Chronic spontaneous urticaria (CSU) is defined as persistent wheals, angioedema, or both lasting for >6 weeks due to known or unknown causes. Some epidemiological studies and case reports suggest that internal parasite infections (PI) can cause CSU. Here, we provide a systematic overview of published findings on the prevalence and relevance of PI in CSU and we discuss possible pathomechanisms. The prevalence of PI in CSU was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two-thirds of these studies reported infection rates of 10% or less). The prevalence of PI in adult and pediatric CSU patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. CSU patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, Anisakis simplex sensitization, and the presence of Blastocystis hominis allele 34 (ST3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 CSU patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in PI patients in 18 independent studies is 1-66.7%. Urticaria including CSU might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in CSU due to PI may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.Chronic spontaneous urticaria (CSU) is defined as the recurrent development of transient wheals (hives), angioedema (AE), or both for >6 weeks due to known or unknown causes (1). The prevalence of CSU in the general population has been estimated to range from 0.5% to 5% (1, 2). In up to 90% of CSU cases, the search for underlying causes is not successful, in routine clinical practice (1-3). Autoimmunity, food intolerance, and infections, including internal parasitic infections (PI), have been described as underlying causes of CSU (1, 4). A possible role for PI in urticaria was suggested as early as in 1949 (5): in a 16-year-old boy with Giardia lamblia and CSU. His CSU resolved completely after specific and effective treatment of the infection. Since then, infections with endoparasites, such as helminths (worms, which consist of many cells and have internal organs) and protozoa (consist of only one cell), have been discussed to cause chronic urticaria, and several clinical studies and reviews on the prevalence and relevance of PI in patients with CSU were performed and published (4,(6)(7)(8)(9)(10).Parasites are more prevalent in equatorial regions and countries with a tropical climate, high humidity, poor sanitation, dirty water, substandard and crowded housing, and in populations with low socioeconomic status (sub-Saharan Africa, Asia, Latin America, and Caribbean) (11,12). According to a ...

Until recently IgG autoantibodies against the basal membrane proteins BP180 und BP230 were considered to be causative in the pathogenesis of BP. However, new in vitro studies as well as data from experimental mouse models have indicated that in addition to specific IgG, also IgE antibodies against BP180 and BP230 play a role in the development of this disease. Based on these new findings, new treatment modalities of BP became possible.

Table of contentsOral AbstractsO1 Functionally distinct HMGB1 isoforms correlate with physiological processes in drug-induced SJS/TENDaniel F. Carr, Wen-Hung Chung, Rosalind E. Jenkiins, Mas Chaponda, Gospel Nwikue, Elena M. Cornejo Castro, Daniel J. Antoine, Munir PirmohamedO2 Hypersensitivity reactions to beta-lactams, does the t cell recognition pattern influence the clinical picture?Natascha Wuillemin, Dolores Dina, Klara K. Eriksson, Daniel YerlyO3 Specific binding characteristics of HLA alleles associated with nevirapine hypersensitivityRebecca Pavlos, Elizabeth Mckinnin, David Ostrov, Bjoern Peters, Soren Buus, David Koelle, Abha Chopra, Craig Rive, Alec Redwood, Susana Restrepo, Austin Bracey, Jing Yuan, Silvana Gaudieri, Mary Carrington, David Haas, Simon Mallal, Elizabeth PhillipsO4 Do we need to measure total ige for the interpretation of analytical results of ImmunoCAP dnd 3gAllergy specific IgE?Douwe De Boer, Paul Menheere, Chris Nieuwhof, Judith BonsO5 Neutrophil activation in systemic anaphylaxis: results from the multicentric NASA studyFriederike Jonsson, Luc De Chaisemartin, Vanessa Granger, Caitlin Gillis, Aurelie Gouel, Catherine Neukirch, Fadia Dib, Pascale Roland Nicaise, Dan Longrois, Florence Tubach, Sylvie Martin, Pierre Bruhns, NASA Study GroupO6 Purpuric drug eruptions due to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for non-small-cell lung cancer (NSCLC): a clinic-pathological study of 32 casesKai-Lung Chen, Shu-Ling Liao, Yi-Shuan Sheen, Yung-Tsu Cho, Che-Wen Yang, Jau-Yu Liau, Chia-Yu ChuPoster presentations: