• Allergy, Asthma & Respiratory Disease
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• v.12 no.4
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• pp.170-176
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• 2024

Atopic dermatitis is one of the most common chronic skin inflammatory diseases in children. Appropriate treatment is difficult due to chronic course with frequent exacerbations, especially in children. Treatment requires caution due to a lack of safety data and information regarding the long-term prognosis of management strategies. The Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD) published the Atopic Dermatitis Treatment Guidelines in 2008, which has been used to direct atopic dermatitis treatment. Accumulating evidence suggests that the guidelines need to be updated regarding bathing methods (duration of bath, temperature, etc.), wet wrap therapy, and topical treatments in line with environmental changes over time and changes in the management strategies of atopic dermatitis. This KAPARD guidelines for atopic dermatitis applied an adaptation based on a systematic review and analysis of selected literature. They are intended to support front-line doctors treating pediatric and adolescent patients with atopic dermatitis in making reasoned, safe, effective empirical treatment decisions. In Part I of the KAPARD guidelines for atopic dermatitis, we included evidence-based skin care management strategies and topical treatment options.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.74-79
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• 2014

Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.409-415
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• 2007

Allergy skin prick test and intradermal test represent one of the major tools in the diagnosis of IgE-mediated diseases like as atopic asthma, allergic rhinitis, atopic dermatitis, food and drug allergy, and insect bite when properly performed. Skin tests are of particular importance in fields such as allergen standardization, pharmacology, and epidemiology. Even if skin tests seem easy to perform, adequate and proper interpretation requires well-trained physicians who can recognize the numerous factors that may modify the results of skin tests.

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.139-140
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• 2021

• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.164-170
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• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.392-402
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• 2021

Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, followed by an open food challenge (OFC) with cow's milk-based formula (CMF). Infants with confirmed CMPA remained on AAF until 9 months of age, in conjunction with a cow's milk protein-free complementary diet. Body weight, length, and head circumference were measured at enrollment and 9 months of age. Measurements were converted to weight-for-age, length-for-age, and head circumference-for-age Z scores (WAZ, LAZ, HCAZ), based on the World Health Organization growth reference. Results: Of 254 infants (median age 16.1 weeks, 50.9% male), 218 (85.8%) were diagnosed with non-IgE-mediated CMPA, 33 (13.0%) tolerated CMF, and 3 (1.2%) did not complete the OFC. The mean WAZ decreased from 0.119 to -0.029 between birth and enrollment (p=0.067), with significant catch-up growth to 0.178 at 9 months of age (p=0.012) while being fed the AAF. There were no significant changes in LAZ (0.400 vs. 0.552; p=0.214) or HCAZ (-0.356 vs. -0.284; p=0.705) from the time of enrollment to age 9 months, suggesting normal linear and head growth velocity. Conclusion: The amino acid-based study formula, in conjunction with a cow's milk proteinfree complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.

• Journal of agricultural medicine and community health
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• v.34 no.2
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• pp.175-187
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• 2009

Objectives: This study was conducted to investigate whether joint effects between family allergy history and environmental tobacco smoke(ETS) by parents were associated with pediatric asthma and wheezing. Methods: The study objects of this study were 2301 element school students and their parents in an urban-rural areas of Gyeonggi-do. Pediatric asthma and wheezing were identified by measures of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires. We investigated history of parental allergy, ETS, and other socioeconomic status of both parent. Data were analyzed using logistic regression methods. Results: After adjusting other variables, children with maternal asthma history were more likely to be reported life time wheezing (OR: 3.79 95%CI:2.43-5.90), recent wheezing (OR:4.09 95%CI:2.28-7.38), and diagnostic asthma (OR:2.61 95%CI: 1.44-4.75). Paternal asthma history increasing risk of life time wheezing (OR 2.01 95%CI:1.19-3.38) and recent wheezing (OR:2.38 95%CI:1.24-4.56). Joint effect between parental allergy history and ETS significantly effected on child's life time wheezing and recent wheezing. The risks of life time wheezing (OR:2.47 95%CI:1.64-3.717) and recent wheezing (OR: 2.51 95%CI:1.34-4.69) were significantly higher than others without both factors. The risk of recent wheezing of children with maternal recent smoking and parental allergy history (OR:4.83 95%CI:1.89-12.33) was higher than their counterpart. Conclusions: The result of this study implies that children with family allergy history and passive smoking are more likely to be get asthma and wheezing than children with family allergy history and non-passive smoking. This study provide the object information to increase the efficiency of non-smoking campaign and education for decreasing pediatric asthma risk.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.355-361
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• 2008

