Postnasal drip syndrome and asthma was the most common cause of chronic cough. Asthma-associated findings were found in some of the patients diagnosed with postnasal drip syndrome. It has been observed that there could be more than one particular cause for cough concerning some patients. The gastroesophageal reflux disease was not a common primary cause of chronic cough in children.

Movement and anxiety during echocardiographic study may reduce the reliability and affect the quality of echocardiographic images. Thus, sedation is an essential component when it is performed in infants. This randomized, single-blinded, placebo-controlled study was undertaken to evaluate the acceptability and effectiveness of intranasal midazolam (INM) versus oral midazolam (OM) in infants during transthoracic echocardiography. Eighty patients between the ages of 6 mo and 3 y who presented for elective echocardiographic study were divided into 3 groups: the OM group received 0.4 mg/kg of injectable midazolam mixed with an equal volume of cherry juice, the INM group received 0.2 mg/kg as drops,and the control group was given oral cherry juice or intranasal serum physiologic. A blinded clinician assessed and scored the level of sedation and comfort during the procedure for each child, and a score for ease of administration was recorded by the nurse. The intranasal route was more acceptable to infants than the oral route (P<.001). No significant difference in the effects of sedation was observed between the OM group and the INM group (P=.583), but significant differences were observed between the sedated groups and the control group (P<.001). The procedure was significantly more comfortable in groups given OM and INM than in the control group (P<.001). Although no difference in sedation score was seen between the oral and nasal routes, INM was better accepted by infants than OM. Echocardiography was performed more reliably and comfortably in those given midazolam than in those in the control group.

Kawasaki disease (KD) is an acute, febrile, and multisystem vasculitis of early childhood with a striking predilection for the coronary arteries. The most significant complication is coronary artery abnormalities, including coronary aneurysms. The etiology of KD remains unknown. Many infectious agents including viruses have been postulated as possible causes of KD. But standard microbiologic techniques, molecular methods and serologic investigations have failed to identify an etiologic agent. We described a patient with atypical KD during cytomegalovirus infection.

Objective: Continued progress in our understanding of the food protein–induced allergic proctocolitis (FPIAP) will provide the development of diagnostic tests and treatments. We aimed to identify precisely the clinical features and natural course of the disease in a large group of patients. Also, we investigated the predicting risk factors for persistent course since influencing parameters has not yet been established. Methods: Infants who were admitted with rectal bleeding and had a diagnosis of food protein–induced allergic proctocolitis in 5 different allergy or gastroenterology outpatient clinics were enrolled. Clinical features, laboratory tests, and prognosis were evaluated. Risk factors for persistent course were determined by logistic regression analyses. Results: Among the 257 infants, 50.2% (n = 129) were girls and cow's milk (99.2%) was the most common trigger. Twenty-four percent of the patients had multiple food allergies and had more common antibiotic use (41.9% vs 11.8%), atopic dermatitis (21% vs 10.2%), wheezing (11.3% vs 1.5%), colic (33.8% vs 11.2%), and IgE sensitization (50% vs 13.5%) compared to the single-food allergic group (P < 0.001, P = 0.025, P = 0.003, P < 0.001, respectively). In multivariate logistic regression analysis, presence of colic (odds ratio [OR]: 5.128, 95% confidence interval [CI]: 1.926–13.655, P = 0.001), IgE sensitization (OR: 3.964, 95% CI: 1.424–11.034, P = 0.008), and having allergy to multiple foods (OR: 3.679, 95% CI: 1.278–10.593, P = 0.001] were found to be risk factors for continuing disease after 1 year of age. Conclusion: Although most children achieve tolerance at 1 year of age, IgE sensitization, allergy to multiple foods, and presence of colic were risk factors for persistent course and late tolerance. In this context, these children may require more close and extended follow-up.

Table of contentsWORKSHOP 4: Challenging clinical scenarios (CS01–CS06)CS01 Bullous lesions in two children: solitary mastocytomaS. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal GokCS02 Multi-System Allergy (MSA) of cystic fibrosis: our institutional experienceJessica Hawley, Christopher O’Brien, Matthew Thomas, Malcolm Brodlie, Louise MichaelisCS03 Cold urticaria in pediatric age: an invisible cause for severe reactionsInês Mota, Ângela Gaspar, Susana Piedade, Graça Sampaio, José Geraldo Dias, Miguel Paiva, Mário Morais-AlmeidaCS04 Angioedema with C1 inhibitor deficiency in a girl: a challenge diagnosisCristina Madureira, Tânia Lopes, Susana Lopes, Filipa Almeida, Alexandra Sequeira, Fernanda Carvalho, José OliveiraCS05 A child with unusual multiple organ allergy disease: what is the primer?Fabienne Gay-CrosierCS06 A case of uncontrolled asthma in a 6-year-old patientIoana-Valentina Nenciu, Andreia Florina Nita, Alexandru Ulmeanu, Dumitru Oraseanu, Carmen ZapucioiuORAL ABSTRACT SESSION 1: Food allergy (OP01–OP06)OP01 Food protein-induced enterocolitis syndrome: oral food challenge outcomes for tolerance evaluation in a Pediatric HospitalAdrianna Machinena, Olga Domínguez Sánchez, Montserrat Alvaro Lozano, Rosa Jimenez Feijoo, Jaime Lozano Blasco, Mònica Piquer Gibert, Mª Teresa Giner Muñoz, Marcia Dias da Costa, Ana Maria Plaza MartínOP02 Characteristics of infants with food protein-induced enterocolitis syndrome and allergic proctocolitisEbru Arik Yilmaz, Özlem Cavkaytar, Betul Buyuktiryaki, Ozge Soyer, Cansin SackesenOP03 The clinical and immunological outcomes after consumption of baked egg by 1–5 year old egg allergic children: results of a randomised controlled trialMerrynNetting, Adaweyah El-Merhibi, Michael Gold, PatrickQuinn, IrmeliPenttila, Maria MakridesOP04 Oral immunotherapy for treatment of egg allergy using low allergenic, hydrolysed eggStavroula Giavi, Antonella Muraro, Roger Lauener, Annick Mercenier, Eugen Bersuch, Isabella M. Montagner, Maria Passioti, Nicolò Celegato, Selina Summermatter, Sophie Nutten, Tristan Bourdeau, Yvonne M. Vissers, Nikolaos G. PapadopoulosOP05 Chemical modification of a peanut extract results in an increased safety profile while maintaining efficacyHanneke van der Kleij, Hans Warmenhoven, Ronald van Ree, Raymond Pieters, Dirk Jan Opstelten, Hans van Schijndel, Joost SmitOP06 Administration of the yellow fever vaccine in egg allergic childrenRoisin Fitzsimons, Victoria Timms, George Du ToitORAL ABSTRACT SESSION 2: Asthma (OP07–OP12)OP07 Previous exacerbation is the most important risk factor for future exacerbations in school-age children with asthmaS. Tolga Yavuz, Guven Kaya, Mustafa Gulec, Mehmet Saldir, Osman Sener, Faysal GokOP08 Comparative study of degree of severity and laboratory changes between asthmatic children using different acupuncture modalitiesNagwa Hassan, Hala Shaaban, Hazem El-Hariri, Ahmed Kamel Inas E. MahfouzOP09 The concentration of exhaled carbon monoxide in asthmatic children with different controlled stadiumPapp Gabor, Biro Gabor, Kovacs CsabaOP10 ...