Poster Walk 1—Anaphylaxis (P01–P09)P1 Anaphylactic reactions during anaesthesia and the perioperative periodRita Aguiar, Anabela Lopes, Natália Fernandes, Leonor Viegas, M. A. Pereira-BarbosaP2 Anaphylaxis to chlorhexidine: is there a cross-reactivity to alexidine?Antonia Bünter, Nisha Gupta, Tatjana Pecaric Petkovic, Nicole Wirth, Werner J. Pichler, Oliver HausmannP3 Cefotaxime-induced severe anaphylaxis in a neonateMehtap Yazicioglu, Pinar G. Ozdemir, Gokce Ciplak, Ozkan KayaP4 Clinical features and diagnosis of anaphylaxis resulting from exposure to chlorhexidinePeter John CookeP5 Drug-induced anaphylaxis: five-year single-center surveyInês Mota, Ângela Gaspar, Filipe Benito-Garcia, Marta Chambel, Mário Morais-AlmeidaP6 Intraoperative severe anaphylactic reaction due to patent blue v dyeLuis Marques, Eva Alcoceba, Silvia LaraP7 Kounis syndrome in the setting of anaphylaxis to diclofenacLeonor Carneiro-Leão, Carmen Botelho, Eunice Dias-Castro, Josefina CernadasP8 Perioperative anaphylaxis audit: Royal Melbourne HospitalKatherine Nicholls, William Lay, Olivia Smith, Christine Collins, Gary Unglik, Kymble Spriggs, Priscilla Auyeung, Jeremy McComish, Jo A. DouglassP9 Recurrent peri-operative anaphylaxis: a perfect stormJonny G. Peter, Paul PotterPoster Walk 2: DH regions and patient groups (P10–P19)P10 A rare presentation of amoxicillin allergy in a young childFabrícia Carolino, Eunice Dias De Castro, Josefina R. CernadasP11 Adverse drug reactions in ...

(Suppl 1):A1Background Asthma is the most common chronic respiratory disease in childhood. However, it is quite difficult to make a prompt diagnosis of asthma in a child 5 years and younger, partly due to a lack of objective diagnostic means. Our previous studies on susceptibility gene of asthma showed that a gene-gene interaction among 4 single nucleotide polymorphisms including IL13 rs20541 and IL4 rs2243250, ADRB2 rs1042713 and FcER1B rs569108 had a predictable role for asthma in wheezing children. Objective The study was aimed to further investigate the predictive effects of the four-loci interaction model in Chinese preschool children with asthma. Methods A total of 212 wheezing children aged 6 months to 5 years were enrolled and followed up for at least one year at Shanghai Xinhua Hospital between Dec 2014 and Mar 2016. Clinical data and lab findings of atopy were collected. All the children were divided into the high-risk group and the low-risk group according to genotypes of the four-loci interaction model. The differences of clinical features were compared between the two groups. The predictive effects for asthma were analyzed among asthma predictive index (API), 2015 Canadian Diagnostic Criteria for Asthma in Preschoolers and our four-loci interaction model. Results Of all the enrolled 212 children, 117 (55.2%) were assigned into the high-risk group and 95 (44.8%) were the low-risk group. Compared with the low-risk group, the high-risk group had more yearly episodes of wheeze and a higher level of blood eosinophilia. More children in the high-risk group presented with afebrile wheeze, eczema and positive food or aero allergens and had a history of tobacco exposure. If the asthma-predictive effect of positive API was considered as 1, the four-loci interaction model had a sensitivity of 77.2%, a specificity of 80.0% and an AUC area of 0.786 with a modest consistency (P=0.22, Kappa=0.49), while the Canadian criteria had a sensitivity of 97.8%, a specificity of 53.3% and an AUC area of 0.539 with a low consistency (P<0.01, Kappa=0.265). ConclusionsThe four-loci interaction model is associated with the phenotypes of wheezing in Chinese preschoolers. It has a consistent predictive effect with API for asthma and is more specific than the Canadian criteria in the diagnosis of asthma, which indicates that the four-loci interaction model may be developed as a new objective predictive tool for asthma in Chinese children 5 years and younger. A2Loss of esophageal epithelial SPINK7 unleashes uncontrolled proteolytic activity, impaired epithelial barrier, defective differentiation and pro-inflammatory cytokine production Background Epithelial barrier impairment has been implicated in the development of allergic disease. However, the molecular mechanisms by which impaired epithelial barrier function induces Th2-type immune responses remain largely unknown. In this study, we examined the role of the serine peptidase inhibitor kazal type (SPINK)7 on epithelial barrier function and mucosal Th2-associated immune responses...

