• Title/Summary/Keyword: Pediatric allergy

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A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants

  • Vandenplas, Yvan;Munasir, Zakiudin;Hegar, Badriul;Kumarawati, Dewi;Suryawan, Ahmad;Kadim, Muzal;Djais, Julistio Tb;Basrowi, Ray Wagiu;Krisnamurti, Deni
    • Clinical and Experimental Pediatrics
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    • v.62 no.5
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    • pp.149-154
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    • 2019
  • The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.

Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

  • Kim, Mi-Ae;Kim, Dong-Kyu;Yang, Hyeon-Jong;Yoo, Young;Ahn, Youngmin;Park, Hae-Sim;Lee, Hyun Jong;Jeong, Yi Yeong;Kim, Bong-Seong;Bae, Woo Yong;Jang, An-Soo;Park, Yang;Koh, Young-Il;Lee, Jaechun;Lim, Dae Hyun;Kim, Jeong Hee;Lee, Sang Min;Kim, Yong Min;Jun, Young Joon;Kim, Hyo Yeol;Kim, Yunsun;Choi, Jeong-Hee;Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.648-661
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    • 2018
  • Purpose: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. Methods: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. Results: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. Conclusions: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

Parthenolide Inhibits Ovalbumin-Induced cyclooxygenase-2 and Inducible Nitric Oxide Synthase Expression

  • Youn, Hyung-Sun
    • Biomedical Science Letters
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    • v.18 no.3
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    • pp.319-323
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    • 2012
  • In recent years, egg allergy has been raised as the most prevalent food hypersensitivity in the pediatric population. One of the major egg allergens is ovalbumin (OVA) which is the major protein in egg white, comprising 54% of its total protein content. Parthenolide isolated from Tanacetum partheniumb has been used to treat many chronic diseases for many years. In the present report, we present biochemical evidence that parthenolide inhibits the nuclear factor-${\kappa}B$ (NF-${\kappa}B$) activation induced by OVA. Parthenolide also inhibits OVA-induced cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) expression. These data suggest new approaches for the efficient alleviation of the allergic symptoms.

A Change in the Diagnosis of a Korean Pediatric Outpatients following the COVID-19 Pandemic (코로나19 유행에 따른 한방소아청소년과 외래 환자의 진단명 변화)

  • Seo, Hae Sun;Park, So Hyun;Park, Sul Gi;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.16-33
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    • 2021
  • Objectives This study aims to provide directions for future Korean pediatric medicine treatment and researches by analyzing the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic. Methods We analyzed the medical records of 10,868 new patients aged 0-18 who visited the Korean pediatrics at Kyung Hee university hospital from January 1, 2019 to June 30, 2021. All patients were divided into 2 groups; patients who visited from January 1, 2019 to December 31, 2019, before the coronavirus epidemic, and patients who visited from January 1, 2020 to June 30, 2021, after the coronavirus epidemic. Within the two groups, the diagnosis distribution was performed for the entire population, by gender and by age group. Diagnoses were classified as allergy, growth, gastrointestinal, respiratory, general body supplementation, neuropsychiatric, skin, urogenital, musculoskeletal, and other systems. Results According to the comparative analysis results of before and after the COVID epidemic, there was a decreasing trend of diagnoses in relates to allergy, respiratory, urogenital, musculoskeletal system. On the other side, there was an increasing trend in gastrointestinal, general body supplementation, growth, neuropsychiatric, skin and other system. Changes in diagnosis based on gender and age group will be described below. Conclusions This study analyzed the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic, and suggested the direction of future Korean medicine treatment and researches for pediatrics. Also, this study aimed to propose proper treatments for children by showing the role of Korean pediatric medicine related to growth and development of children during the epidemic. However, this study has limitations such as failure to track the long-term impact of COVID-19. Thus, long term follow-up studies are needed to show the effect of COVID-19 on Korean pediatric medicine.

Middle East Consensus Statement on the Diagnosis and Management of Functional Gastrointestinal Disorders in <12 Months Old Infants

  • Vandenplas, Yvan;Alturaiki, Muath Abdurrahman;Al-Qabandi, Wafaa;AlRefae, Fawaz;Bassil, Ziad;Eid, Bassam;El Beleidy, Ahmed;Almehaidib, Ali Ibrahim;Mouawad, Pierre;Sokhn, Maroun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.153-161
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    • 2016
  • This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and ${\beta}$-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added ${\beta}$-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.