A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : Epidemiologic studies have shown that low serum 25-hydroxyvitamin D (25(OH)D) levels are associated with increased risk of lower respiratory tract infections in young children. Almost all viral respiratory tract infections occur between November and March, months that also are associated with vitamin D deficiency. Vitamin D recently has been shown to have an important role in the immune regulation especially in innate immunity as well as production of antimicrobial peptides. In this study, we evaluated the relationship between serum 25(OH)D levels and recurrent respiratory tract infections with wheezing in young children. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Serum 25(OH)D levels were analysed in 60 wheezy infants, aged 6-36 months, with three or more viral wheezing episodes and 40 healthy controls at the same age. The study was done between November 2009 and March 2010, months that viral infection-associated wheezing episodes were common. Vitamin D levels were categorized into deficient (≤20 ng/mL), insufficient (21-29 ng/mL) and sufficient (≥30 ng/mL), based on previous recommendations. R Re es su ul lt ts s: : The mean serum 25(OH)D concentration of wheezy infants (30.1±7.6 ng/mL) was lower than the healthy controls (33.9±9.8 ng/mL) (p=0.049). Vitamin D deficiency was found in 7/60 (12%) of wheezy infants and 2/40 (5%) of healthy controls.Vitamin D insufficiency frequency was 21/60 (35%) in wheezy infants and 13/40 (32%) in healthy controls. The differences between wheezy infants and controls were insignificant. Serum vitamin D level was significantly associated with age, duration of breastfeeding and maternal clothing in wheezy infants. C Co on nc cl lu us si io on n: : Vitamin D insufficiency is prevalent among young children in our region. According to the previous studies supporting the role of vitamin D in innate immunity and antiviral defence, we suggest that it might be particularly important in wheezy children. Future investiagtions will demonstrate the exact role of vitamin D on respiratory tract infections and wheezing illnesses in young children.

Bee pollen is given to children by mothers in order to strengthen their immune systems. There are no studies related with the side effects of bee polen in the literature. In this article, the literature was reviewed by presenting a case of allergic eosinophilic gastropathy related with bee polen. A 5-year old child was admitted due to abdominal pain. Edema was detected on the eyelids and pretibial region. In laboratory investigations, pathology was not detected in terms of hepatic and renal causes that would explain the protein loss of the patient diagnosed with hypoproteinemia and hypoalbuminemia. Urticaria was detected during the follow-up visit. When the history of the patient was deepened, it was learned that bee pollen was given to the patient every day. The total eosinophil count was found to be 1 800/mm 3 . Allergic gastroenteropathy was considered because of hypereosinophilia and severe abdominal pain and endoscopy was performed. Biopsy revealed abundant eosinophils in the whole gastric mucosa. A diagnosis of allergic eosinophilic gastropathy was made. Bee polen was discontinued. Abdominal pain and edema disappeared in five days. Four weeks later, the levels of serum albumin and total eosinophil returned to normal. (Turk Pediatri Ars 2015; 50: 189-92)

Atopik alerjik rinitli çocuk hastalarda intranazal salbutamol uygulanmasının etkisi olup olmadığını araştırmak. Gereç ve Yöntemler: Yaşları 6 ile 17 arasında atopik alerjik rinitli on altı çocuk hastaya (9 erkek, 7 kız) intranazal salbutamol uygulandı ve ilaç uygulamasından önce ve hemen sonra akustik rinometri ile değerlendirildi. Bulgular: İntranazal salbutamol uygulamasından önce ve sonra sol ve sağ nazal kaviteler arasında CSA(Çapraz kesit alanı)1 SD(standart deviasyon) ve ayrıca sağ nazal kavitede CSA1 alanı ve CSA3 mesafesi arasında istatistiksel olarak anlamlı fark vardı. Sonuç: İntranazal salbutamol uygulaması atopik alerjik rinitli çocuk hastalarda hiçbir yan etkisi olmaksızın faydalıdır. Ayrıca intranazal salbutamol akut burun tıkanıklıklarında kurtarıcı ilaç olarak kullanılabilir.