Search

Background Atopic dermatitis is a common illness in childhood. Children with atopic dermatitis are prone to develop cutaneous sensitization due to skin barrier dysfunction. Aim The aim of this study was to evaluate the frequency of cutaneous sensitizations in patients with atopic dermatitis and to identify the most frequent causative allergens. Study design The study group consisted of 112 children with atopic dermatitis, aged 1–18 years (median 88.5 months) and 39 healthy controls, aged 1–8 years (median 88.48 months). Methods The diagnosis of atopic dermatitis was established by modified Hanifin and Rajka criteria; severity of the disease was assessed by scoring of atopic dermatitis. Serum blood eosinophil count, total IgE and skin prick tests for common aeroallergens and food allergens were performed. Patch tests with cosmetic series and European standard patch test series (Stallegenes© Ltd, Paris, France) were applied. Results Of the children with atopic dermatitis, 17% (n = 19) were sensitized to either cosmetic or standard series or both of them; no children in the control group had a positive patch test (p = 0.001). Atopy and severity of atopic dermatitis was not a significant risk factor for cutaneous sensitization. The most common allergens were Nickel sulphate and Methychloroisothiazinolone (4.5% and 4.5%) in the European standard patch test and cocamidoproplybetaine (12.5%) in the cosmetic series patch test. Conclusion Cutaneous sensitization can develop in children with atopic dermatitis, therefore allergic contact dermatitis should be kept in mind.

Mastocytosis is a heterogeneous disorder characterized by clonal proliferation and accumulation of mast cells in one of more organs which may lead to different clinical pictures. Pathological increase and activation of mast cells in various tissues can cause different clinical pictures. Cutaneous mastocytosis limited to the skin is the most typical clinical picture observed in children and systemic mastocytosis is very rare in the pediatric age group. The diagnosis of cutaneous mastocytosis is based on clinical findings, but is often delayed due to lack of clinical awareness of the disease and lack of its consideration in the differential diagnosis. This article focuses on the current diagnosis, management and treatment of cutaneous mastocytosis in children in order to increase awareness about this issue.

The pathogenesis of chronic spontaneous urticaria (CSU) has not been fully understood; nevertheless, significant progress has been achieved in recent years. The aim of this study was to investigate the possible role of reactive oxygen species (ROS) in the pathogenesis of CSU. Sixty-two children with CSU and 41 healthy control subjects were enrolled in the study. An extensive evaluation of demographic and clinical features was done, and serum oxidative stress was evaluated by plasma total oxidant status (TOS) and total antioxidant status (TAS) measurements. The median value of plasma TOS was found to be 10.49 μmol H2O2 equiv./L (interquartile range, 7.29–17.65) in CSU patients and 7.68 μmol H2O2 equiv./L (5.95–10.39) in the control group. The difference between the groups was statistically significant (p=0.003). Likewise, the median plasma TAS level in the CSU group was decreased significantly compared to that of the control group (2.64 [2.30–2.74] versus 2.76 [2.65–2.86] mmol Trolox equiv./L, resp.,p= 0,001). Our results indicated that plasma oxidative stress is increased in children with CSU when compared to healthy subjects, and plasma oxidative stress markers are positively correlated with disease activity.

