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Öğe Acquired atopic disease after liver transplantation in children; similarities to and differences from adults: a preliminary study(Lippincott Williams & Wilkins, 2014) Topal, Erdem; Catal, Ferhat; Selimoglu, Mukadder Ayse; Karabiber, Hamza; Kilic, Talat; Baskiran, Adil; Senbaba, ElifObjective The aim of this study was to determine the similarities and differences in the frequency and follow-ups of newly diagnosed atopic diseases after liver transplantation in pediatric and adult patients. Materials and methods Patients who underwent liver transplants between 2005 and 2013 and who are still alive were enrolled in the study. Patients who came for checkups filled out a survey evaluating atopic diseases. Those who had an atopic disease before transplantation were excluded from the study. Results A total of 165 patients were enrolled in this study; 114 (69.1%) were males and 29 (17.6%) were children. The average transplantation age was 40.8 (0.3-67) years, and the most frequent reason for transplantation was chronic viral hepatitis. In 22 patients, atopic diseases [allergic rhinitis in nine patients (5.5%), asthma in six patients (3.9%), atopic eczema in six patients (3.9%), food allergy in six patients (3.9%), and drug allergy in one patient (0.6%)] developed after transplantation. Atopic diseases after transplantation were more common in children (P=0.03). When the atopic diseases were examined on a case-bycase basis, there were no differences between children and adults with respect to asthma (P=0.284), allergic rhinitis P=1.0), or atopic eczema (P=0.284), but food allergy (P=0.009) and peripheral eosinophilia (P=0.002) were more common in children. The periodicity of allergic diseases after transplantation (P=0.192) and total IgE levels (P=0.086) were similar. Conclusion Atopic diseases developed after liver transplantation and had a greater impact on children than adults. Therefore, after undergoing liver transplantation, patients should be monitored closely for signs of atopic diseases. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe A case of acute generalised exanthematous pustulosis (AGEP) induced by amoxicillin-clavulanic acid(Bilimsel Tip Yayinevi, 2014) Senbaba, Elif; Catal, Ferhat; Topal, Erdem; Ermistekin, Halime; Varol, Fatma Ilknur; Akpolat, NusretAcute generalised exanthematous pustulosis (AGEP) is a rare skin reaction characterized by sterile, small pustules on the erythematous background. Drugs, especially antibiotics are major caustic factors in etiology. The diagnosis of disease is made by the scoring system which determined by European Severe Cutaneous Adverse Reactions (EuroSCAR)s' working group. The four-year-old patient applied with the complaint of numerous pustular skin eruptions on the erythematous background and had the history of amoxicillin-clavulanic acid treatment which was given two days ago. The biopsy samples were taken from pustular lesions. The diagnosis of AGEP was made according to EuroSCAR score, evaluating clinical feature and the histopatological examination of the biopsy sample. In this presentation, we aimed to emphasize that AGEP can rarely be seen in childhood age and to review the clinical properties, diagnosis and treatment of disease.Öğe Delayed severe systemic reaction (anaphylaxis) after subcutaneous immunotherapy injections: case report(Bilimsel Tip Yayinevi, 2013) Senbaba, Elif; Catal, Ferhat; Topal, Erdem; Ermistekin, Halime; Yildirim, Nurdan; Sinanoglu, M. SelcukCurrently, allergen specific immunotherapy is administered to allergic rhinitis or asthmatic patients with uncontrolled symptoms despite medical treatment and avoidance of environmental allergens. Local or systemic reactions can occur after subcutaneous immunotherapy. Although almost all severe systemic reactions are reported to begin within 30 minutes after administration of injections, late onset reactions could be seen. Our case was 15 years old female patient with asthma whose complaints could not controlled by medical treatment and subcutaneous immunotherapy with Dermatophagoides farinae extract that she was sensitized was administered to her. Severe systemic reaction (anaphylaxis) has developed in the patient within fourth hours of post-injection observation period at the maintenance dose of 0.8 mL. We want to emphasize that severe late onset systemic reactions are rare but could occur after subcutaneous immunotherapy injections.Öğe Developing anaphylaxis to egg after liver transplantation: a case report(Bilimsel Tip Yayinevi, 2014) Senbaba, Elif; Catal, Ferhat; Topal, ErdemFood allergy has been increasingly reported in children who had orthotopic liver transplantation. The exact mechanism of post-liver transplantation allergies remains to be elucidated. Children are at risk for the development of food allergy for the first year of transplantation and immunosuppression with tacrolimustreated patients. 11-month-old patient that underwent transplantation of liver at the month of 5 due to giant cell hepatitis, consulted to our pediatric emergency department after 15 minutes with body itching, redness, swelling of the lips, and rapid breathing, cough after 10 minutes of eating egg. The patient was diagnosed as anaphylaxis, and then injected epinephrine intramusculer. After 4 weeks, the patient whose clinical findings improved, 5 x 5 mm induration (negative control 0 mm, positive control, 6 x 6 mm) of white egg were detected in the skin prick test. Our aim of presenting this fact is to emphasize the necessity to closely monitor the patients especially in the age group of infants with hepatic transplant for the development of food allergies.Öğe The prevalence and severity of reaction during the oral food challenge(Bilimsel Tip Yayinevi, 2014) Topal, Erdem; Catal, Ferhat; Senbaba, Elif; Varol, Fatma Ilknur; Sinanoglu, Muhammed Selcuk; Yildirim, Nurdan; Ermistekin, HalimeObjective: The diagnostic gold standard of food allergy is the oral food challenge. Oral food challenge may induce allergic reactions, ranging from mild cutaneous symptoms to severe, potentially life-threatening reaction. Our aim was to investigate the prevalence and severity of reactions during oral food challenge. Materials and Methods: A retrospective charts review of children undergoing oral food challenge at the our Allergy Clinic between September 2012 and September 2013 was performed. Results: A total of 63 oral food challenges were included the study. Most frequently involved foods were cow's milk, pistachio nut and egg. Oral food challenge were carried out to confirm the diagnosis in 50 (79.4%) patients and were carried out to demonstrate the development of food tolerance in 13 (20.6%). 13/63 (20.6%) were positive. Twelve patients were defined mild reactions and one patient was anaphylaxis. There were no significant differences between the oral food challenge negative group and oral food challenge positive group in terms of sex, age at the time of oral food challenge, concomitant atopic disease, history of IgE mediated food allergy, peripheral eosinophils per cent, serum specific gE and total IgE (p>0.05). But there was a positive correlation between the size of skin prick test and oral food challenge positivity (rho: 0.307, p=0.019). Conclusion: The majority of reactions during oral food challenge were mild. The size of skin prick test was the risk factor for the development of reaction during oral food challenge. Therefore, oral food challenge should be done by the experts and size of skin prick test should be taken into consideration before oral food challenge.
