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Introduction: Nutritional habits have been associated with differing allergy risk. The aim of this study was to explore the role of the frequency of consuming different food in the urban (city of Zagreb) and rural (Natural park Lonjsko polje) in development of allergic symptoms. Methods: Schoolchildren aged 6-13 years old, from the city of Zagreb and Lonjsko polje, participated in the study. The prevalence of allergic symptoms, as well as the frequency of consuming different food (fresh green vegetables, raw green vegetables, fruits, fruit juice, meat, fish, sparking drinks and hamburgers), were assessed using the International Study of Allergy and Asthma in Children (ISAAC) questionnaire. The association of allergic symptoms (asthma, allergic rhinitis (AR) and atopic dermatitis (AD)) and food was assessed using logistic regression, based on the odds ratio (OR) and 95% confidence interval (CI). Results: 1741 children participated in the study, 885 girls and 856 boys, 648 from Lonjsko polje and 1093 from the city of Zagreb. In the city of Zagreb, consumption of raw green vegetables was associated with the lower risk of wheezing during last 12 months (OR 0.751, 95% 0.567-0.994, p=0.044), while in the area of Lonjsko polje meat consumption was associated with the lower risk of wheezing during last 12 months (OR 0.025, 95% CI 0.001-0.025, p=0.012). Consumtion of sparkling drinks was a risk factor for wheezing ever-in-a-lifetime in Lonjsko polje (OR 0.767, 95% CI 0.631-0.934, p=0.008). In the city of Zagreb, consumption of raw (OR 0.759, 95% CI 0.596-0.965 p=0.024) and cooked green vegetables (OR 0.751, 95% CI 0.569-0.991, p=0.043) were associated with the lower risk of AR symptoms during last 12 months. In Lonjsko polje, meat consumption was associated with the lower risk of diagnosed AR (OR 0.594, 95% CI 0.424-0.833, p=0.002). Consumption of hamburgers in Lonjsko polje was associated with the increased risk of AR symptoms ever-in-a-lifetime OR 1.226, 95% CI 1.039-1.446, p=0.015, during last 12 months (OR 1.226, 95% CI 1.039-1.446, p=0.015) and diagnosed AR (OR 1.351, 95% CI 1.003-1.819, p=0.048). In the city of Zagreb, consumption of cooked green vegetables was associated with lower risk of AD symptoms during last 12 months (OR 0.833, 95% CI 0.697-0.995, p=0.043). Conclusion: Our study showed raw and cooked green vegetables to be associated with lower risk of the symptoms of asthma, AR and AD (current activity of the disease) in the urban area. Fast food consumption was a risk factor for AR symptoms and asthma in the rural area. Green vegetables consumption should be encouraged in allergic patients in order to control the symptoms. Fast food consumption should be avoided in order to prevent the diseases.

Anafilaksija ovisna o hrani, potaknuta naporom (engl. food dependent exercise induced anaphylaxis, FDEIA) poseban je oblik preo- sjetljivosti na hranu posredovan IgE protutijelima, koji se javlja u bolesnika koji unutar nekoliko sati od konzumacije određene namir- nice budu izloženi tjelesnoj aktivnosti. U djece je posebice rijedak, a najčešće je uzrokovan pšeničnim brašnom, iako ga mogu uzro- kovati i druge žitarice, ribe, plodovi mora, orašasti plodovi, kikiriki, jaje, mlijeko i druga hrana. Dijagnoza se postavlja temeljem karakterističnih simptoma koji se pojavljuju tijekom ili nekoliko sati nakon tjelesne aktivnosti, kojoj prethodi ingestija određene hra- ne, in-vitro i in-vivo pretraga te provokacijski pokusi. Sama tjelesna aktivnost ili konzumacija hrane u odsustvu tjelesne aktivnosti, ne izaziva simptome. U ovom radu prikazujemo 17-godišnju bolesnicu koja je pokazala FDEIA-u nakon konzumacije proizvoda od pšeničnog brašna. Iako rijedak, ovaj je entitet potrebno poznavati kako bi se izbjegle životno ugrožavajuće alergijske reakcije, a temelj dijagnoze je detaljna anamneza., Food-dependent and exercise induced anaphylaxis (FDEIA) is a rare type of IgE-mediated food hypersensitivity precipitated by a combination of food and exercise. It is very rare in children, and most commonly caused by wheat, although it can also be caused by nuts, fish, eggs, milk and other foods. It is diagnosed based on clinical history, in-vitro and in-vivo diagnostic procedures and pro- vocative tests. We present a 17-year-old girl who suffered from several attacks of FDEIA after consuming wheat products. Although a rare disorder, healthcare professionals should be aware of FDEIA. A detailed history is the most important step in diagnosing FDEIA.