Aim: We aimed to evaluate serum vitamin D levels among children who have atopic dermatitis (AD) and to determine relationship with its clinical features and laboratory.Material and Methods: One hundred twenty children (66 B, 54 G) with AD, aged between 1-16 years, followed up from Pediatric Allergy Outpatient Clinic were enrolled. Family history of atopy, comorbid allergic diseases, allergy skin prick tests, serum total peripheral blood eosinophil counts, IgG, IgA, IgM, IgE levels, were recorded. AD severity was determined by using Scoring Atopic Dermatitis (SCORAD) index. The serum 25(OH)D vitamin levels were studied with HPLC method.Results: The mean serum total IgE level was 557 ± 425.3kU/L and mean blood eosinophil count was 557 ± 425.3 mm3. The meanserum 25(OH) vitamin D level was 28.42 ± 10.56 ng/ml. One of the patients (0.83%) had severe vitamin D deficiency, 16 (13.3%) had deficiency and 55 (45.8%) had insufficiency. Serum vitamin D level was normal in 48 (40 %) patients. According to SCORAD index, mean serum vitamin D level was higher in patients with mild AD (32.18 ± 7.91 ng/ml) than in patients with moderate disease(28.79 ± 11.02 ng/ml) or in patients with severe AD (23.78 ± 8.92 ng/ml)(p0,05).Serum 25(OH)D levels were inversely correlated with SCORAD index values (r =-0.273, p= 0.003). Conclusions: In this study, we showed a reverse correlation between serum 25(OH)D vitamin level and atopic dermatitis severity. Vitamin D deficiency should be thought in unresponsive AD cases.

Introduction Periostin has some effects on the pathogenesis of atopic dermatitis (AD) via release of pro-inflammatory cytokines and chemokines from activated keratinocytes and it is related to chronicity of skin lesions. Aim To evaluate the relationship between plasma periostin levels and severity and chronicity of AD in children. Material and methods The study population consisted of 29 children with atopic dermatitis without concomitant allergic disease such as asthma or allergic rhinitis and 31 healthy controls. Data of demographic features, serum eosinophil, total IgE and skin prick test results were collected through the patient's medical records. The severity of the disease was assessed by the SCORAD index. Serum periostin levels were measured with a human periostin ELISA kit. Results The mean ages of the AD patients and the control group participants were 80.7 ±52.8 and 90.3 ±41.6 months, respectively. Mean plasma periostin levels were 63.0 ±19.0 ng/ml in AD patients, and 23.6 ±7.3 in healthy controls, and there was a statistically significant difference between the two groups (p = 0.001). Plasma periostin level did not vary according to total IgE or serum eosinophil count (p > 0.05). Age of onset and duration of symptoms also were not correlated with plasma periostin levels. Although there was a positive relationship between plasma periostin level and the SCORAD index of patients, it was not statistically significant (r = 0.19, p > 0.05). Conclusions This study showed that plasma periostin levels were increased in children with atopic dermatitis. Periostin may have a partial role in the pathogenesis of atopic dermatitis, but it is not associated with severity or chronicity in children with atopic dermatitis.

WOS: 000437812300003 PubMed: 29555105 Introduction and objectives: Atopic dermatitis is a chronic, relapsing, highly pruritic, inflam- matory skin disease characterized by typical localization with increasing prevalence of 10-20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective. The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively. Material and methods: One hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit. Results: The statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27). Conclusion: IL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity. (C) 2018 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.

Anaphylaxis is a life-threatening, emergency clinic conditi- on, so it is essential to diagnose and treat anaphylaxis immediately. Adrenaline is the first choice in the treatment of anaphylaxis; it is the only drug that prevents death and hospitalization. It is also very important to prevent anaph- ylaxis as much as treatment, since it is not predictable when it will appear. Adrenaline auto-injectors AAI should be prescribed for individuals who have anaphylaxis and are at high risk for anaphylaxis, and they should be infor- med about when and how to use them. Generally, in adult and pediatric patients, administration of adrenaline in anaphylactic reactions is inadequate and AAI is prescribed at low rates for patients at risk of anaphylaxis

The incidence of food allergy is increasing in the worldwide and also in our country. Cow’s milk and eggs are the most common foods that cause allergy in children. Cow’s milk allergy can be classified as IgE mediated, non-IgE mediated and mixed type reactions. However, in clinical practice, type of immunologic reactions cannot be easily classified just based on history and clinical findings. In this article approach to a child with cow’s milk allergy is reviewed based on the current knowledge in this field

Cocamidopropyl betaine (CAPB) is an amphoteric, synthetic detergent that has been increasingly used in cosmetics and personal hygiene products and induces a relatively mild skin irritation. This case evaluates allergic contact dermatitis developing due to CAPB. Allergy to CAPB was first reported in 1983. This case suffered from allergic contact dermatitis due to CAPB, which is a rare phenomenon despite widespread CAPB use.

