A case report of anaphylaxis after contact with raw potato in a 4-year-old boy

Although white potato is very common nutrition, allergic reactions to potato are rarely seen and allergy to uncooked potato has been reported mainly in adults. In this article, we present the case of a 4-year-old male patient who admitted to the Emergency Unit with complaints of urticaria, angioedema, and vomiting. The boy was just playing with raw potatoes just before the onset of his complaints. Therefore, tests were performed with uncooked potato and found to be positive. Our case points towards the importance of heat-labile allergens. Even the patient is able to eat a cooked form of suspicious food, tests for the raw form of the same food must be conducted

Is anaphylaxis with egg a risk factor for propofol sensitivity?

BACKGROUND: Propofol rarely causes allergic reactions. On the other hand, its relationship with egg allergy is con-troversial. This study aimed to evaluate propofol sensitivity in patients with suspected allergic reactions to propofol and patients with proven immunoglobulin E-mediated egg allergy.METHODS: Patients who underwent propofol skin tests due to suspected hypersensitivity reaction to propofol (group 1) or children with confirmed immunoglobulin E mediated or mixed egg allergy (group 2) were included in the study as two groups. The data were obtained from the patients' medical records and retrospectively analyzed. Propofol sensitivity was confirmed by determining the positivity of skin tests. Egg allergy has been confirmed by in-vivo and in-vitro tests, including oral challenge tests.RESULTS: Thirty-two of the patients had a history of suspected hypersensitivity reactions after using propofol. The remaining 16 had a confirmed egg allergy. Propofol sensitivity was confirmed in 3 patients, one with a suspected hyper-sensitivity reaction to propofol and two with egg allergy. Both of the egg-allergic patients had histories of anaphylaxis after consuming small amounts of egg, and they had never been exposed to propofol.CONCLUSIONS: Propofol skin test may be positive in patients with severe immunoglobulin E-mediated hen's egg allergy. To avoid reactions that may occur during the use of propofol, detailed history of hen's egg allergy should be obtained, and in the presence of severe reactions, an alternative drug should be preferred. (Cite this article as: Siileyman A, Guler N. Is anaphylaxis with egg a risk factor for propofol sensitivity? Gazz Med Ital -Arch Sci Med 2022;181:545-51. DOI: 10.23736/S0393-3660.21.04673-8

Risk Factors for the Development of IgE-Mediated Food Allergy in Preschool Children with Asthma

Background Food allergy is a component of the atopic march and may have effects on asthma. This study aimed to evaluate the risk factors for confirmed immunoglobulin E-mediated food allergies and their impact on the clinical picture in preschool children with asthma. Methods Clinical history and allergic assessment results were obtained from medical records and analyzed retrospectively. Preschool children with asthma were included in the study and the characteristics of food allergy and asthma were evaluated. The patients were grouped as those with food allergy (Group I, n = 60) and those without (Group II, n = 98). Results In patients with food allergy and asthma, the number of episodes requiring systemic steroids in the last year (p = 0.002), atopic dermatitis (p = 0.001), parental atopic disease (p = 0.009) and aeroallergen sensitivity rates (p < 0.001) was higher than patients without food allergies. The use of medium or high doses of inhaled steroids to achieve asthma control was more frequent in patients with food allergies (p = 0.014). Parental history of atopic disease [p = 0.007, odds ratio (OR): 3.27, 95% confidence interval (CI) 1.37-7.77)], atopic dermatitis (p = 0.017, OR: 2.80, 95% CI: 1.19-6.57), starting complementary food after 6 months (p = 0.004, OR: 3.9, 95% CI: 1.5-10.0) and having aeroallergen sensitivity (p < 0.001, OR: 6.01, 95% CI: 2.21-16.29) were identified as significant risk factors for food allergy. Conclusion Asthmatic preschool children with food allergies are more likely to have a parental atopic disease, atopic dermatitis, aeroallergen sensitivity and starting complementary food after 6 months. These patients experience more asthma attacks and need higher doses of steroids

Risk Factors for Immediate-Type Local Anesthetic Hypersensitivity Reactions in Pediatric Patients: A Retrospective Case-Control Study

Background: Local anesthetics (LA) are relatively safe and rarely cause immediate hypersensitivity reactions. The data on immediate LA hypersensitivity and its risk factors in children are limited

Antibiotic allergy in children with cystic fibrosis: A retrospective case-control study

