We showed sensitisation to goat and sheep cheese in two patients, and only to sheep cheese in another two of the studied patients.

Background: Multiple food allergies (MFAs) affect 30% of the child population with food allergy. The current treatment is the exclusion diet, which frequently affects the quality of life for these patients. The objective of the study was to describe the effect of omalizumab treatment in children diagnosed with MFAs who experienced frequent anaphylactic reactions and the impact on their quality of life.Material and methods: A descriptive observational study. Patients with severe food restrictions and high-risk due to multiple episodes of anaphylaxis were included. The allergy was confirmed by compatible clinical, skin tests, positive specific IgE and oral food challenges (OFCs). Omalizumab treatment was initiated and the impact on the life quality of patients and their families was assessed using the validated Food Allergy Quality of Life Questionnaire-Parent Form.Results: Five patients with an average age at diagnosis of 3.58 years (range between 1.5–7.9 years), were diagnosed with MFAs. All patients presented with anaphylaxis. All patients were treated with omalizumab between 2013 and 2019. Omalizumab treatment was initiated at a mean age of 6.05 years (range between 4.5–8.25 years). All patients have undergone OFC to reintroduce food successfully. 2 patients had their dose of omalizumab reduced by half, and 1 patient has had the time interval extended between administrations due to the maintenance of food tolerance. No immediate local or systemic adverse reactions were documented. Two patients have commenced omalizumab administration at home without incident.Conclusions: Children with MFAs who are treated with omalizumab do not show reactions in response to most of the foods to which they previously had anaphylaxis. Consequently, these patients were able to significantly expand the variety of their diet, improving the life quality and avoid anaphylaxis following the inadvertent intake of these foods.

Topical application of antihistamines commonly leads to sensitization for patients, but systemic administration of antihistamines rarely induces allergic hypersensitivity, which is mainly linked to phenothiazine-derived and piperazine-derived compounds. We report a 70-year-old woman whose medical history included lichen planus, and who was referred by the dermatology department of our hospital for suspected allergy to corticosteroids. The reason for referral was that on the fourth day of treatment with prednisone and hydroxyzine, the patient presented a bilateral highly pruritic palmar erythema that evolved to a generalized morbilliform rash with subsequent complete desquamation. At a later time, she took cetirizine for a cold, and developed palmar erythema and desquamation. Skin tests (prick and intradermal tests) were performed with steroids, and patch tests (read after 48 and 96 h) with corticosteroids and antihistamines. Controlled oral challenge tests were performed with prednisone and with an alternative antihistamine. Skin tests were negative for all corticosteroids. Patch tests were negative for all corticosteroids, but the antihistamine test was positive for hydroxyzine. Oral challenge with prednisone and dexchlorpheniramine was negative. The patient was diagnosed with cutaneous drug eruption from hydroxyzine and cetirizine. We consider it is important to assess every patient whose skin condition worsens after treatment with antihistamines, especially hydroxyzine, because it is known that antihistamines are often not recognised as the culprit in cases of cutaneous eruption.

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The twin-twin transfusion syndrome (TTTS) is a congenital pathology affecting 15% of monochorionic twin pregnancies [1]. The treatment modes most frequently applied at present include serial amnioreduction [2] and selective endoscopic laser coagulation of anastomoses (ELCA) [3]. The only prospective, randomized, controlled study that has been performed to compare the effectiveness of these two treatment techniques for TTTS is the EUROFETUS multicenter trial [4], in which it was concluded that endoscopic laser coagulation of anastomoses is a more effective first-line treatment than serial amnioreduction for severe twinto-twin transfusion syndrome diagnosed before 26 weeks of gestation.One of the criteria for exclusion from the EUROFETUS study was whether the fetuses had been subjected to any previous invasive treatment for the syndrome. It has been suggested that the performance of amnioreduction prior to laser surgery could worsen the results obtained by ELCA. Nevertheless, an important proportion of pregnant women who attend tertiary referral centers for ELCA treatment of TTTS had previously been treated unsuccessfully, on one or more occasions, by amnioreduction. The objective of the present study was to determine whether previous amnioreduction treatment has any effect on the results of ELCA therapy.An analysis was made of the results obtained from a sample of 16 pregnant women treated for TTTS by ELCA at a single tertiary referral center between