopathic urticaria (CIU) and chronic inducible urticaria (CIndU), with CIU having an often unknown etiology, whereas CIndU is triggered by physical stimuli. Our study aims to explore the clinical and demographic characteristics, laboratory results, and possible etiological factors in children diagnosed with CU, and to assess the necessity of aeroallergen skin prick tests (SPTs) in these patients. <b><i>Methods:</i></b> The study evaluated the medical records of 242 children with CU, treated at the Pediatric Allergy-Immunology Clinic of Prof. Dr. Cemil Taşcıoğlu City Hospital from January 2018 to January 2024. Data on age, gender, presence of angioedema, dermatographism, concomitant allergic diseases, family history of atopy, infection status, urticaria duration, SPT results, and laboratory tests were collected and analyzed. <b><i>Results:</i></b> Results showed that 48.3% of patients were females and 51.7% were males, with an average age of 12.8 years and an average onset age of 9.9 years. Angioedema was present in 15.7% of patients, dermatographism in 17.8%, concomitant allergic diseases in 24%, and a family history of atopy in 14.5%. Infections were documented in 10.8% of patients, with urinary tract infections, <i>Helicobacter pylori (H. pylori)</i> infections, and dental infections identified. <b><i>Discussion:</i></b> Our study found no significant differences in clinical features, treatment requirements, or response to treatments between patients with positive and negative SPT results. Laboratory parameters such as eosinophilia, total Immunoglobulin E (IgE), and thyroid function tests also showed no significant differences. These findings suggest that routine SPTs for the management of CU in children will only be useful if IgE-mediated allergic comorbidities are suspected but may not be necessary in other cases, prompting a reevaluation of their use in clinical practice to seek more cost-effective diagnostic methods.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Considerations for an Academic Pediatric Asthma Specialist in the 3rd Decade of the 21st Century.","authors":"Russell J Hopp","doi":"10.1089/ped.2024.0106","DOIUrl":"10.1089/ped.2024.0106","url":null,"abstract":"","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"85-88"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Iron Deficiency in Preschool Children with Chronic Rhinitis.","authors":"Yu-Fang Lo, Jia-Kan Chang","doi":"10.1089/ped.2024.0097","DOIUrl":"10.1089/ped.2024.0097","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Iron deficiency (ID) has been intricately linked with various inflammatory diseases. Chronic rhinitis stands as one of most common respiratory inflammation disorders in children. This study aimed to investigate the prevalence of ID among preschool children with chronic rhinitis and to explore the association between ID and chronic rhinitis in this population. <b><i>Methods:</i></b> This cross-sectional study included children aged 3 to 7 years diagnosed with chronic rhinitis. ID was defined as transferrin saturation <20%, with absolute ID being defined as ferritin <15 ng/mL. Logistic regression analyses were performed to identify factors associated with ID. <b><i>Results:</i></b> A total of 72 children with chronic rhinitis were included, revealing a prevalence of ID of 47.2%. Only 5.9% children with ID exhibited absolute ID. Multivariate analysis revealed that neutrophils (odds ratio [OR] = 1.205, 95% confidence interval [CI] = 1.013-1.433, <i>P</i> = 0.035) and monocytes (OR = 1.803, 95% CI = 1.198-2.713, <i>P</i> = 0.005) were independently and significantly associated with ID. <b><i>Conclusion:</i></b> This study revealed a notable prevalence of ID in the preschool children with chronic rhinitis. The significant association between neutrophils and monocytes with ID implied an intricate involvement of innate immunity in the manifestation of ID.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"98-105"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Systemic Immune Inflammation Index, Systemic Inflammation Response Index, Aggregate Index of Systemic Inflammation, and Follistatin-Like Protein-1 Levels in Children Diagnosed with Pneumonia.","authors":"Kamile Yucel, Sekibe Işık Disci","doi":"10.1089/ped.2024.0082","DOIUrl":"10.1089/ped.2024.0082","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aims to evaluate systemic immune inflammation index, systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and follistatin-like protein-1 (FSTL-1) levels in children with pneumonia and healthy controls. <b><i>Methods:</i></b> The study was carried out at the Seydisehir State Hospital between February 1, 2024 and June 1, 2024. The patient group included 44 children diagnosed with pneumonia and the control group included 45 healthy children without any disease. Index values obtained from hemogram data. Enzyme-linked immunosorbent assay was used to measure FSTL-1 levels. <b><i>Results:</i></b> A total of 89 participants, 44 in the patient group and 45 in the healthy control group, were included in the study. White blood cells, monocyte, eosinophil, neutrophil, c-reactive protein, SIRI, and AISI levels were significantly higher in the patient group than in the control group. FSTL-1 levels were higher in the patient group, but did not differ statistically significant. The patient and control groups were compared in the receiver operating characteristics analysis, we found the highest area under curve (AUC) in the SIRI (AUC: 0.754) and AISI (AUC: 0.713) parameters. <b><i>Conclusion:</i></b> In conclusion, compared to healthy controls, SIRI and AISI levels were significantly higher in the patient group, and the highest AUC values belonged to these indices. Therefore, we believe that SIRI and AISI indices, which are inexpensive and simple tests, are useful for early diagnosis and treatment of pneumonia.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"106-111"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Immune Deficiency Disorders in the Clinic-A Case for Routine Testing of Monocyte Subsets with CD14 and CD16 Expression.","authors":"Yaddanapudi Ravindranath, Prahlad Parajuli","doi":"10.1089/ped.2024.0129","DOIUrl":"10.1089/ped.2024.0129","url":null,"abstract":"","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"116-117"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}