Antibiotic allergy is a big problem that may affect the treatment and life quality of patients with cystic fibrosis (CF). Aim To evaluate predictive factors for confirmed antibiotic hypersensitivity in children with CF. Methods In this case-controlled study, we examined 15 patients with CF who had been confirmed with antibiotic allergy. Additionally, we included a control group of age- and gender-matched 45 CF patients with no antibiotic allergy. The diagnosis of antibiotic allergy was confirmed in the presence of a compatible history and a positive response in the drug skin test or provocation test. Multiple drug hypersensitivity was classified according to the temporal relationship of antibiotics: (i) distant, (ii) simultaneous, and (iii) sequential. The data were analyzed by conditional logistic regression. Results beta-lactam allergy was confirmed in eight patients (ceftazidime n = 5, piperacillin-tazobactam n = 3) and non-beta-lactam allergy was confirmed in two patients (ciprofloxacin n = 1, azithromycin n = 1). Additionally, multiple drug hypersensitivity in five patients (distant n = 4, sequential n = 1), among whom two patients showed hypersensitivity against ceftazidime/piperacillin-tazobactam+ ciprofloxacin/levofloxacin, two patients showed hypersensitivity against ceftazidime+ ciprofloxacin n = 2, and one patient showed hypersensitivity against piperacillin-tazobactam+ amikacin+ trimethoprim-sulfamethoxazole. All patients (n = 13) with confirmed beta-lactam allergy were meropenem tolerant. Multivariate analysis indicated that immediate reactions (, p < 0.001) and allergic evaluation in the first six months after the reaction (p = 0.036) were significant risk factors for the prediction of antibiotic hypersensitivity. Conclusion Beta-lactam antibiotic allergy is the most commonly confirmed drug allergy in children with CF. However, unlike normal children, ceftazidime and piperacillin-tazobactam account for the majority

Risk Stratification as a Predictive Factor for Cephalosporin Allergy: A Case-Controlled Study

Background: Compared to penicillin, cephalosporin allergies are less common in children, and their diagnostic approach is less standardized. A recent European Academy of Allergy and Clinical Immunology position paper provided a risk stratification system for patients with suspected beta-lactam hypersensitivity reactions. Objective: This study aimed to evaluate risk stratification and predicting factors for confirmed cephalosporin hypersensitivity. Methods: The case-controlled study included patients with confirmed cephalosporin hypersensitivity (skin tests, n = 53; drug provocation, n = 19). For each patient, 2 age- and gender-matched control subjects were included in the study. Data were retrieved from patients' records and analyzed retrospectively. Risk stratification was performed according to the severity of index reactions, which was initially divided as high and low risk and then further divided as immediate and nonimmediate. Results: According to risk stratification, the patient and control groups were divided as follows: high-risk immediate (66.7% vs. 13%, respectively), high-risk delayed (1.4% vs. 8.3%, respectively), low-risk immediate (16.7% vs. 16%, respectively), and low-risk delayed (15.3% vs. 62.9%, respectively). Immediate reactions (odds ratio [OR]: 12.1, 95% confidence interval [CI]: 9-24.8,

Local Anaesthetic Neurotoxicity Mimicking Anaphylaxis

Lidocaine and articaine are commonly used in infiltration anesthesia, extremity blockage, topical anesthesia and intravenous regional anesthesia due to high activity and rapid onset effect. Although commonly administered, the allergic drug reactions of local anesthetics are rarely reported. However, reactions related to systemic toxicity can be seen Hereby, we reported two cases related to drug allergy and convulsion after administering of lidocaine and articaine

Local anaesthetic neurotoxicity mimicking anaphylaxis Anafilaksiyi Taklit Eden İlaç Reaksiyonu: Lokal Anestezik Nörotoksisites

Lidocaine and articaine are commonly used in infiltration anesthesia, extremity blockage, topical anesthesia and intravenous regional anesthesia due to high activity and rapid onset effect. Although commonly administered, the allergic drug reactions of local anesthetics are rarely reported. However, reactions related to systemic toxicity can be seen Hereby, we reported two cases related to drug allergy and convulsion after administering of lidocaine and articaine

APPROACH TO MANAGEMENT OF ASTHMA EXACERBATION IN CHILDHOOD WITH CURRENT GUIDELINES

Asthma is the most common chronic disease of childhood that causes hospital and emergency admissions and school absences. Asthma exacerbation is characterized by an increase in symptoms of shortness of breath, wheezing, chest tightness, nocturnal cough; decrease in exercise tolerance; reduced daily activities; increase in need of bronchodilators and decrease of expiratory flow rate. Management of chronic asthma and exacerbation shows some varieties, because the anatomical and physiological characteristics are quite different in children who are younger and older than 5 years old. In this article we evaluated current guidelines of asthma exacerbation in children