Pollen is very important causing factor for allergy such as allergic rhinitis, allergic conjunctivitis, and asthma, and pollen allergy has a remarkable clinical impact all over Korea. The main pollination period covers about half the year, from spring to autumn, and the distribution of airborne pollen taxa of allergological interest is related to pollen season dynamics. Korean academy of pediatric allergy and respiratory diseases (KAPARD) has evaluated the pollen characteristics and nationwide pollen count for over 10 years since 1997. Airborne particles carrying allergens were collected daily from nationwide 8 stations (Seoul, Guri, Cheongju, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler (Burkard Manufacturing Co Ltd, Hertfordshire, UK) in South Korea (July 1, 1997-June 30, 2007). They were counted and recorded along with the meteorological factors daily. Tree pollen is a major airborne allergen in spring, grass is most common in summer, and weed pollen is major pollen in autumn in Korea. There has two peak seasons for pollen allergy, as summer and autumn. There is some evidence suggesting that the prevalence of allergic diseases in Korea has been on the increase in the past decade. However, recent findings of the phase I and II studies of the international Study of Asthma and Allergies in Childhood (ISAAC) study showed the absence of increases or little changes in prevalence of asthma symptoms and diagnosis rates in Korea, whereas the prevalence of allergic rhinitis and atopic dermatitis were increased. We reported the evidence that sensitization rate to weed pollen has been increased yearly since 1997 in childhood. Climate change and air pollution must be the major causing factors for the increase of pollen counts and sensitization rate to pollen. Climate change makes the plants earlier pollination and persisting pollination longer. In conclusion, data on pollen count and structure in the last few years, the pathogenetic role of pollen and the interaction between pollen and air pollutants with climate change gave new insights into the mechanism of respiratory allergic diseases in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.1
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• pp.43-49
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• 2023

Purpose: The cow's milk-related-symptom-score (CoMiSS) tool was developed as an awareness tool for the assessment of cow's milk-related symptoms in infants or children. Fecal calprotectin (FC) is a noninvasive biomarker of gut inflammation that can be measured in serum and stool. This study aimed to investigate the relationship between FC levels and CoMiSS scores in infants with cow's milk protein allergy. Methods: Infants (aged 6-12 months) who were allergic to cow's milk protein were enrolled prospectively. Following completion of the CoMiSS scoring, the infants were divided into group 1 (positive CoMiSS scores ≥12) and group 2 (negative CoMiSS scores <12). FC was measured using immunoassay. Results: Of the 120 infants enrolled in this study, 60 (50.0%) had positive CoMiSS scores (group 1), while 60 (50.0%) had negative scores (group 2). The mean FC level was higher in the infants in group 1 than those in group 2 (2,934.57 ㎍/g vs. 955.13 ㎍/g; p<0.001). In addition, there was a positive correlation between FC and CoMiSS scores (R=0.168, p<0.0001). A FC level of 1,700 ㎍/g provided a sensitivity of 98.3%, specificity of 93.3%, and accuracy of 95.8% for the diagnosis of cow's milk protein allergy (CMPA). Conclusion: FC measurement may have a role in the assessing infants with CMPA.

• Clinical and Experimental Pediatrics
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• v.63 no.6
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• pp.203-210
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• 2020

The drug allergy "label" may have a lifetime of consequences for a child. Many children with alleged drug allergies are proven to be tolerant to the culprit medication when challenged. The field of drug hypersensitivity is a recently evolving field of research, but studies on its epidemiology and diagnostic tools are lacking in children. Clinical history is significant in the diagnosis and classification of drug hypersensitivity in children. Diagnostic tools have been evaluated in a limited number of children; therefore, the guidelines are mainly in line with those for adults. Here, we review the clinical characteristics, main drugs, risk factors, and diagnosis of drug hypersensitivity to aid in its accurate diagnosis in children.