@article {10756, title = {Anaphylaxis in atypical cold urticaria: case report and review of literature.}, journal = {Ital J Pediatr}, volume = {44}, year = {2018}, month = {2018 Nov 13}, pages = {135}, abstract = {

BACKGROUND: Cold-induced urticaria is a kind of physical urticaria characterized by the appearance of wheals after exposure to cold. The atypical form is a rare sub-type characterized by appearance of hives even in areas not directly exposed to the cold and by a negative cold stimulation test. Its diagnosis is often challenging because of the lack of specific tests and it is usually based on the patient{\textquoteright}s clinical history. Hypotension due to generalized exposure to the cold is described both in the typical and the atypical forms.

CASE PRESENTATION: We describe a 9-year-old boy who, at the beginning of the summer after the first swim in the sea, developed generalized urticaria, dyspnea, conjunctival hyperemia, blurred vision and loss of strength. The child was treated with intramuscular steroid and intravenous antihistamine, and the symptoms quickly resolved. Insect bite, contact with fish and drug ingestion were denied, and no unusual food had been eaten before the swim. A tentative diagnosis was made of either aquagenic urticaria or cold urticaria, but the specific tests were negative. Although the cause was unknown, prophylactic treatment with antihistamines was prescribed but in spite of this, wheals developed all over the body, after every swim in the sea. The child then came to our attention and relying on clinical history a diagnosis of atypical cold urticaria was made: development of hives even in areas not directly exposed to cold and a negative response to the cold stimulation test, are the characteristic features of this rare form of cold urticaria.

CONCLUSION: Atypical cold urticaria should be suspected in all cases of anaphylaxis related to cold exposure (i.e. contact with water) with a negative cold stimulation test.

}, keywords = {Anaphylaxis, Child, Cold Temperature, Humans, Male, Swimming, Urticaria}, issn = {1824-7288}, doi = {10.1186/s13052-018-0578-6}, author = {Benelli, Elisa and Longo, Giorgio and Barbi, Egidio and Berti, Irene} } @article {8523, title = {Decline in Lung Function in Childhood Asthma.}, journal = {N Engl J Med}, volume = {375}, year = {2016}, month = {2016 Aug 18}, pages = {e13}, keywords = {Anti-Inflammatory Agents, Asthma, Female, Humans, Lung, Male}, issn = {1533-4406}, doi = {10.1056/NEJMc1608228$\#$SA2}, author = {Bibalo, Cristina and Longo, Giorgio and Ventura, Alessandro} } @article {7739, title = {Food protein-induced enterocolitis syndrome caused by fish and/or shellfish in Italy.}, journal = {Pediatr Allergy Immunol}, year = {2015}, month = {2015 Aug 19}, abstract = {

BACKGROUND: The study describes the demographic features, culprit foods, clinical features and outcomes for children presenting with acute fish and/or shellfish food protein-induced enterocolitis syndrome (FPIES) in four Italian paediatric allergy centres.

METHODS: A retrospective/prospective study was undertaken. All children diagnosed with fish or shellfish FPIES were enrolled. The diagnosis of FPIES was based on Sicherer{\textquoteright}s or Miceli Sopo clinical criteria. Skin prick tests (SPT) were performed in all patients, at the time of diagnosis and prior to OFC.

RESULTS: Seventy children were enrolled. Mean age at first episode was 14 months (range 6-46 months); mean age at diagnosis was 34 months (range 6-164 months). Sole and cod were the fish most commonly implicated. Fifty-seven of 70 (81\%) children had FPIES exclusively to fish, 37 of 57 (65\%) children had single-fish FPIES, 20 of 57 (35\%) multiple-fish FPIES, nine of 70 (13\%) presented adverse reactions exclusively to shellfish, and four of 70 (6\%) presented adverse reactions to both fish and shellfish. Only four (5.7\%) children presented episodes of acute FPIES with different foods (2 to cow{\textquoteright}s milk, 1 to egg, 1 to beef); in all cases, onset was prior to that of fish or shellfish FPIES. Fifteen of 70 (21\%) children tolerated fish other than the offending fish. Twenty-four of 70 (34\%) children achieved tolerance (age range 24-102 months).

CONCLUSIONS: The chief peculiarities of acute fish and shellfish FPIES, compared to more frequent cow{\textquoteright}s milk or soy FPIES, are (i) later age of onset, (ii) longer persistence and (iii) possibility of tolerating fish other than the offending fish. Adverse reactions with shellfish are possible.