Background. Rapid climate changes and low biodiversity threaten human health by contributing to the increasing number of allergic persons in countries with westernized lifestyle. We have to expand our understanding of the mechanisms by which these environmental changes induce harmful immune reaction in order to prevent events in which large number of people seek emergency treatment (e.g. in Melbourne in 2016, when 9 people died of thunderstorm asthma). Some epidemiological studies that have been monitoring the trends in prevalences of allergic diseases have reported that allergy epidemic in developed countries has reached its plateau, while a rise is expected in developing ones. Also, different impact of rural and urban milleu has been gaining considerable scientific interest because of its role in immune system education.Objective. Our aim was to compare prevalence of allergic diseases and associated causative factors among schoolchildren from the city of Zagreb (Croatia, a low-income European country) sixteen years after first resuts collected by same methodology and on the population of same age. This is a part of the bigger study which involved also children living in rural setting of Natural Park Lonjsko polje.Methods. Symptoms of asthma, allergic rhinitis (AR) and atopic dermatitis (AD), along with prenatal, early-life, and current exposures were assessed using The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. An allergic profile was determined by the skin prick test. Results. Prevalence of current, ever-in-a-lifetime and diagnosed AR of 35.7%, 42.5% and 14.9%, and AD of 18.1%, 37.1% and 31.1% demonstrated a significant increase. Asthma prevalence of 5.7% remained unchanged. Maternal smoking in pregnancy, dampness and mould in homes, day-care facility and pertussis vaccination increased during the observed period. Allergen sensitivity rate remained similar, but pollens became dominant. Exposures to mould and dog allergens were risks for asthma (OR 14.505, OR 2.033, respectively). Exposure to cat allergens appeared as protective in AR (OR 0.277). Fast food onsumption was rare, not contributing to the AD increase. Parental history of allergy was a risk factor in all conditions. Conclusion. Over sixteen-year-period, prevalences of AR and AD in Zagreb considerably increased accompanied with the high proportion of children’s atopy, which was not affected by the passage of time. Prevalence of asthma remained the same. During this observed period, lifestyle factors like maternal smoking in pregnancy, dampness and mould in homes, day-care facilities and pertussis vaccination also increased, but were identified as risks only in relation with asthma together with dog exposure. Rapidly progressing AR was related only with cat exposure but in an protective way. Our explanation for high AR prevalence is based on data of contemporary observed higher proportion of children with pollen sensitisation in comparison to previous hystoric period. Reported higher PM10 concentration in city of Zagreb could not be eliminated as cofounding factor. This two causative factors are obviously in relationship with continuously registering climate changes. Further research is necessary to provide an explanation for the longstanding question about unique role of cat allergen in allergic individuals. Stabile asthma trend remains insufficiently understood. We speculate that it could be a result of decreased sensitisation to indoor allergens whose role is more important than the role of outdoor ones in this allergic disease. We did not provide explanation for high prevalence of 31.1% of physician-diagnosed AD in our urban children cohort. Strong genetic background in all three condition is evident, but influence of environmental factors on gene functioning could not be examined by this type of studies.

