• Title/Summary/Keyword: Oral allergy syndrome

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Approach to children with IgE-mediated food allergy with a focus on oral allergy syndrome

  • Eun Kyo Ha;Ju Hee Kim;Jeewon Shin;Youn Ho Shin;Hye Mi Jee;Man Yong Han
    • Allergy, Asthma & Respiratory Disease
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    • v.12 no.2
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    • pp.78-84
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    • 2024
  • Purpose: To assess the prevalence of food allergy, with a focus on oral allergy syndrome (OAS) in a population of children and to investigate relevant allergen sensitization associated with these adverse reactions. Methods: This study involved 1,660 children (aged 4 to 13 years) experiencing seasonal allergy symptoms, who were enrolled in the 2015 prospective Seongnam Atopy Project (SAP 2015) in a South Korean municipality. Parents completed a structured questionnaire to assess children with OAS, collecting information on the duration, severity, and factors related to symptoms. Skin prick tests (n= 498) and blood sampling (n= 464) were performed to measure allergic sensitizations, total eosinophil counts, and levels both total immunoglobulin E (IgE) and birch-specific IgE. Results: The prevalence of OAS among the children enrolled in this study was 4.4% (95% confidence interval, 3.7%-5.1%). The most common symptom was mouth itching (n= 106, 65.0%), and the primary food allergen associated with symptoms was kiwi (n= 48, 29.5%). Peanut sensitization (14.8% vs. 57.1%, P< 0.001) and sensitization to other nut products (15.6% vs. 47.6%, P= 0.001) were linked to a higher incidence of systemic reactions. Conclusion: The prevalence of 4.4% underscores the significant health impact of OAS, especially in children experiencing food allergy-related symptoms. Notably, common allergens, such as kiwi, and the potential for additional systemic reactions associated with this condition highlight the importance of raising awareness.

A case of a 6-year-old boy diagnosed with lipid transfer protein syndrome using the ImmunoCAP and ImmunoCAP Immuno Solid-phase Allergen Chip

  • Sang Hoon Lee;Yoon Ha Hwang
    • Allergy, Asthma & Respiratory Disease
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    • v.12 no.1
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    • pp.31-34
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    • 2024
  • We experienced a rare case of a 6-year-old boy who was suspected of having lipid transfer protein (LTP) syndrome; the patient was diagnosed with LTP syndrome using the ImmunoCAP/ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) test. LTP syndrome affects patients who are already sensitized to pollens with signs and symptoms of allergic rhinitis with or without bronchial asthma. Its severity is closely associated with the geographical location as well as the level, nature, and duration of the allergen exposure in a susceptible individual with or without cofactors, such as exercise, alcohol, chemicals, or nonsteroidal anti-inflammatory drug. Patients with LTP syndrome may present with diverse manifestations ranging from local symptoms, such as mild contact urticaria, oral allergy syndrome, or gastrointestinal problems, to anaphylaxis and even anaphylactic shock. Our case highlights the usefulness of the ImmunoCAP/ImmunoCAP ISAC test in establishing a diagnosis of LTP syndrome.

Pollen-food allergy syndrome in children

  • Jeon, You Hoon
    • Clinical and Experimental Pediatrics
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    • v.63 no.12
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    • pp.463-468
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    • 2020
  • Pollen-food allergy syndrome (PFAS) is an immunoglobulin E-mediated immediate allergic reaction caused by cross-reactivity between pollen and the antigens of foods-such as fruits, vegetables, or nuts-in patients with pollen allergy. A 42.7% prevalence of PFAS in Korean pediatric patients with pollinosis was recently reported. PFAS is often called oral allergy syndrome because of mild symptoms such as itching, urticaria, and edema mainly in the lips, mouth, and pharynx that appear after food ingestion. However, reports of systemic reactions such as anaphylaxis have been increasing recently. This diversity in the degree of symptoms is related to the types of trigger foods and the characteristics of allergens, such as heat stability. When pediatric patients with pollen allergy are treated, attention should be paid to PFAS and an active effort should be made to diagnose it.

