Severe food-induced vasculitis in two children

Food-induced vasculitis seems to be rare and is considered by some as controversial. The reported cases in the literature are few and mostly on adult patients. Described in this report are two children with severe vasculitis caused by specific foods. They were diagnosed at two separate allergy centers that have a special interest in food allergies. Case 1 was an 8-year-old girl with a 9-month history of cutaneous vasculitis with large joints involvement. Case 2 was a 23-month-old girl with an 8-month history of multiple hospitalizations for recurrent acute severe cutaneous and mucous membrane vasculitis with large joints involvement. In both patients. skin biopsy showed leucocytoclastic vasculitis. In neither of the patients could the symptoms be attributed to drug intake, infection, autoimmunity, or other systemic disease. Case 1 had a moderately elevated serum total immunoglobulin E (IgE) level and strongly positive skin test and radioallergosorbent test (RAST) to cow's milk and hen's egg, both of which were proven to be the cause by elimination-challenge tests. Case 2 had a slightly elevated serum total IgE level, but negative skin tests to foods, including chocolate that was suspected by the mother. Avoidance of chocolate resulted in remission, except following accidental investigation cocoa-containing products. These findings support the few previous reports on food-induced vasculitis, an entity that seems rare but may be more commn than currently realized

Correlation between female sex and allergy was significant in patients presenting with dysphonia.

Aim of the present study was to investigate the prevalence of allergy in patients affected by both organic and/or functional vocal fold disorders. The secondary aim was to assess the correlation between sex and allergy in dysphonic patients. A retrospective chart review was performed on dysphonic patients. A total of 76 patients underwent fiberoptic endoscopy to assess the objective picture. Logistic regression analyses have been conducted to assess the association between sex and the outcome variables. The laryngoscopic examination revealed the presence of poor glottic closure in 32.9%, hyperkinesias in 11.8%, redness in 11.84%, polyps in 5.3%, oedema in 3.95%, vocal fold hypertrophy in 5.3%, nodules in 42.1%, cordectomy in 2.6%. Allergic rhinitis was present in 56.6%, milk intolerance in 13.2%, asthma in 9.2%, atopic dermatitis in 3.9%, drugs intolerance in 11.8%. A total of 76.32% patients presenting with dysphonia were allergic. A statistically significant association was found between female sex and presence of allergy. In conclusion, allergy testing should be performed routinely on female professional voice users. Mild respiratory disorders must be taken into serious consideration in female professional voice users, who may primarily complain of vocal dysfunction rather than upper and lower respiratory diseases

Effect of preseasonal enzyme potentiated desensitisation (EPD) on plasma-IL-6 and IL-10 of grass pollen-sensitive asthmatic children.

EPD is a method of preventive immunotherapy which employs b-glucuronidase as a biological response modifier. Plasma IL-6 and IL-10 were measured before a single injection of EPD, 24 hours later and 15 days after in a group of 17 children suffering from grass pollen asthma. 17 normal untreated children were used as controls. Although the study was conducted before the grass pollen season when the allergic children were free of symptoms, their plasma IL-6 and IL-10 were significantly elevated before the injection of EPD. 24 hours after treatment the plasma IL-10 had increased significantly and there was also a slight rise in IL-6. 15 days after treatment IL-6 had fallen to normal but IL-10 was still elevated. These findings suggest antigen-specific and non-specific mechanisms by which EPD may produce clinical improvement

Prévention de la chronicité en psychosomatique: approche systémique de l'asthme infantile.

Authors present a research focused on testing the value of an integrated, multidisciplinary and systems oriented therapeutic intervention aimed at improving clinical symptoms and preventing chronicity of infantile asthma. Twenty children suffering from chronic bronchial asthma were divided into two groups : an experimental group, which received pharmacological treatment and family psychotherapy and a control group which received only pharmacological treatment. Outcome has been measured in regard to two sets of parameters: clinical parameters as well as relational parameters. The obtained results indicate a clear improvement of the symptoms (reduction of the number of the crisis and of the pharmacological treatment) in the patients of the experimental group compared with the control one. The statistical validation confirms the significance of the results

Prevention of chronicity in Psychosomatic illness: research study into the treatment of childood asthma.

This article presents the results of a research study examining the usefulness of an integrated, multidisciplinary, systemic treatment in improving symptoms and preventing chronicity in childhood asthma. The study began with the hypothesis that the experimental treatment, integrating pharmacological therapy and family psychotherapy, would be more effective than a simply pharmacological approach in preventing asthma from becoming chronic. Twenty children (6-13 years of age; 50% male, 50% female) were grouped into 10 homogeneous pairs. Grouping variables were gender, age, family composition and social status. One group served as the "experimental" group, the other acted as the "control." Outcome variables included clinical parameters of asthma and relational parameters (assessment of family dynamics). Clinical parameters of the asthma were examined before, during, and after the 3 to 4 months study period. Relational parameters, tested with a modified version of Wiltwyck Family Tasks method, were examined before and after the family therapies. The Wilcoxon non-parametrical test for paired samples was used to assess pre- and post-treatment differences in relational parameters for the experimental group. All 7 parameters showed significant improvement. The Mann-Whitney non-parametrical test for independent samples was used to test for differences between the experimental and control groups in two main clinical parameters (frequency of asthma attacks and dependency on pharmacological treatment). Whereas there were no significant differences between the two groups before therapy, there were significant differences after therapy. The improvement of the experimental patients compared with the control patients was maintained at three follow-up evaluations (6 months, 1 year, and 2 years after the end of the therapy). The results show the effectiveness of an integrated systemic approach based on complex treatment compared to a reductionist approach