Food Allergy and Philagrine Mutation in Children with Atopic Dermatitis

Objective: To determine the frequency and type of food allergy in patients having atopic dermatitis and to show the presence of mutations genetically. Methods: Patients diagnosed as having atopic dermatitis according to the Hanifin Rajka criteria were evaluated retrospectively. Eosinophils, total immunoglobin E, milk-specific immunoglobulin E, egg-specific immunoglobulin E, wheat-specific immunoglobulin E, and filaggrin gene mutation results were recorded. Nutrient elimination was performed for 1 month in patients who were thought to have food allergy owing to skin prick test and milk-specific immunoglobulin E results. The diagnosis was confirmed through a food loading test for the patients who benefited from the elimination. Results: Of the 66 patients included in the study, 42 (63.63%) were male. Food allergies were detected in 40 patients (60.6%). According to the Scoring of Atopic Dermatitis index, 9 out of 16 patients aged 40 years and over had food allergy and 31 out of 50 patients aged under 40 years had food allergy. There was no significant difference between the groups (P=.56). All patients included in the study were examined for filaggrin. Only 1 patient with a Scoring of Atopic Dermatitis index below 40 and milk allergy was found to have p.R501 * and c.2282-2285delCAGT mutations. Conclusion: Atopic dermatitis food allergy was found to be 60.6%. The most common improvement was egg allergy and egg elimination. There was no difference between atopic dermatitis severity and food allergy and laboratory tests. Severe atopic dermatitis was found to be 24.2%

Günlük pratikte inek sütü alerjisinde IgE non IgE dağılımı ve tanı yöntemlerinin katkısı

Amaç: İnek sütü alerjisi olan hastalarımızın immün reaksiyonun tipine göre dağılımını ve tanı yöntemlerinin rutin uygulamadaki yerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Nisan 2014- Aralık 2014 arası ÇÜTF Çocuk Alerji- İmmünoloji kliniğine başvuran hastalardan inek sütü alerjisi düşünülen 54 hasta alındı. Laboratuar değerlendirmede eozinofil sayısı, süt spesifik immungloblin E, deri prik test, prik to prik testi, yama testi ve süt yükleme testi yapıldı. Bulgular: Hastaların (n:54) %50'si (n:27) kız ve %50'si (n:27) erkekti. Tüm hastaların yaş ortalaması 38,3±37,9 aydı. Hastaların %66,6'sı (n:36) IgE aracılı, %14'ü (n:8) miks tip, %18,5 (n:10) Non IgE aracılı idi. IgE aracılıklı 36 hastanın %88,8'ine inek sütü yükleme testi yapıldı. %34,3'ünde (n:11) yükleme testi pozitifti. Miks gruptaki 8 hastanın 5'ine inek sütü yükleme testi yapıldı %40'ında pozitif bulundu. Non IgE grubunda 10 hastadan 7'sine inek sütü yükleme testi yapıldı ve hiçbirinde pozitif bulunmadı. Sonuç: Bu çalışmada IgE aracılıklı olgulara (%66,6), Non IgE ve miks gruba göre daha sık rastladık. Eozinofil düzeylerinde gruplar arasında fark bulunmadı. Beklendiği gibi süt spesifik IgE, IgE aracılıklı grupta yüksek iken deri prik test pozitifliği miks grupta yüksekti. Yama testi IgE aracılıklı grupta %30, miks grupta %12 pozitif iken Non IgE grubunda hiçbir hastada pozitif bulunmadı. Bu çalışmada iki dikkat çekici sonuç vardır; yama testi Non IgE grupta pozitif beklenirken IgE ve miks grupta pozitif bulundu ve IgE aracılıklı grupta yama testi pozitif olanlarda yükleme testleri pozitiftiAim: It is aimed to evaluate the place of the diagnosis method in routine practice and the ISA patients range according to the types of immune reactions. Materials and Methods: 54 patients were taken among patients considered cows milk allergy and also consulted at ÇUTF children allergy immunology clinic between April 2014 and December 2014. As a laboratory evaluation the amount of eosinophils, milk spesific IgE, skin prick test, prick to prick test, patch test and provocation performed. Results: 50% (n:27) of patients were male and 50% (n:27) were female. All patients ages average was 38,3 ±37,9 month. 66,6% (n:36) of patients were IgE referenced, 14% (n:8) mix type, 18,5% (n:10) Non IgE referenced. Provocation is done 88,8% of patients amoung 36 IgE referenced patients. The test was positive at 34,3% (n:11). The provocation test was done 5 patients among 8 patients mix group, the 40% of patients results were positive. At Non IgE referenced group, test is done on 7 patients among 10 and no positive results were found. Conclusion: In this study, we encountered more IgE referenced diagnosis (66,6%) when compared to Non IgE and mix group. Eosinophils showed no difference between groups. It can be guessed that while milk specific IgE was high in IgE referenced group, it was high in SPT mix group, too. Patch test at IgE referenced group was 30%, at mix group was 12%, on the other hand there was no positive result at Non IgE group patients. In this study, there are two striking results: Patch test are found positive at IgE and mix group when it is guessed it may be possitive at Non IgE group and at IgE referenced group, the patients whose patch test 'are positive had also positive provocation test