Objective: One of the many factors that involved with the pathogenesis of atopic dermatitis (AD) is sensitivity to allergens. Food allergy is a known etiological factor and evidence connecting sensitivity to inhalant allergens with atopic dermatitis also keeps increasing. Our study aimed to investigate allergen hypersensitivity together with clinical features and allergic parameters of children with atopic dermatitis who live in Istanbul. Materials and Methods: A total of 826 children aged 2-18 years who had been followed-up with an AD diagnosis at the Istanbul University Medical School’s Allergy and Immunology Department between January 2010 and December 2013 were included in our study. Age, gender, atopy history in the family, serum levels of total IgE, presence of additional allergic disease, eosinophil percentage in total blood count and the results of skin prick tests were recorded for these patients. Results: Among the patients included in the study, 41.2% (n:340) were female and 58.8% (n=486) were male, and the mean age was 6.48±3.50 years. Atopic children made up 80% and non-atopic children 20% of the patient population. Patients whose Ig E level was >100 were found to be more sensitive to allergens (p

Besin alerjisi besin proteinlerine karsi gelistirilen spesifik IgE antikorlari araciligi ile ortaya cikan Tip I asiri duyarlilik reaksiyonu olarak tanimlanmaktadir Dunyada oldugu gibi ulkemizde de tum alerjik hastaliklarda oldugu gibi besin alerjisinin gorulme sikligi giderek artmaktadir Anne baba ya da kardeslerinde alerjik rinit bronsiyal astim atopik dermatit ve besin alerjisi gibi alerjik etiolojiye dayali bir hastalik bulunan bebekler besin allerjisi acisindan yuksek risk grubundadirlar Besin alerjisi yonunden risk grubunda bulunan bebeklere uygulanmasi gereken tani ve tedavi yontemlerinin belirlenmesi dogru tani ve tedavinin yapilabilmesinde yararli olacaktir ldquo;Cocuk Alerji ve Astim Akademisi Dernegi rdquo; olarak hazirladigimiz bu protokolun amaci; ldquo;Aile Hekimleri rdquo; ve ldquo;Cocuk Sagligi ve Hastaliklari Uzmanlari rdquo; icin besin alerjilerinin taninmasi ve tedavisi konusunda bir kaynak olarak yol gosterici olmaktir Turk Ped Arfl 2013; 48: 270 4

Hereditary angioedema (HA) is a rare, autosomal-dominant genetic disorder presenting with recurrent attacks of angioedema. The most commonly involved organs include the extremites, face, neck, upper respiratory tract, genital region and the gastrointestinal tract. Edema of the intestinal mucosa can cause temporary obstruction and severe abdominal pain that can be confused with acute abdomen. Pediatricians and emergency physicians should keep in mind this rare disease in the differential diagnosis of severe abdominal pain.

Evidence suggests caries experience is higher in children with asthma. This study compared caries experience in asthmatic and non-asthmatic children and defined whether variation in the distribution of caries experience differed between the two groups and was dependent on the presence of genetic variation in enamel formation genes. Children with asthma were recruited at the Istanbul University, Faculty of Medicine, Department of Paediatrics, Division of Paediatric Allergy and Pulmonary Diseases, and non-affected children were recruited at the Istanbul University, Faculty of Dentistry, Department of Paedodontics. Cases (N = 100) were defined as children between the ages of 6 and 12 years with asthma and controls (N = 100) as children without asthma. Cases and controls were matched by sex and age. All study subjects received a complete dental exam, provided demographic and other caries and asthma risk factors data, and a saliva sample for DNA extraction. Caries experience was defined based on DMFT/dmft and DMFS/dmfs scores. Genotypes of 11 SNPs were selected in intronic regions of enamel development genes. PCR with TaqMan chemistry was used for genotyping all selected markers. Association between caries experience (caries-free versus caries affected) depending on asthma status and SNPs was tested with PLINK by logistic regression, adjusting by risk, and other preventive measures. p values below 0.0045 (0.05/11) were considered statistically significant. Logistic regression analysis showed an association between AMBN rs4694075 and caries experience (p = 2.525e−007). This study provides, for the first time, evidence that ameloblastin is associated with caries in asthmatic children.

