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Introduction: Patients with food protein-induced enterocolitis syndrome (FPIES) have elevated thymus and activation-regulated chemokine (TARC) levels in the acute phase. However, to the best of our knowledge, no study has evaluated TARC levels in the acute phase of immunoglobulin E-dependent food allergy (IgE-FA). If TARC elevation is a specific response to FPIES among FAs, TARC measurement may help distinguish between FPIES and IgE-FA. Thus, we investigated acute phase TARC levels in patients with FPIES and IgE-FA. Methods: Thirty-one episodes in 16 patients with FPIES and 20 episodes (13 were anaphylaxis) in 20 patients with IgE-FA were included. Patients with eczema were excluded. Serum TARC levels within 6 h of allergic reaction onset and age-adjusted TARC ratios (TARC levels divided by age-specific normal TARC values) were compared between the groups. Results: The median age was 1.1 and 3.6 years in the FPIES and IgE-FA groups, respectively (P < 0.001). The median (range) serum TARC (pg/mL) levels were significantly higher in the FPIES group than in the IgE-FA group [1,283 (410–3,821) versus 377 (109–1,539); P < 0.001]. The median (range) age-adjusted TARC ratios were also significantly higher in the FPIES group [2.56 (0.57–7.86) versus 1.08 (0.15–2.17); P < 0.001]. The area under the curve (AUC) for TARC to distinguish FPIES from IgE-FA was 0.926, and the AUC for the age-adjusted TARC ratio was 0.850. The odds ratio for FPIES diagnosis per 1,000 pg/mL increase in TARC was 31.6 (P = 0.002), and the odds ratio adjusted by age was 17.1 (P = 0.016). Conclusion: Acute phase TARC levels were higher in patients with FPIES than in patients with IgE-FA. The increase in acute phase TARC levels was considered to be a specific response to FPIES among FAs. Measurement of TARC levels in the acute phase may help differentiate FPIES from IgE-FA. [ABSTRACT FROM AUTHOR]

Background: The modified pulmonary index score (mPIS) is reported to be useful for assessing bronchial asthma severity. However, mPIS has not been compared with other scores to date. In this study, we have compared mPIS with other scores and clarified the usefulness of mPIS. Materials and Methods: The study assessed children (n = 67; median age = 3 years) hospitalized for acute exacerbation of bronchial asthma without pneumonia between April 2016 and August 2017. We evaluated mPIS, pulmonary index score (PIS), and modified Wood's Clinical Asthma Score (mWCAS) from their medical record at admission, and we retrospectively evaluated the correlation between each score and clinical outcomes. Results: The median values for mPIS, PIS, and mWCAS were 9, 7, and 3, respectively. The median durations of hospitalization and of systemic glucocorticosteroid therapy were 7 and 4 days, respectively; 27 patients (40.2%) received continuous inhalation therapy with isoproterenol. All the scores were moderately positively correlated with the duration of hospitalization as follows: mPIS, 0.566 (P < 0.001); PIS, 0.488 (P < 0.001); and mWCAS, 0.411 (P < 0.001). Moderate positive correlations were observed between all scores and the duration of systemic glucocorticosteroid therapy as follows: mPIS, 0.488 (P < 0.001); PIS, 0.407 (P < 0.001); and mWCAS, 0.367 (P = 0.002). Receiver operating characteristic curve analysis of need for continuous inhalation therapy with isoproterenol yielded areas under the curve of 0.91, 0.83, and 0.87 for mPIS, PIS, and mWCAS, respectively. Conclusions: Correlation of mPIS and outcome was equal to or stronger than that of PIS or mWCAS, and mPIS can be useful for assessing the severity of acute exacerbations of bronchial asthma and predicting prognosis. [ABSTRACT FROM AUTHOR]