}, issn = {1399-3038}, doi = {10.1111/pai.12461}, author = {Miceli Sopo, Stefano and Monaco, Serena and Badina, Laura and Barni, Simona and Longo, Giorgio and Novembre, Elio and Viola, Serena and Monti, Giovanna} } @article {7749, title = {Treatment of asthma based on symptoms.}, journal = {J Pediatr}, volume = {166}, year = {2015}, month = {2015 May}, pages = {1324-5}, keywords = {Asthma, Female, Humans, Male, Spirometry}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2015.01.029}, author = {Bibalo, Cristina and Longo, Giorgio and Ventura, Alessandro} } @article {3493, title = {Cow{\textquoteright}s milk allergy in children, from avoidance to tolerance.}, journal = {Endocr Metab Immune Disord Drug Targets}, volume = {14}, year = {2014}, month = {2014 Mar}, pages = {47-53}, abstract = {

Food allergy is the primary cause of anaphylaxis in paediatric age affecting roughly 4\% of children and their families worldwide, and requiring changes in dietary habits. The prognosis for food allergy in children has traditionally been regarded as good for the most frequent allergens, however the prognosis for cow{\textquoteright}s milk allergy in the pediatric age is currently considered to be worse than previously believed. There is now enough evidence that measures of avoidance for children at risk did not have any preventive effect whatsoever, but they still came to be counterproductive by avoiding the physiological interaction between food allergens and gastrointestinal mucosal immune system. Programs of specific oral tolerance induction (SOTI) have obtained interesting results in the treatment of food allergy supporting the idea that antigen exposure through gastrointestinal section is important to allow the development of tolerance. Nevertheless this approach is not yet considered "ready" for community recommendations. In this paper we describe our experience in the field of SOTI in children with cow{\textquoteright}s milk allergy.

}, keywords = {Animals, Cattle, Child, Child, Preschool, Desensitization, Immunologic, Humans, Immune Tolerance, Milk Hypersensitivity, Milk Substitutes, Retrospective Studies}, issn = {2212-3873}, author = {Calligaris, Lorenzo and Longo, Giorgio and Badina, Laura and Berti, Irene and Barbi, Egidio} } @article {1974, title = {Under pressure.}, journal = {Eur J Pediatr}, volume = {172}, year = {2013}, month = {2013 Mar}, pages = {417}, abstract = {

Physical urticaria is a rare but challenging subset of chronic urticaria. Wheals of pressure urticaria are typically delayed in appearance. A pressure test can easily be done to confirm the diagnosis.

}, keywords = {Child, Humans, Male, Pressure, Urticaria}, issn = {1432-1076}, doi = {10.1007/s00431-012-1819-0}, author = {De Cunto, Angela and Berti, Irene and Minute, Marta and Longo, Giorgio} } @article {1935, title = {The dietary paradox in food allergy: yesterday{\textquoteright}s mistakes, today{\textquoteright}s evidence and lessons for tomorrow.}, journal = {Curr Pharm Des}, volume = {18}, year = {2012}, month = {2012}, pages = {5782-7}, abstract = {

During the last decades the prevalence of food allergy has significantly increased among children and antigen avoidance still remains the standard care for the management of this condition. Most reactions are IgE-mediated with a high risk of anaphylaxis requiring emergency medications in case of inadvertent ingestion. Recent studies showed that continuous administration of the offending food, rather than an elimination diet, could promote the development and maintenance of oral tolerance. Indeed, intestinal transit of food proteins and their interaction with gut-associated lymphoid tissue (GALT) is the essential prerequisite for oral tolerance. On the contrary, low-dose cutaneous exposure to environmental foods in children with atopic dermatitis and altered skin barrier facilitates allergic sensitization. The timing and the amount of cutaneous and oral exposure determine whether a child will have allergy or tolerance. Furthermore, previous preventive strategies such as the elimination diet during pregnancy and breastfeeding, prolonged exclusive breastfeeding and delayed weaning to solid foods did not succeed in preventing the development of food allergy. On the other hand, there could be an early narrow window of immunological opportunity to expose children to allergenic foods and induce natural tolerance. Finally, the gradual exposure to the offending food through special protocols of specific oral tolerance induction (SOTI) may be a promising approach to a proactive treatment of food allergy.

}, keywords = {Anaphylaxis, Antigens, Breast Feeding, Child, Dermatitis, Atopic, Female, Food Hypersensitivity, Humans, Immunoglobulin E, Pregnancy, Time Factors}, issn = {1873-4286}, author = {Badina, Laura and Barbi, Egidio and Berti, Irene and Radillo, Oriano and Matarazzo, Lorenza and Ventura, Alessandro and Longo, Giorgio} } @article {1810, title = {Exhaled nitric oxide as a guide to management of asthma in pregnancy.}, journal = {Lancet}, volume = {379}, year = {2012}, month = {2012 Feb 25}, pages = {708; author reply 708-9}, keywords = {Asthma, Breath Tests, Female, Glucocorticoids, Humans, Nitric Oxide, Pregnancy, Pregnancy Complications}, issn = {1474-547X}, doi = {10.1016/S0140-6736(12)60300-6}, author = {Bibalo, Chiara and Badina, Laura and Longo, Giorgio and Ventura, Alessandro} }