SummaryBackgroundOur aim was to assess the differences in intraregional prevalence of asthma in adolescents in Split-Dalmatia County to determine asthma risk factors in our population and estimate the specificity and sensitivity of the questionnaire used.Material/MethodsWe conducted the study using the European Community Respiratory Health Survey II short questionnaire supplemented by some questions from the International Study of Asthma in Childhood questionnaire. The participants suspected to have asthma were invited for examination by an asthma specialist who established the final diagnosis of asthma according to the medical history, physical examination, skin-prick tests, and peak flow measurements.ResultsA total of 4027 students (51.2% male) participated in the study. According to the prevalence of wheezing during the last 12 months, asthma prevalence was estimated at 9.7%. The total prevalence of asthma confirmed by an asthma specialist in the selected population was 5.60% (95% CI, 4.93–6.36%); 6.18% in Split (95% CI, 5.37–7.09), 5.63% in Imotski (95% CI, 3.48–8.58), and 2.90% in Sinj (95% CI, 1.67–4.68) (P=0.0028). We found sensitization to aeroallergens and peanuts, and active smoking to be independent risk factors for asthma.ConclusionsSplit-Dalmatia County has moderate asthma prevalence, with a significant intraregional difference. Asthma prevalence estimated by a questionnaire (9.7%) overestimates the prevalence of asthma confirmed by an asthma specialist (5.6%) in adolescents in Croatia. Our data confirmed the need of a more complex questionnaire to evaluate the accurate prevalence of current asthma or the need for subsequent clinical evaluation of the questionnaire obtained data. Allergic sensitization to aeroallergens and active smoking were important risk factors for asthma.

The results of our study show that northern Croatia is a region with moderate prevalence rates of atopic dermatitis. Following risk factors were family atopy, female gender and sleeping on feather pillow. Because of controversial results of previous studies conducted on the same topic further investigations should be made.

Background: Selective IgA imunodeficiency is the most frequently occurring primary antibody deficiency. Serum IgA level is decreased or even completly absened, while IgM and IgG antibodies displey normal serum levels. IgA plays an important role in immune protection in the gastrointestinal and respiratory tract. Patients with selective IgA imunodeficiency can be asimptomatic (>50% of cases) and can suffer from recurrent gastointestinal and respiratory infecitions, allergies and autoimmune diseases. Allergic rhinitis (AR) is the most common cause of chronic rhinitis. Characteristic feature of allergic rhinitis is eosinophilic inflammation of the nasal mucosa. Several studied have shown that IgA represents a potent trigger of eosinophil degranulation, while other studies have shown that IgA imunodeficiency is a well-known risk factor for atopy. Objective: Objective of this study was to evaluate the frequency of allergic rhinitis and other allergic and autoimmune disorders in children with IgA immunodeficiency. Methods: The study included 36 children diagnosed with IgA imunodeficiency. The presence of allergic and autoimmune disorders was evaluated by specialist of allergology, immunology, rheumatology and otorhinolaryngology. Results: 22 (71,1%) of children were male and the mean age of the patients was 10.5 years. Among the patients 31 (86,11%) had at least one allergic disease: 20 (55,55%) had asthma, 17 (47,22%) had allergic rhinitis, 6 (16,67%) had atopic dermatitis and 5 (13,89%) had urticaria. 14 (38,89%) had at least one of autoimmune disordes: 8 (22,22%) had reactive arthritis, 5 (13,89%) had juvenile idiopathic arthritis, 2 (5,56%) had Mb Hashimoto and 1 (2,78%) had SLE. Conclusion: This study showed that the main clinical manifestations in patients with IgA deficiency were asthma and allergic rhinitis. Results also show increased frequencies in other allergic and autoimmune diseases, compared to available data from general population.

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Goal Henoch-Schönlein purpura (HSP) is the most common vasculitis of the childhood. Among all possible symptoms/ complications, nephritis (HSPN) is the main and almost only cause of morbidity and mortality in HSP. The aim of the study was to investigate the value of erythrocyte glutathione S-transferase (e-GST) activity as an early predictor of HSPN. Methods Ninety-seven children with HSP were enrolled into the study. The control group consisted of 52 children without clinical and laboratory signs of inflammation. In all participants e-GST activity was determined spectrometrically from the whole blood samples, after incubation with a commercial GST assay. Results At the beginning of the disease the e-GST activity was significantly higher in HSPN patients who developed the nephritis during the six month follow up period, compared to the group of HSP patients without signs of nephritis: median (interquartile range) 5,70 U/mgHb (4,38-7,50 U/ mgHb) compared to 3,10 U/mgHb (2,20-4,20 U/mgHb); P<0,001. Similar results were obtained after the comparison of the HSPN patients and control group: 5,70 U/mgHb (4,38-7,50 U/mgHb) vs.3,13 U/mgHb (1,91-4,20 U/mgHb); P<0,001. There were no statistically significant differences between the group of HSP patients without nephritis and control group (P=0,837). During the follow up period, a significant decrease of e-GST activity was observed in the HSPN patients, but it was still significantly higher compared to the group of HSP patients without nephritis (P<0,001/ P<0,001). Conclusion e-GST activity is a reliable, independent marker of early nephritis risk assessment in children with HSP. As a sensitive, specific and feasible laboratory test, it has potential practical utility in the diagnostic algorithm and monitoring of the children with HSP.