Distribution of Allergen Sensitization in Childhood with the Skin Test

Giriş: Deri Prik testi (DPT), aeroallerjenler, besinler, ilaçlar ile oluşan klinik reaktiviteyi doğrulamada sıklıkla kullanılır. Çalışmamızın amacı kliniğimize başvuran hastalar arasında allerjen duyarlılığının güncel dağılımını belirlemektir.Gereç ve Yöntem: Ocak 2014-Aralık 2014 tarihleri arasında kliniğimize atopi şüphesi ile başvuran ve deri testi yapılan 2512 hastanın deri testi sonuçları geriye dönük olarak değerlendirildi. Ev tozu, küfler, polenler; besinlerden süt, yumurta, buğday, fıstık ve lateks ile test yapıldı. Yaşlarına göre 2 yaş ve altındakiler grup I, 3-5 yaş aralığındakiler grup II, 6-12 yaş aralığındakiler grup III, 12 yaşından büyükler grup IV olarak sınıflandırıldı. Yaş gruplarına, cinsiyete, aylara göre deri testi sonuçları incelendi. Bulgular: Çalışmaya dahil edilen 2512 hastanın 1068'i (%42.5) kızdı. Hastalarımızın 1058'inde (%42.3) en az bir deri testi pozitifti. Kızlarda deri testinde %38.4, erkeklerde %44.8 oranında pozitiflik saptandı. Çalışmamızda çoklu allerjen duyarlılığı oranı %93 idi. Aeroallerjenlerden ev tozu akarlarını [Dermatophagoides pteronyssinus (%73.8) ve Dermatophagoides farinae (%71.6)], küf (%23.4) ve hububat -ot karışımı (%23.8) izledi. Besin grubundan en fazla yumurta (%3.8) ve süt (%3.1) ile duyarlılık belirlendi. Lateks ile reaksiyon hiçbir hastamızda saptanmadı. Yaş gruplarından en fazla grup III'te (%50.4) pozitiflik sonuç saptandı. Aylara göre değerlendirildiğinde aeroallerjenlerden polenlere daha çok Mayıs, Haziran; küflere Mayıs, Eylül ayında; ev tozlarına ise yıl boyu benzer oranlarda reaksiyon tespit edildi.Sonuç: Deri prik testi allerjen duyarlılığı belirlemede uygulanabilecek pratik bir yöntemdirObjective: Skin prick testing (SPT) is widely used for assessing the clinical reactivity to aeroallergens, foods, and drugs. The aim of our study was to investigate the prevalence of allergic sensitivity in the patients presenting to our clinic. Materials and Methods: The retrospective study included 2,512 patients who presented to our clinic and underwent SPT due to suspected atopy between January and December 2014. SPT was based on sensitivity against house dust mites, molds, pollens, and foods including milk, egg, wheat, chestnut, and latex. Based on their ages, the patients were divided into four groups: Group I; 2 years or younger, Group II; 3-5 years, Group III; 6-12 years, and Group IV; over 12 years. The SPT scores were evaluated based on the age groups, gender, and the month. Results: The 2,512 patients included 1,444 (57.5%) boys and 1,068 (42.5%) girls. At least one SPT was positive in 1,058 (42.3%) patients. Skin test was positive in 44.8% of boys as compared to 38.4% of girls. Multiple allergen sensitivity was present in 93% of the patients. Most of the patients were allergic to house dust mites [Dermatophagoides pteronyssinus (%73.8) and Dermatophagoides farinae (%71.6)], followed by mold (23.4%) and grasses-cereals mix (23.8%). Among the foods, eggs (3.8%) and milk (3.1%) had the highest rate of allergic reaction. No patient had allergic reaction to latex. Among the age groups, Group III had the highest rate (50.4%) of positivity. An evaluation based on the months revealed that the patients were sensitive against aeroallergens, particularly pollens, in May and June, against molds in May and September, and against house dust mites all year round. Conclusion: The skin prick test is a practical method for the assessment of allergic sensitivit