Table of contents Poster walk 11: miscellaneous drug hypersensitivity 2 (P92–P94, P96–P101) P92 16 years of experience with proton pump inhibitors (PPIs) Javier Dionicio Elera, Cosmin Boteanu, Maria Aranzazu Jimenez Blanco, Rosario Gonzalez-Mendiola, Irene Carrasco García, Antonio Alvarez, Jose Julio Laguna Martinez P93 Allergy evaluation of quinolone induced adverse reactions Jaume Martí Garrido, Carla Torán Barona, Carolina Perales Chorda, Ramón López Salgueiro, Miguel Díaz Palacios, Dolores Hernández Fernández De Rojas P94 Bupropion-induced acute urticaria and angioedema, a case report Emre Ali Acar, Ayse Aktas, Aylin Türel Ermertcan, Peyker Temiz P96 Delayed type hypersensitivity and study of cross-reactivity between proton-pump inhibitors Chien-Yio Lin, Chung-Yee Rosaline Hui, Ya-Ching Chang, Chih-Hsun Yang, Wen-Hung Chung P97 Diagnostic work-up in suspected hypersensitivity to proton-pump inhibitors: looking at cross-reactivity Fabrícia Carolino, Diana Silva, Eunice Dias De Castro, Josefina R. Cernadas P98 Management of infusion-related hypersensitivity reactions to enzyme replacement therapy for lysosomal diseases Luis Felipe Ensina, Carolina Aranda, Ines Camelo Nunes, Alex Lacerda, Ana Maria Martins, Ekaterini Goudouris, Marcia Ribeiro, José Francisco Da Silva Franco, Leandra Queiroz, Dirceu Solé P99 Management of insulin allergy with continuous subcutaneous insulin infusion Ceyda Tunakan Dalgiç, Aytül Zerrin Sin, Fatma Düsünür Günsen, Gökten Bulut, Fatma Ömür Ardeniz, Okan Gülbahar, Emine Nihal Mete Gökmen, Ali Kokuludag P100 Off-label use of icatibant for management of serious angioedema associated with angiotensin inhibitors Ana M. Montoro De Francisco, Talía Mª De Vicente Jiménez, Adriana M. Mendoza Parra, Angella M. Burgos Pimentel, Amelia García Luque P101 Thiocolchicoside anaphylaxis: an unusual suspect? Luis Amaral, Fabricia Carolino, Leonor Carneiro Leão, Eunice Castro, Josefina Cernadas Poster walk 12: betalactam hypersensitivity (P102–P111) P102 A curious delayed reading: a case report of a β-lactam allergy in a child Nicole Pinto, Joana Belo, João Marques, Pedro Carreiro-Martins, Paula Leiria-Pinto P103 Betalactam-induced hypersensitivity: a 10-years’ experience Amel Chaabane, Haifa Ben Romdhane, Nadia Ben Fredj, Zohra Chadly, Naceur A. Boughattas, Karim Aouam P104 Cefazolin hypersensitivity: towards optimized diagnosis Astrid P. Uyttebroek, Chris H. Bridts, Antonino Romano, Didier G. Ebo, Vito Sabato P105 Clavulanic acid allergy: two cases report Anabela Lopes, Joana Cosme, Rita Aguiar, Tatiana Lourenço, Maria-João Paes, Amélia Spínola-Santos, Manuel Pereira-Barbosa P106 Diagnosis of betalactam allergy in an allergy department Cíntia Rito Cruz, Rute Pereira Dos R...