Alergija na kravlje mlijeko najčešća je alergijska bolest u ranom djetinjstvu. Oko 80% proteina prisutno je u krutoj frakciji (kazeini, kazeinski kompleks), a oko 20% u tekućoj frakciji (sirutki) mlijeka. Sirutka sadrži α-laktalbumin (Bos d 4) i β-laktoglobulin (Bos d 5), albumin goveđeg seruma (Bos d 6), imunoglobuline (Bos d 7) i laktorferin. Ukupni kazein (Bos d 8) čine četiri različite frakcije: αS1-kazein (Bos d 9), αS2-kazein (Bos d 10), β-kazein (Bos d 11) i κ-kazein (Bos d 12). Za određivanje tih pojedinačnih alergenskih molekula primjenjuje se tzv. komponentna dijagnostika (engl. Component Resolved Diagnosis, CRD), koja je omogućila identifika- ciju glavnih (Bos d 4 i Bos d 5 i sve kazeinske molekule) i sporednih (Bos d 6, Bos d 7 i laktoferin), odnosno križno reaktivnih (Bos d 5 i Bos d 6) alergenskih molekula. Buduća istraživanja omogućit će određivanje dijagnostičke značajnosti otkrivanja pojedinačnih aler- genskih molekula. Veliki napredak očekuje se i u području molekularne biologije, genomike, proteomike i bioinformatike., Cow’s milk allergy is the most common allergic disease in infancy. About 80% of protein is present in the solid milk fraction (caseins, casein complex), and about 20% in the liquid milk fraction (whey). Whey contains α-lactalbumin (Bos d 4), β-lactoglobulin (Bos d 5), bovine serum albumin (Bos d 6), immunoglobulins (Bos d 7) and lactoferrin. Total casein (Bos d 8) consists of four different fractions: αS1-casein (Bos d 9), αS2-casein (Bos d 10), β-casein (Bos d 11) and κ-casein (Bos d 12). Determination of these individual allergen molecules is carried out using the so-called component resolved diagnostics (CRD), which allows identification of major (Bos d 4 and Bos d 5 and all casein molecules), minor (Bos d 6, Bos d 7 and lactoferrin), as well as cross-reactive (Bos d 5 and Bos d 6) allergen molecules. Future research will make it possible to assess diagnostic role of detecting individual allergen molecules. Progress is also expected in the field of molecular biology, genomics, proteomics and bioinformatics.

Background: Children living in rural areas have a lower risk for developing allergic diseases, which has particulary been observed for allergic asthma and atopic dermatitis, but less for allergic rhinitis. Methods: A cross-sectional study was conducted in 39 randomly selected elementary schools in the urban environment of the city of Zagreb and the rural, surrounding area of Lonjsko polje National Park, during school-year 2017/2018. All children aged 6-7, 10 and 13-14 years were eligible to participate. The study was based on the original ISAAC questionnaires answered by parents. To assess skin sensitivity, skin prick tests on common inhalant allergens were done on 400 randomly selected children from both regions. Lonjsko polje is the biggest complex of natural and preserved lowland riparian forests in Europe and the ornithological reserve with more than 1500 species living there. The two areas differ in GDP and economy, with more than two times higher GDP in the city of Zagreb.Results: A total sample of 1745 children participated in the study, 646 (37%) from Lonjsko polje and 1099 (63%) from the city of Zagreb. The children from Lonjsko polje showed a lower risk for developing symptoms of allergic rhinitis ever in their lives in the 13-14-year age group (OR 0.531, 95% CI=0.37-0.76, p 0.001) and lower risk for active rhinitis in all age groups (6-7 y ; OR 0.373, 95% CI=0.21-0.63 , p 0.003 ; 10 y ; OR 0.563, 95% CI=0.32-0.98, p 0.042 ; 13-14 y ; OR 0.173, 95% CI=0.07-0.40, p

Background: Urbanisation delays postnatal maturation of adaptive immunity. Interplaying with genetical determinants it is drammatically increasing the risk for all types of allergy, especially among children. Rural living comprises protective (not fully understood) immunomodulatory factors inducing immunotolerance. The main aim of our study was to investigate prevalence differences in asthma (A), rhinitis (AR) and atopic dermatitis (AD) symptoms between three age groups of children living in the city of Zagreb and children living in Natural Park Lonjsko Polje, complex of lowland riparian forests with 1500 species living there. Second, we intend to get insight into differences of some urban/rural early-life environmental exposures assessed from ISAAC questionnaires. Patients and methods: In the schoolyear 2017/2018 total of 1745 schoolchildren aged 6-14 years (6-7 yrs, 10-11 yrs and 13-14 yrs age groups), from 39 randomly selected elementary schools, were included. Questionnaires were answered by parents. The results were compared with the study in Zagreb in year 2002. Results: Regarding allergic rhinitis, children from rural setting showed lower risk for current AR (last 12- months symptoms) (OR 0, 373 ; 0, 563 ; 0, 172 for all age groups respectivelly) in comparison to the children from the urban area who reported more drugs usage for current AR (X2 Yates corect 0, 46, p

Psoriasis is a T-cell mediated chronic inflammatory disorder of the skin. There are three age groups of pediatric psoriasis: infantile psoriasis, early onset psoriasis and pediatric psoriasis with psoriatic arthritis. Upper respiratory infection is the most common trigger of infantile psoriasis. We report two patients of early, Napkin psoriasis.

