Background Atopic dermatitis (AD) is a multifactorial inflammatory skin disease with frequent hypersensitivity to allergens. However, the role of exposure to indoor allergens on AD severity is unclear.Methods Children aged 0-17 years with active AD from central Chile were recruited; disease severity was evaluated with SCORAD and POEM scores. A home environment survey was applied to parents. Bedroom dust samples were collected for all subjects and analyzed by multiplex assay to quantify dust mite (Der p1, Der f1), dog (Can f1), cat (Fel d1), and alternaria alternata (Alt a1) allergens.Results Twenty-five children aged 3.9 AE 3.8 years were included. Fifty-two percent were female. Mean SCORAD was 29 AE 14 (range 11-61), and mean POEM was 10.7 AE 6.2.No direct association was found between tobacco exposure, pet ownership, aerosol use, visible dust, or home carpets/rugs with SCORAD (all P > 0.05). Dust samples from all homes had Can f1 and Fel d1 allergens, regardless of pet ownership. Homes that had indoor dogs or cats had significantly higher amounts of these allergens (P < 0.001). Forty percent of homes had dust mite allergens, and none had alternaria alternata. Children with AD living in homes with elevated dust mite and animal dander allergen concentrations had higher SCORAD than those from homes with low allergen concentrations (40 AE 13 vs.26 AE 13, P = 0.025). ConclusionsHigh concentrations of indoor allergens may influence AD severity in children. Further studies assessing indoor allergens and allergen sensitization are warranted to fully evaluate the role of indoor allergens on AD.
California, 11 Ann & Robert H. Lurie Children, 12 Northwestern Medicine. RATIONALE: Previous studies link gastroesophageal reflux (GERD) and food allergy (FA), but racial differences are unclear. This study assesses the relationship between race, GERD, FA type, asthma, eczema, and gastroenterology consultation. METHODS: We analyzed intake and 6 month follow-up surveys for FORWARD, a multicenter prospective study of Black and White food allergic children aged 0-12 years. We evaluated potential links between race, GERD, associated conditions and specific types of FA. Univariable statistics described demographics and GERD-related variables including GERD prevalence and treatment. Chi square tests of independence determined associations between categorical variab RESULTS: There were 654 food allergic children in the current analyses, and 126 (19.3%) reported GERD. (Black, 15%, n537; White, 21.2%, n589). White children (83.2%) received more treatment for GERD than Black children (56.8%; p50.002). Black children were more likely to have co-existing eczema and GERD (97.2%) vs. eczema without GERD (80.7%, p50.015). White children with GERD were likely to have coexisting milk allergy (p<0.001) or egg allergy (p50.02). Black children with GERD had shellfish allergy (43.2%), versus Black children with shellfish allergy without GERD (29.8% ) (p>0.05). Six months follow-up, Black children with GERD were less likely to be followed by a gastroenterology physician (Black, 5.6%; White, 30.4%; p50.03). CONCLUSIONS: GERD was reported in 19% of food-allergic children, similar to the general population, without racial differences. The association between GERD and FA reveals racial differences in associated conditions, food allergens, and gastroenterology care. We will further explore these associations as we finalize recruitment of the FORWARD cohort.
Las vasculitis asociadas a ANCA (AAV) son enfermedades infrecuentes en la edad pediátrica. La literatura internacional en pediatría es escasa y la mayoría de las publicaciones se refieren a otras vasculitis de mayor incidencia en la infancia, como la vasculitis IgA y enfermedad de Kawasaki.Objetivo: Describir las características clínicas y de laboratorio de una serie de pacientes pediátricos con diagnóstico de AAV.Pacientes y Método: Estudio retrospectivo, descriptivo, de pacientes con diagnóstico de AAV atendidos en un centro terciario de salud en Santiago, Chile, entre los años 2000 y 2020. Se revisaron fichas electrónicas recolectando datos epidemiológicos, de laboratorio, imágenes y biopsias.Resultados: Se presentan cinco pacientes pediátricos con AAV de severidad variable, rango de edad al debut 5,5 a 13,5 años. Destaca una frecuencia elevada de compromiso renal en casos de poliangeítis microscópica (MPA) y el compromiso orbitario de tipo pseudotumor inflamatorio en pacientes con granulomatosis con poliangeítis (GPA); manifestación poco frecuente en series pediátricas internacionales. Los pacientes fueron tratados según recomendaciones extrapoladas de ensayos clínicos en población adulta con respuesta clínica satisfactoria; en su mayoría con corticoides sistémicos y ciclofosfamida o rituximab en etapa de inducción. Durante la mantención, la mayoría de pacientes se mantuvo estable con rituximab, azatioprina o metotrexato. Ningún paciente evolucionó con secuelas en órganos afectados y todos lograron suspender la terapia corticoidal.Conclusión: El presente reporte describe las características clínicas de una serie de pacientes pediátricos con AAV. En esta serie, la afectación renal fue frecuente en MPA y la afectación ocular por pseudotumor inflamatorio en GPA. La respuesta clínica con tratamiento según recomendaciones extrapoladas de población adulta fue favorable.
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