Netherton syndrome (NS) is a rare autosomal recessive disorder characterized by ichthyosiform scaling, hair abnormalities, and variable atopic features. Mutations in the serine protease inhibitor Kazal type 5 (SPINK5) gene leading to lymphoepithelial Kazal-type-related inhibitor (LEKTI) deficiency cause NS. Growth retardation is a classic feature of NS, but growth hormone (GH) deficiency with subsequent response to GH therapy is not documented in the literature. It is proposed that a lack of inhibition of proteases due to a deficiency of LEKTI in the pituitary gland leads to the overprocessing of human GH in NS. Herein we report three patients with NS who had growth retardation associated with GH deficiency and responded well to GH therapy.

Bir ilacin profilaksi, tani veya tedavi amaci ile kullanimi sirasinda veya sonrasinda olusan istenmeyen etkiler ilac asiri duyarlilik reaksiyonu (ADR), ilac ters etkisi veya ilac reaksiyonu olarak tanimlanir. Ilac reaksiyonlarinin % 80’ini Tip A olarak adlandirilan ve ilacin farmakolojik etkisi ile iliskili, doz bagimli ve ilac kesildiginde kolayca geri donebilen kismi olusturur, bu tip reaksiyonlarin klinik bulgulari beklenen reaksiyonlardir. Tip B ilac reaksiyonlari ise; % 20 oraninda gorulmekte olup, doz bagimli degildir, ongorulemez, klinik bulgular beklenmedik reaksiyonlardir. Taninin en onemli kismini dikkatli alinan bir anamnez olusturur. Oncelikle reaksiyonun ilac alerjisi ile iliskisi belirlenmeli, sonrasinda da bu durumun immunolojik reaksiyon mu yoksa nonimmun reaksiyon mu olduguna karar verilmelidir. Oykuye gore tanisal testler planlanmalidir. Ilac alerjilerinin akut tedavisi suclanan ilacin kesilmesi ve aktif lezyonun durumuna gore gerekli destek medikal tedavi uygulanmasi seklindedir. Hastalarda uzun donemli yaklasim plani yapmak son derece onemlidir. Ilac alerjisi olan hastalar akilci ilac kullanimi konusunda egitilmelidir. Bu yazida cocuklarda ilac alerjilerine yaklasim guncel rehberler dogrultusunda degerlendirilecektir.

Adverse reactions to drugs have been defined by the WHO as unwanted effects that occur during the use of a drug. The diagnosis of drug allergies is not always straightforward due to confounding factors such as the use of multiple drugs and similarity of the pertinent symptoms to those that can be attributed to disease processes. In children, drug allergies are most commonly mistaken for rashes induced by viral infections. The first step towards the diagnosis of drug allergies is a detailed history and the second step is choosing a laboratory test according to this history. Skin prick testing is preferred for immediate type reactions while skin patch testing should be performed for delayed type reactions. When allergy tests are negative, drug provocation testing is the gold standard. In this paper, a case with a negative skin patch test that was ultimately diagnosed through a provocation test is presented.