Alergijske bolesti u posljednja su dva desetljeća u razvijenim zemljama svijeta, te urbanim dijelovima zemalja u razvoju u dramatičnom porastu. Na zabrinjavajući trend porasta prevalencije alergijskih bolesti u svojim dokumentima upozoravaju i Europska akademija za alergologiju i kliničku imunologiju (EAACI) te Svjetska alergološka organizacija (WAO) (1, 2). Procjenjuje se kako je učestalost astme u Europi oko 20%, alergijskog rinitisa i do 30%, a atopijskog dermatitisa oko 15% (2). Iako je sklonost atopiji u velikoj mjeri nasljedna, tako značajan porast učestalosti alergijskih bolesti posljednjih desetljeća ne može se objasniti isključivo promjenama gena. Prva su istraživanja pokazala kako djeca koja žive na farmama rjeđe obolijevaju od alergijskih bolesti u odnosu na djecu odraslu u gradovima, što je poznato kao higijenska hipoteza. Velike populacijske studije potvrdile su izrazite razlike u prevalenciji alergijske senzibilizacije u odnosu na način života, stupanj urbanizacije te industrijalizacije u pojedinim područjima (razlike Istočna-Zapadna Njemačka, Estonija-Švedska, urbana i ruralna Mongolija, studija Karelija) (4-8). Istraživanja imigranata pokazala su kako se nakon 10 godina života u novoj sredini imunološki sustav prilagođava novom okolišu (9). Seljenjem iz biološki raznolikih, u urbanizirana područja, u navedenom se periodu gubi imunotolerancija. Navedena istraživanja podloga su suvremenoj hipotezi o etiologiji alergijskih bolesti-Hipotezi o biološkoj raznolikosti, koja porast prevalencije alergijskih bolesti u razvijenim zemljama povezuje s gubitkom ukupne biološke raznolikosti mikroorganizama u okolini (10). Dodatno u prilog hipotezi o biološkoj raznolikosti govori i niz novijih studija: 1. Istraživanja mikrobioma 2. Istraživanja razvoja imunološkog sustava 3. Epidemiološke studije u ruralnim i urbanim područjima 4. Epigenetske studije Mikrobiom, razvoj imunološkog sustava i imunoregulacija Razvoj metoda sekvenciranja genoma u sklopu Projekta humanog mikrobioma omogućio je identificiranje mikroorganizama koji žive u simbiozi s čovjekom, a nalazimo ih na koži te sluznicama probavnog i respiratornog sustava (11). Istraživanja na životinjama prva su pokazala da mikrobiota utječe na razvoj imunološkog sustava, budući da miševi uzgajani u sterilnim uvjetima (eng. germ free) ne razvijaju pravilno imunološki sustav pridružen probavnoj cijevi, smanjeno proizvode regulatorne limfocite T (Treg), imaju manju količinu IgA i plazma stanica, hipereozinofiliju te su skloni razvoju astme (12). Također, navedena istraživanja pokazuju da je rani razvoj ključni period pravilnog razvoja imunološkog sustava, koji koevoluira paralelno s promjenama sastava crijevne mikrobiote. Iako se ranije mislilo da je probavni sustav djeteta pri rođenju sterilan, a zatim započinje njegova kolonizacija, 2008. godine osjetljivim je metodama dokazana prisutnost bakterija u mekoniju (13). Također, placenta sadrži nekoliko sojeva nepatogenih bakterija, koje najvjerojatnije odgovaraju majčinom oralnom mikrobiomu (14). Stoga se može zaključiti da okolišni čimbenici povezani s majkom (prije svega prehrana) putovanjem kroz placentu mogu utjecati na sastav mikrobiote fetusa i razvoj njegovog imunološkog sustava (15). Rani kolonizatori probavnog sustava djeteta postporođajno su uglavnom enterični i kožni fakultativni anaerobi (Lactobacillus, Enterococcus, and Streptococcus) te koagulaza negativni stafilokoki. Zatim počinju doiminirati obligatni anaerobi (Bifidobacterium, Bacteroides, Clostridium i Eubacterium), a u dobi 3 godine sastav crijevne mikrobiote postaje sličan odraslome, uz iznimku zapadnih zemalja, gdje se maturacija događa već u dobi godinu dana (16). U djece rođene vaginalnim putem, dominiraju Lactobacillus, Prevotella ili Sneathia, a kod djece rođene carskim rezom kožne bakterije Staphylococcus, Corynebacterium, i Propionibacterium (17). U vaginalno rođene djece izraženiji je stanični nego humoralni imunološki odgovor (18). Mikrobiota potiče aktivaciju imunološkog odgovora u interakciji s epitelnim stanicama sluznica te drugim imunokompetentnim stanicama putem posebnih receptora smještenih intracelularno te na površini epitelnih stanica, od kojih je najpoznatija obitelj TLR (od engl. Toll-like receptor). Ovi receptori imaju sposobnost prepoznavanja bakterijskih epitopa. TLR dijele se u dvije skupine: 1) TLR1, 2, 4, 5, 6, 10 i 11 smješteni su na površini stanica, a prepoznaju proteine, lipoproteine i polisaharide na staničnoj površini bakterija, te 2) TLR3, 7, 8 i 9, koji su smješteni intracelularno, prepoznajući bakterijske nukleinske kiseline (tablica1). TLR ligand TLR1 triacillipopeptidi TLR2 lipoproteini, peptidoglikani TLR3 dvostruka RNA TLR4 lipopolisaharidi, HSP60 TLR5 flagelin TLR6 diacillipopeptidi TLR7 sintetskekomponente TLR8 nepoznat TLR9 CpG DNA TLR10 nepoznat TLR11 nepoznat