Is This Symptom Even a Food Allergy?: Clinical Types of Food Protein-induced Enterocolitis Syndrome

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.74-79
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    • 2014
  • Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

A Case of Goodpasture's Syndrome Combined with Crohn's Disease (크론씨 병에 동반된 Goodpasture 증후군 1예)

  • Kim, Ji-Yon;Bae, Jun-Yong;Jung, Eun-Jung;Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-Up;Uh, Soo-taek;Hwang, Jung-Hwa;Jin, So-Young;Lee, Dong-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.384-388
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    • 2006
  • A 29-year-old male patient was admitted due to his general weakness and poor oral intake for several months. He was diagnosed as having Crohn disease 16 years ago and total colectomy was performed 10 years ago. On the 3rd day after admission, gross hematuria and sudden hemoptysis combined with diffuse infiltration were noted on chest X-ray. His symptoms and the diffusely increased lung opacities improved with administering high-dose steroid therapy. Later, anti-GBM antibody was found to be positive on the laboratory findings. We report here on a rare case of Goodpsture syndrome combined with prolonged Crohn disease along with a review of literature.

Loeffler's Syndrome Induced by Ingestion of Urushiol Chicken

  • Jeong, Shin-Ok;Oh, Ji-Hyun;Kwak, Yun-Mi;Lee, Junehyuk;Jang, An-Soo;Kim, Do-Jin;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.258-261
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    • 2015
  • Eosinophilic lung diseases are heterogeneous disorders characterized by varying degrees of pulmonary parenchyma or blood eosinophilia. Causes of eosinophilic lung diseases range from drug ingestion to parasitic or fungal infection as well as idiopathic. The exact pathogenesis of eosinophilic lung disease remains unknown. Urushiol chicken can frequently cause allergic reactions. Contact dermatitis (both local and systemic) represents the most-common side effect of urushiol chicken ingestion. However, there has been no previous report of lung involvement following urushiol chicken ingestion until now. A 66-year-old male was admitted to our hospital with exertional dyspnea. Serial chest X-ray revealed multiple migrating infiltrations in both lung fields, with eosinophilic infiltration revealed by lung biopsy. The patient had ingested urushiol chicken on two occasions within the 2 weeks immediately prior to disease onset. His symptoms and migrating lung lesions were resolved following administration of oral corticosteroids.

Food Protein-induced Enterocolitis Syndrome: an Update on Clinical Approaches and Its Pathophysiology (식품 단백질 유발성 장염 증후군: 임상적 접근과 병태생리의 최신 지견)

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.117-128
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    • 2007
  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.

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Stevens-Johnson Syndrome : A Case Report (스티븐 존슨 증후군 : 증례보고)

  • Song, Yongho;Lee, Nanyoung;Lee, Sangho;Jih, Myeongkwan;Lim, Yujin;Yoon, Youngmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.455-460
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    • 2017
  • Stevens-Johnson syndrome (SJS), an extremely severe acute hypersensitivity reaction, causes extensive necrosis on the skin and the mucous membrane. SJS is a disease of unknown cause that can occur in all age groups. It is thought to be caused by drug allergy or induced by bacterial infection. Epidermal surface invasion of less than 10 percent is called SJS, and invasion of more than 30 percent is called toxic epidermal necrolysis. Although it is rare with an incidence of 1 - 2 cases per million people per year, it has effects on tooth development and therefore on children who are in a growth phase. The purpose of this case report is to examine the effect of SJS on tooth development in children. In general, eruption of the upper and lower 1st molars and lower central incisors starts at 6 - 7 years of age. Root development also occurs at this time. In the case reported here, SJS occurred in a 6-year-old patient. Although the patient's SJS was completely cured, he still suffers from aftereffects. Developmental abnormalities in the patient's teeth were observed only in teeth for which root development had been completed at the time. The purpose of this case report is to illustrate how to diagnose such systemic diseases by intra-oral features and to recognize and resolve tooth development problems associated with the disease.