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    Experiences and attitudes of parents of children with cow's milk and other food-allergy
    (Codon Publications, 2022) Karakurt, Tuba; Bozkurt, Hayrunnisa Bekis; Kaplan, Fatih; Aksit, Anil; Cavkaytar, Ozlem; Topal, Erdem; Arga, Mustafa
    Introduction and objective: The attitude and behaviors of parents are important in the management of children with food allergy (FA). The aim of this study is to evaluate the experiences and attitudes of parents of children with allergy to cow's milk and other FA. Materials and methods: The parents of children with FA were asked to complete an 18-item questionnaire to evaluate the FA history and experiences during diagnosis, treatment, and follow up. Results: The data from 558 (91.2%) survey questionnaire that were filled completely were analyzed. The mean age of the parents was 33.4+4.9. It was found that most common food allergen was cow's milk (85.3%). The mean time to diagnosis from the onset of symptoms was 10.9 +/- 18.4 months. Around 229 parents (41.6%) admitted to at least four different physicians and 68 (12.3%) parents admitted to at least five different physicians before diagnosis. The median time to diagnosis from the onset of symptoms was five (1-108) months in the patients admitted to four or more physicians, but it was one (1.48) month in the patients that admitted to less physicians (p<0.001). The most common symptoms were dermatitis and mucus-bloody stool, the least common ones were cardiovascular symptoms. Only 21.1% of the patients were able to use hypoallergenic formulas (HAF) in accordance with the recommendation of the physician. Conclusions: Delayed diagnosis of FA is a major concern, and during this period the patients admit many physicians. A majority of the patients with CMPA experience difficulties while using HAFs, and only one-fifth of them is able to use formula regularly. (C) 2022 Codon Publications. Published by Codon Publications.
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    Proven Food-Induced Acute Urticaria and Predictive Factors for Definitive Diagnosis in Childhood
    (Karger, 2021) Aydogan, Metin; Topal, Erdem; Uysal, Pinar; Acar, Hazal Cansu; Cavkaytar, Ozlem; Demirkale, Zeynep Hizli; Aydogmus, Cigdem
    Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.
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    Subcutaneous allergen-specific immunotherapy with Gramineae pollen in children with allergic rhinoconjunctivitis
    (2023) Yılmaz, Ercan; Topal, Erdem; Karagol, Hacer Ilbilge Ertoy; Ozbey, Mehmet Yavuz; Cavkaytar, Ozlem; Arga, Mustafa
    Aim: Patients experiencing persistent complaints of moderate-severe allergic rhinoconjunctivitis despite symptomatic treatment are considered candidates for Allergen Specific Immunotherapy (ASIT). The present study aims to assess the effectiveness and safety of ASIT using Gramineae pollen in children afflicted by allergic rhinoconjunctivitis. Materials and Methods: The study involved participants between 5 and 18 years of age who had allergic rhinoconjunctivitis. These participants were divided into two distinct groups. The initial group underwent ASIT, while the other constituted the control group that refrained from it. The control group comprised participants with akin ages and equivalent disease durations. Visual analog scores (VAS), daily symptom scores (dSS), daily medication scores (dMS), and combined symptom and medication scores (CSMS) were assessed at three specific time junctures: Baseline, post the initial year of ASIT, and after the second year of ASIT. Results: The study encompassed 188 children who had been diagnosed with allergic rhinoconjunctivitis. Among these, 94 patients had undergone immunotherapy. Of the total cases, 105 (55.9%) were male, with a median age of 14 years (range: 7-18 years). Among the patients who had received ASIT, there were statistically significant reductions in VAS, dSS, dMS, and CSMS after one and two years of therapy when compared to the baseline values (p<0.001). Upon comparing the group receiving ASIT with the control group after a two-year follow-up, notable reductions were observed in VAS, dSS, dMS, and CSMS (p<0.001). Five patients (5.3%) experienced systemic reactions. Conclusion: The current study demonstrated that ASIT with Gramineae pollen is clinically effective in patients with Graminae pollen-induced allergic rhinoconjunctivitis.