Imunološki sustav gastrointestinalnog trakta organiziran je u limfno tkivo pridruženo sluznici probavne cijevi-GALT (od engl. gut associated lymphoid tissue). Nedavno je prepoznata i imunološka uloga epitelnih stanica koje luče antimikrobne peptide, produciraju crijevni glikokaliks i imaju predočnu funkciju. Dendritičke stanice (CD 103+ DS) glavne su predočne stanice crijevne imunosti. Potiču imunoregulatorne mehanizme, kojima se prema antigenima hrane i crijevne mikrobiote normalno uspostavlja imunotolerancija. Glavni je mehanizam uspostave imunotolerancije poticanje diferencijacije naivnih limfocita T prema regulatornim limfocitima (T reg). T reg lučenjem antiinflamatornih citokina IL-10 i TGFß (transformirajući čimbenik rasta β), inhibiraju proinflamatornu imunološku kaskadu (Th1, Th2, Th17). U uspostavi imunotolerancije ulogu imaju i sekretorna IgA antitijela koja smanjuju imunogenost antigena, okružuju ih i odvajaju od sluznice, te sprječavaju kontakt s imunološkim stanicama. Pravilna diferencijacija limfocita T ovisi o interakciji stanica nespecifične imunosti i crijevne mikrobiote. U sluznici probavnog sustava nalazi se oko 1013 bakterija, od kojih 85% čine laktobacili i bifidobakterije. Za mnoge je pripadnike crijevne mikrobiote (B. fragilis, F. prauznitsii) pokazano da stimuliraju upravo diferencijaciju T reg. Poremećaj diferencijacije T reg i promjene crijevne mikrobiote smatraju se važnima u razvoju alergijskih reakcija na hranu. Stoga se proučava terapijska uloga probiotika i specifične imunoterapije, s ciljem poticanja imunotolerancije. Kod bolesnika s upalnim bolestima crijeva, nađeno je niz promjena nespecifične i specifične imunosti. Najčešće se spominju polimorfizmi NOD2 (od od engl. Nod-like receptor) i TLR4 (od engl. Toll-like receptor) te dominacija Th17 limfocitnog odgovora. Niz je novosti vezanih uz patogenezu celijakije koja je povezana s Th1 i Th2 obrascima preosjetljivosti na gluten i njegove frakcije. Otkrivena je značajna uloga IL-15 u patogenezi refraktorne celijakije, što otvara mogućnost uspješnijem liječenju ovih bolesnika. Sindrom iritabilnog crijeva također se povezuje s imunološkim promjenama te se postižu dobri terapijski rezultati probioticima. Eozinofilni ezofagitis i gastroenteritis u posljednje su vrijeme u porastu te se povezuju s alergijama na hranu. Ipak, potrebna su daljnja istraživanja njihove patogeneze., The mucosal immune system includes diffuse lymphoid cells and organized lymphoid structures that form gut associated lymphoid tissue-GALT. The immunological role of epithelial cells has also been confirmed. They produce glycocalyx and antimicrobial peptides that control different classes of microorganisms. Dendritic cells (DC) have the main role in antigen presenting. Under steady-state conditions, CD 103+ DC are specialized in driving mucosal tolerogenic responses. They induce T regulatory cell development. T reg produce IL-10 and TGFß (transforming growth factor β), that have an antiinflamatory effect and inhibit Th1, Th2 and Th17 cell development. IgA are also important to control intestinal immune homeostasis via two actions. They reduce the expression of inflammatory bacterial epitopes by opsonization and inhibit their contact with immune cells. The intestinal microbiota is composed of 1013 microorganisms. Lactobacilli and Bifidobacteria dominate (> 85% of total bacteria). Microbiota has diverse effect on immune cells. For instance, B. fragilis and F. prauznitsii are able to promote T reg differentiation. The role of gut microbiota dysbiosis and deviation in T reg cells differentiation has been well studied in the pathogenesis of food allergy. Further studies are needed to investigate therapeutic effects of probiotics and speciffic imunotherapy. There are many disorders in adaptive and innate immunity whitch are thought to have a role in the pathogenesis of inflammatory bowel disease. Mutations of NOD2 (Nod- like receptor) and TLR4 (Toll- like receptor), as well as increased activity of Th17 pathway, have been studied in the context of inflammatory bowel disease. New pharmacological approaches due to these mechanisms are needed to be studied. Coeliac disease is both Th1 and Th2 disorder caused by a gluten hypersensitivity. The role of IL-15 in refractory coeliac disease has recently been highlighted. Irritable bowel syndrom has also been explained by some immunological mechanisms. Recent studies have shown that probiotics have good results in treatment of these patients. Eosinophilic esophagitis and eosinophilic gastroenteritis have receantly been recognised as increasing disorders, at least partly connected with food allergy. Further studies are needed to explain pathogenesis of these disorders.