Acquired immune deficiency syndrome can be encountered with hypereosinophilia and hyperimmunoglobulin E (hyper-IgE) values, though these levels are rarely so high to be compared with hyperimmunoglobulin E syndrome. A 9-year-old boy presented with the complaint of fatigue, weakness, weight loss and generalized pruritic rash lasting for a year. He had frequent respiratory tract infections, wheezing episodes and urticarial skin lesions before that. On admission, he was cachectic and he had generalized lymphadenopathy, hepatosplenomegaly, oral moniliasis and pruritic rash all over his body. Laboratory evaluation revealed marked lymphopenia and hypergammaglobulinemia with extremely high IgE values (IgE: 59 300 kU/l). He was diagnosed with stage 4 human immunodeficiency virus (HIV) infection and started on antiretroviral treatment. In conclusion, HIV infection can be presented with increased IgE values.

Background: Chronic spontaneous urticaria (CSU) is an idiopathic condition that seriously affects quality of life. It is well known that oxidative stress and nitrosative stress (NS) are generally involved in many chronic inflammatory diseases. This study aimed to evaluate the possible role of NS in the pathogenesis of CSU. Methods: Thirty-two children with CSU and 22 healthy control subjects were enrolled in the study. Demographic and clinical features were defined, and disease activity was quantified using the urticaria activity score (UAS). Serum NS was assessed by the plasma levels of total nitric oxide (NOx) metabolites and nitrite and nitrate measurements using a Griess method-based commercial kit. Results: Plasma NOx levels were 82.5 ± 11.3 µmol/L in the CSU group and 50.9 ± 9.4 µmol/L in the control group. The difference was statistically significant (p < 0.001). CSU patients also had higher plasma nitrite levels than controls (53.3 ± 13.8 vs. 30.2 ± 10.1 µmol/L, respectively, p < 0.001). The median values of plasma nitrate were 27.5 µmol/L (IQR 19.1-35.5) in CSU patients and 20.9 µmol/L (IQR 17.9-23.2) in the control group, and the difference was statistically significant (p = 0.009). In addition, plasma NOx and nitrite levels were positively correlated with the UAS (rho = 0.512, p = 0.03 and rho = 0.452, p = 0.011, respectively). Conclusion: Plasma NS is elevated and positively correlated with disease activity in children with CSU.

Purpose: Chronic spontaneous urticaria (CSU) is a disease that is primarily seen in adults and is comparatively rare in children. Consequently, only a few studies have focused on the pathogenesis of the disease in children. This study investigated the possible role of metalloproteinase-9 (MMP-9) in the pathogenesis of CSU in children. Methods: The study group was composed of 54 children with CSU; 34 healthy children comprised the control group. The demographic and clinical features of the study group were extensively evaluated, and laboratory assessments were also performed. An enzyme-linked immunosorbent assay was used to evaluate levels of plasma MMP-9. Disease activity was quantified using the urticaria activity score (UAS). Results: The median value of plasma MMP-9 was 108.9 ng/mL (interquartile range, 93.3-124.1) in the CSU group and 87.8 ng/mL (69.4-103.0) in the control group. The difference between the 2 groups was statistically significant (P0.05). Conclusions: Plasma MMP-9 levels were elevated in children with CSU and were positively correlated with disease activity. MMP-9 may be both a good biomarker of disease activity and a potential therapeutic target in CSU. Bezmiâlem Vakıf Üniversitesi

Mucopolysaccharidosis type VI (MPS VI) is a progressive, chronic, and multisystem lysosomal storage disease. Enzyme replacement therapy (ERT) with the recombinant human arylsulfatase B enzyme (galsulfase [Naglazyme]) is recommended as first-line therapy. It is generally reported as safe and well tolerated. Frequently observed mild to moderate infusion-related reactions which can be easily handled by reducing or interrupting the infusion and/or administering additional antihistamines, antipyretics, and corticosteroids are mostly mediated by non-IgE mechanisms. Here we report two children with MPS VI who experienced IgE-mediated reactions with galsulfase at the second year of the therapy. One child had anaphylaxis and the other had urticarial eruptions. They could receive ERT after successful rapid desensitization. To our knowledge, this is the second report on galsulfase allergy with IgE-mediated reaction. It is important to recognize IgE-mediated reactions since they can be life-threatening and do not respond to the standard therapies. We recommend allergy skin tests in the evaluation of infusion-related reactions unresponsive to standard therapies, so that continuation of ERT will be feasible after successful desensitization.