Polymorphisms of the CTLA-4 promoter(-318) and exon 1(+49) genes with atopic dermatitis in Korean children (아토피피부염 환아에서 CTLA-4 exon 1과 promoter 유전자 다형성)

  • Song, Tae Won;Yang, Hea Sun;Lee, Kyung Eun;Kim, Kyung Won;Kim, Eun Soo;Sohn, Myung Hyun;Kimc, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.545-551
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    • 2006
  • Purpose : The gene-encoding cytotoxic T lymphocyte-associated antigen-4(CTLA-4) is one of the candidate genes for conferring susceptibility to atopic dermatitis(AD). The aim of the study was to investigate the association between Korean children with AD and the polymorphisms of CTLA-4 gene promoter(-318) and exon 1(+49). Methods : The CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) polymorphisms were genotyped via restriction fragment length polymorphism methods in 145 children with atopic eczema, 69 children with non-atopic eczema, and 96 healthy controls. Results : There was no significant difference in genotype and allele frequencies of the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms when the atopic eczema, non-atopic eczema, and control groups were compared. Additionally the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms were not shown to be associated with severity, IgE level, or eosinophil counts. Conclusion : Our data show that the polymorphisms within the CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) genes are not associated with susceptibility to AD in Korean children.

Increased B cell-activating factor (BAFF) level in the sputum of children with asthma

  • Jee, Hye-Mi;Choi, Bong-Seok;Kim, Kyung-Won;Sohn, Myung-Hyun;Han, Man-Yong;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.795-800
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    • 2010
  • Purpose: B cell-activating factor (BAFF) is a tumor-necrosis factor (TNF) superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is observed in naive cells as well as in effector/memory T cells. We aimed to explore whether BAFF in sputum is expressed at elevated levels in asthmatic airways and associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. Methods: One hundred and fifty-four asthmatic children and 98 healthy children were enrolled in the study. Sputum supernatants were collected and sputum BAFF and eosinophil cationic protein (ECP) levels were measured. We performed pulmonary function tests and methacholine challenge tests, while measuring total eosinophil count, total serum IgE, and serum ECP in all subjects. Results: Asthmatic children had significantly higher levels of BAFF in induced sputum [26.50 (10.50-100.27) pg/mL] compared to healthy children [18.32 (7.68-44.63) pg/mL; $P$=0.011]. Sputum BAFF positively correlated with sputum eosinophils (${\gamma}$=0.406, $P$<0.001) and sputum ECP (${\gamma}$=0.789, $P$<0.001). Significant negative correlations were found between sputum BAFF and FEV1 (${\gamma}$=-0.291, $P$<0.001) or post-bronchodilator FEV1 (${\gamma}$=-0.334, $P$<0.001), whereas nonsignificant correlations were found between sputum BAFF and bronchial hyperresponsiveness, serum eosinophil count, and serum ECP. Conclusion: These findings suggest that BAFF may play a role in childhood asthma, and BAFF levels in sputum could be a supportive marker that represents airway inflammation, especially eosinophilic inflammation.

Clinical and laboratory findings of childhood buckwheat allergy in a single tertiary hospital

  • Park, Kyujung;Jeong, Kyunguk;Lee, Sooyoung
    • Clinical and Experimental Pediatrics
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    • v.59 no.10
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    • pp.402-407
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    • 2016
  • Purpose: Buckwheat allergy is one of the most severe types of food allergy in some countries, especially among children. However, few studies have investigated this condition. The aim of this study was to report the clinical and laboratory findings in Korean children with buckwheat allergy. Methods: Thirty-seven subjects, aged 1 to 14 years, were enrolled by retrospective medical record review from January 2000 through May 2015 at the Department of Pediatrics in Ajou University Hospital. The demographic profile, previous exposure to buckwheat pillows, clinical symptoms, and laboratory findings of each subject were recorded. Results: Twenty-six of the 37 children had immediate-type allergic symptoms to buckwheat, while 11 subjects were tolerant to buckwheat. Seventeen out of 26 buckwheat allergic children (65.4%) had anaphylaxis. The median buckwheat specific IgE level in the buckwheat allergic group ($7.71kU_A/L$) was significantly higher (P<0.001) than in the buckwheat tolerant group ($0.08kU_A/L$) with an optimal cutoff value of $1.27kU_A/L$ (sensitivity 84.6%, specificity 100%). When adjusted for age, the difference between the 2 groups showed no statistical significance (P=0.063). In subjects who had anaphylaxis, buckwheat-specific IgE levels ranged from 0.37 to $100kU_A/L$. Conclusion: Almost two-thirds of buckwheat-allergic children had anaphylaxis, and a wide-range of buckwheat specific IgE levels were observed in these children. Anaphylaxis occurred in a subject with a remarkably low IgE level ($0.37kU_A/L$).