In vitro-dijagnostika alergijskih bolesti temelji se na određivanjju koncentracije ukupnih i specifičnih IgE-protutijela u serumu, koncentraciji IgG-protutijela, serumske triptaze, eozinofilnoga kationskog proteina te testu aktivacije bazofilnih granulocita. Upotreba in vitro-dijagnostičkih testova mora biti temeljena na korelaciji anamneze, kliničke slike te in vivo provokativnih testova. Kliničko značenje povećane serumske koncentracije serumskih IgE-a u dijagnostici alergijskih bolesti jest ograničena, budući da se ona susreće i u drugim nealergijskim bolestima. Povećana konc. specifičnih IgE-a zajedno s pozitivnom anamnezom, indikativne su za klinički značajnu alergijsku bolest. Preporučena laboratorijska metoda za određivanje koncetracije IgE-a u serumu jest fluoeoenzimimunokemijska metoda. Povećane serumske koncentracije IgG-protutijela nemaju dokazanu ulogu u dijagnostici alergije na hranu, a mogu poslužitiu procjeni uspješnosti alergen-specifične imunoterapije (ASIT) na alergene kukaca te procjeni rizka razvoja anafilaksije uzrokovane ovom skupinom alergena. Povećana koncentracij atriptaze (podtip beta), indikator je degranulacije mastocita uzrokovane specifičnim alergenom. Povećanje koncentracije ECP-a nastupa tijekom kasne faze alergijske reakcije, te se može koristiti u praćenju alergijskih i drugih upalnih stanja u kojima eozinofilni granulociti imaju glavnu ulogu. Test aktivacije bazofilnih granulocita (BAT) temelji se na određivanju staničnih razlikovnih obilježja CD63 i CD203 metodom protočne citometrije. BAT je koristan u dijagnostici alergija na alergene kukaca, nutritivnih te medikamentnih alergija. Alergološka dijagnostika temeljena na ekstraktima alergena može se koristiti u monosenzibiliziranih bolesnika s jasnom kliničkom slikom te u bolesnika kojima se planira propisati samo simptomatska terapija. U suvremenoj su kliničkoj praksi razvijenih zemalja mnogo češćo špčosenzibilizirani bolesnici s kompleksnom simptomatologijom te sumnjom na križnu reaktivnos. Kod tih se bolesnika preporuča kotistiti molekularnu alergološku dijagnostiku.

Prikaz slučaja bolesnika sa solitarnim rektalnim ulkusom i mogućom diferencijalnom dijagnozom.

Prikaz slučaja kod pacijenta s inicijalnom manlnutricijom i depresijom kao prodromalnim simptomima reumatoidnog artritisa

U radu je prikazan slučaj pacijenta s orijaškim perianalnim kondilomom.

Prikaz slučaja kod pacijenta s atipičnom slikom za hemokromatozu.

U radu se prikazuju razlike u histološkom nalazu u odnosu na kliničku prezentaciju kod bolesnika s intestinalnom limfangiektazijom.

U radu se prikazuje slučaj pacijentice s multiplim primarnim tumorima.

U ovom radu se prikazuje diferencijalna dijagnoza slučaja nodularne fokalne hiperplazije.