Summary An increased isolation of fungi from the respiratory tract of patients with cystic fibrosis (CF) has been reported. The prevalence of different fungi in CF patients from Turkey is not known. Our aim was to determine the frequency of fungi in the respiratory tract of Turkish CF patients. We investigated a total of 184 samples from 48 patients. Samples were inoculated on Medium B+ and CHROMagar Candida. Candida albicans was the predominant yeast isolated [30 patients (62.5%)], followed by C. parapsilosis [6 (12.5%)] and C. dubliniensis 5 (10.4%). Aspergillus fumigatus was the most common filamentous fungus [5 (10.4%)] and non-fumigatus Aspergillus species were isolated from four (8.3%) patients. Staphylococcus aureus was the most frequently detected bacterium in C. albicans positive samples (53.57%). A. fumigatus and Pseudomonas aeruginosa or S. aureus were detected together in 75% of A. fumigatus positive samples each. No statistically significant relationship was detected between growth of yeast and moulds and age, gender, the use of inhaled corticosteroids or tobramycin. No significant correlation was found between the isolation of C. albicans, A. fumigatus and P. aeruginosa, Stenotrophomonas maltophilia or S. aureus, and the isolation of C. albicans and Haemophilus influenzae. Other factors which may be responsible for the increased isolation of fungi in CF need to be investigated.

Anahtar kelimeler: Klinik etik; hasta mahremiyeti; tibbi uygulamada akilli telefonlar; halk sagligi etigi; teknoloji ve riskleri. Keywords: Clinical ethics; confidentiality; smartphones in medical practice; public health ethics; technology and risks.

Aim: To evaluate whether mucolytic agents have an adjuvant role with antibiotics in the treatment of children with rhinosinusitis. Methods: Ninety-two children with rhinosinusitis were recruited for this randomized, placebo controlled, double-blinded clinical trial. Mean age was 8.5 ± 3.2 years. Erdosteine (5–8 mg/kg/day) was administered to 49 children, and 43 children received placebo. Changes in symptoms were recorded with the standard S5 scoring for 14 days. Complete resolution of symptoms on day 14 was considered to be clinical improvement. Results: Eighty-one participants completed the study. Forty-one were in the treatment group and 40 in the placebo group. The average S5 scoring value at the onset of study was 11.0 in treatment group and 12.1 in placebo group. On day 14, mean scores were 3.1 in the treatment group and 2.8 in the placebo group. Complete improvement was 78% in the treatment group and 74.4% in the placebo group. There was no significant difference between the groups. There were no clinically detected serious side effects or complications in both groups. Conclusion: Use of erdosteine as a mucolytic agent in children with acute rhinosinusitis does not directly affect the success of treatment.

Background Munchausen by proxy (MBP) is a severe form of abuse in which a caregiver simulates or fabricates illness in another person, primarily the elderly and children, which can even result in death., Case We report two siblings who were victims of MBP, one of whom died. A very rare diagnosis, cicatricial pemphigoid was suspected in the 2-year-old girl who was first abused. She was hospitalized twice, for 3 and 4 months, respectively. Her second hospitalization ended with her death. MBP was diagnosed after the second sibling's admission with similar atypical signs and symptoms. It was realized that a household-cleaning product, sodium hydroxide, was administered repeatedly by oral route to the children by their own mother., Conclusions Physicians must consider the diagnosis of MBP whenever they are confronted with unusual, persistent or recurrent signs and symptoms in a child.