HYPERACTIVE BEHAVIORAL CHARACTERISTICS BY PARENTAL REPORTS IN ALLERGIC CHILDREN (부모보고에 의한 알레르기 환아의 과잉 행동특성)

  • Choi, Bo-Moon;Lee, Joon-Sung;Park, Nan-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.98-105
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    • 1993
  • Objective ' The purpose of this study was to investigate the behavioral characteristics of children with allergic disease Method : In a population of 80 children who were registered at a pediatric allergic clinic in Kangnam St Mary's hospital, parents completed a standardized child behavior checklist (CBCL) to evaluate their children Clinical factors associated with allergy were examined in relation to the rated scores of CBCL Results : Allergic children were rated significantly more aggressive and delinquent, and less withdrawned on the CBCL rating when compared to the age- and sex-matched normal control children. Within the allergic population, children who had family history of allergic disease had higher scores of CBCL in hyperactivity and aggressive behavior than the children without family history. Conclusion : The results were discussed with the respect to familial traits of allergy and temperament as risk factors for the emergence of behavior problems in childhood allergy

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Clinical Study for Herbal Medicine Therapeutic Effect on the Pediatric Chronic Sinusitis using Plain Radiography and Computed Tomography (소아(小兒) 축농증(蓄膿症)의 한방(韓方) 치료효과(治療效果)에 대한 단순촬영(單純撮影) 및 CT(전산화단층촬영(電算化斷層撮影))를 이용한 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Junng;Jin Gong-Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.2
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    • pp.187-224
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    • 1999
  • Background: In recent years, pediatric chronic sinusitis patients who don't respond with antibiotics are increasing, but there are a few reports on the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis before and after treatment using computed tomograpy (CT) and plain radiograpy. Materials and methods: Ninty patients (45 mail and 45 femail) treated in our hospital between February 1998 and August 1999 were studied. Ages ranged from 3 to 13 years (mean age :6.5 years). Sixty two patients had a underlyiing family history (allergy or sinusitis of parents or brothers), In the past history, 68 patients had asthma, allergy of milk, atopic dermatitis, bronchiollitis and irritable bowel syndrom. Illness period was from 10 days to 96 months (mean period:12.4 month). Duration of treatment were from 25 days to 200days (mean:96 days). To ascertain the efficacy of treatment, CT in the 42 and plain radiopgrapy in the 48 patients were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. CT findings of the chronic sinusitis were analyzed for mucoperiostal thickening before and after treatment using 4 grades;(normal, mild, moderate, severe). Normal was defined as below 3mm thickening of mucoperiosteum; mild was 3-5mm thickening; moderate was 5mm-1cm thickening; severe was above 1cm thickening. Plain radiograpy using Water's view provided maxillary sinus, anterior ethmoid sinus, frontal sinus. Normal was defined as simillar to density between sinus and oronasal cavity; mild was defined as generally increased density with no significant mucoperiosteal thickning; moderate was partial mucosal thickening without bony hypertropy; severe was total haziness with mucoperiosteal thickening. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms Results: Of the 90 patients, 84 patients showed complete recovery (93%), 4 patients showed no significant interval change(4%) and 2 patients were aggrevated (2%). Sixty patients were severe(67%) and 26 patients were moderate (29%), 4 patients were mild(4%) The duration of treatment was varied with patient conditions (91 days in average); severe were 101.7 days, moderate were 70 days and mild were 63 days. Fifty three patients with maxillary and ethmoid sinusitis were 114 days, 35 patients with maxillary sinusitis only were 71.5 days. Fifty eight patients with both maxillary sinusitis were 94.6 days, 26 patients with either maxillary sinusitis were 65 days. The symtoms of chronic sinusitis were nasal obstruction(75%), cough(69%), purulunt or mucosal discharge(62%), lymphoid follicle(54%), postnasal dripping(49%), headache(23%) and nose bleeding(22%). Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis using plain radiograpy and CT. The duration of treatment may be significant assosiation with the location and degree of chronic sinusitis.

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