Objective: Allergic rhinitis is a common chronic illness of childhood. The aim of the study was to evaluate the prevalence and risk factors of allergic rhinitis in 6-12-year-old schoolchildren in Istanbul. Methods: A total of 2500 children aged between 6 and 12 years in randomly selected six primary schools of Istanbul were surveyed by using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire between April and May 2004. Results: Of them 2387 (1185 M/1202 F) questionnaires were appropriately completed by the parents with an overall response of 95.4%. The prevalence of physician-diagnosed allergic rhinitis was 7.9% (n = 189). A family history of atopy (aOR = 1.30, 95% CI = 1.00-1.68), frequent respiratory tract infection (aOR = 1.36, 95% CI = 1.08-1.70) and sinusitis (aOR = 2.29, 95% CI = 1.64-3.19), antibiotic use in the first year of life (aOR = 1.26, 95% CI = 1.01-1.57), cat at home in the first year of life (aOR = 2.21, 95% CI = 1.36-3.61), dampness at home (aOR = 1.31, 95% CI = 1.04-1.65) and perianal redness (aOR = 1.26, 95% CI = 1.01-1.57) were significant for increased risk for allergic rhinitis. Frequent consumption of fruits and vegetables were inversely, and frequent consumption of lollipops and candies were positively associated with allergic rhinitis symptoms. Conclusion: Our study reconfirmed that family history of atopy, frequent respiratory tract infections, antibiotics given in the first year of life, cat at home in the first year of life, dampness at home, perianal redness and dietary habits are important independent risk factors for AR. Researchers worldwide should be focused to these factors and try to develop policies for early intervention, primary and secondary preventions for allergic diseases. © 2006 Elsevier Ireland Ltd. All rights reserved.

Izoniazid cocukluk cagi tuberkulozunun tedavi ve profilaksisi icin en sik kullanilan ilaclardan biridir. Yaygin bir sekilde kullanilmasina paralel olarak kaza veya kasitli olarak zehirlenme vakalari gorulmektedir. Konvulziyon, metabolik asidoz ve koma uclemesi ile basvuran hastalarda INH zehirlenmesi dusunulmeli ve hizla piridoksin tedavisi baslanmalidir. Oz kiyim ozellikle ergenlik doneminde sik karsilasilan durumlardan birsidir. Bu makalede oz kiyim amacli isoniazid zehirlenmesi ile gelen ergen bir vaka sunularak, izoniazid zehirlenmesine ve ergenlerin oz kiyim girisimlerine yaklasim degerlendirilecektir.

We report the cases of 4-year-old identical twin sisters who presented with severe atopic dermatitis with intractable skin manifestations and multiple food allergies. Netherton syndrome (NS) (OMIM 256500) was suspected due to very high serum IgE levels, growth retardation, severe food allergies and typical hair finding (trichorrhexis invaginata). A definite diagnosis was made by genetic analysis. Our cases are unique in being the first identical twins with NS diagnosed by a novel mutation in the SPINK5 gene. NS should be considered in differential diagnosis in children who have generalized erythema with intractable eczematous lesions and elevated levels of IgE.

The aim of this study was to evaluate the prevalence of allergic rhinitis and its relationship with various risk factors in 6-7-year-old children living in İstanbul. A total of 11,483 children aged 6-7 years in 75 primary schools from all districts of İstanbul were surveyed. Prevalence of symptoms of allergic rhinitis was assessed using a translated version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Of them, 9,875 (50.7% M, 49.3% F) questionnaires were appropriately completed by the parents. The prevalence rates of lifetime, current and physician-diagnosed allergic rhinitis were 44.3%, 29.2% and 8.1%, respectively. There was nearly a two-fold variation in the prevalence rates of rhinitis between the districts of İstanbul. Frequent paracetamol and antibiotic use in the first year of life, history of frequent upper respiratory tract infections, adenotonsillectomy, breastfeeding less than six months, dog at home or perianal redness in the first year of life, and frequent trucks passing near the home were independent risk factors.