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Article ; Online: In vitro diagnostic testing for drug allergy in children.

Saretta, Francesca / Tomei, Leonardo / Mori, Francesca / Mayorga, Cristobalina

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

2023 Volume 34, Issue 4, Page(s) e13955

Abstract: Diagnosing Drug Hypersensitivity Reactions (DHRs) could be a complicated process especially in children, since allergic-like manifestation at this age is more often the expression of concomitant infections rather than a actual DHRs. In vivo tests are ... ...

Abstract	Diagnosing Drug Hypersensitivity Reactions (DHRs) could be a complicated process especially in children, since allergic-like manifestation at this age is more often the expression of concomitant infections rather than a actual DHRs. In vivo tests are usually suggested as a first step; however, prick and intradermal tests could be painful and have shown different sensitivity and specificity among published studies. In some cases, in vivo tests such as Drug Provocation test (DPT) could be even contraindicated. Therefore, the need for in vitro testing is compelling, to add useful information along the diagnostic pathway and to limit the need of DPT. In this review, we analyze the different types of in vitro tests, focusing on those used more widely such as specific IgE and on those that are still for research settings, such as basophil activation test and lymphocyte transformation test, but that have shown some useful diagnostic potential.
MeSH term(s)	Humans ; Child ; Drug Hypersensitivity/diagnosis ; Hypersensitivity/diagnosis ; Basophil Degranulation Test ; Sensitivity and Specificity ; In Vitro Techniques ; Skin Tests
Language	English
Publishing date	2023-04-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.13955
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Local Anesthetic Hypersensitivity Reactions in Pediatric Patients: Recognition and Management.

Franceschini, Fabrizio / Bottau, Paolo / Caimmi, Silvia / Bianchi, Annamaria / Crisafulli, Giuseppe / Liotti, Lucia / Mori, Francesca / Riscassi, Sara / Saretta, Francesca / Valluzzi, Rocco Luigi / Caffarelli, Carlo

Discovery medicine

2024 Volume 36, Issue 180, Page(s) 16–21

Abstract: Local anesthetics (LAs) are commonly used in all medical specialties, particularly in association with surgery, obstetrics, dentistry, and emergency departments. Most individuals, starting from young children, are exposed to LAs during life. LA hardly ... ...

Abstract	Local anesthetics (LAs) are commonly used in all medical specialties, particularly in association with surgery, obstetrics, dentistry, and emergency departments. Most individuals, starting from young children, are exposed to LAs during life. LA hardly induces adverse events when used in recommended doses and with proper injection techniques. However, immediate anaphylactic reactions to LA injections may be a rare but life-threatening manifestation. A comprehensive report of the event and performing a specialist examination are crucial to prevent further episodes. The diagnosis should be based on history, medical records, skin and challenge tests.
MeSH term(s)	Humans ; Child ; Child, Preschool ; Anesthetics, Local/adverse effects ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/etiology ; Drug Hypersensitivity/therapy ; Skin
Chemical Substances	Anesthetics, Local
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2415544-5
ISSN	1944-7930 ; 1944-7930
ISSN (online)	1944-7930
ISSN	1944-7930
DOI	10.24976/Discov.Med.202436180.2
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Article: Drug-Induced Anaphylaxis in Children.

Bianchi, Annamaria / Valluzzi, Rocco / Crisafulli, Giuseppe / Bottau, Paolo / Caimmi, Silvia / Franceschini, Fabrizio / Liotti, Lucia / Mori, Francesca / Riscassi, Sara / Saretta, Francesca / Scavone, Sara / Caffarelli, Carlo

Biomedicines

2024 Volume 12, Issue 3

Abstract: Drug-induced anaphylaxis in children is less common than in adults and primarily involves beta-lactams and nonsteroidal anti-inflammatory drugs. Epidemiological studies show variable prevalence, influenced by age, gender, and atopic diseases. The ... ...

Abstract	Drug-induced anaphylaxis in children is less common than in adults and primarily involves beta-lactams and nonsteroidal anti-inflammatory drugs. Epidemiological studies show variable prevalence, influenced by age, gender, and atopic diseases. The pathophysiology includes IgE-mediated reactions and non-IgE mechanisms, like cytokine release reactions. We address drug-induced anaphylaxis in children, focusing on antibiotics, nonsteroidal anti-inflammatory drugs, neuromuscular blocking agents, and monoclonal antibodies. Diagnosis combines clinical criteria with in vitro, in vivo, and drug provocation tests. The immediate management of acute anaphylaxis primarily involves the use of adrenaline, coupled with long-term strategies, such as allergen avoidance and patient education. Desensitization protocols are crucial for children allergic to essential medications, particularly antibiotics and chemotherapy agents.
Language	English
Publishing date	2024-02-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines12030527
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Article ; Online: Imported allergens in Italy: an emerging issue.

Pecoraro, Luca / Giovannini, Mattia / Mori, Francesca / Barni, Simona / Castagnoli, Riccardo / Arasi, Stefania / Mastrorilli, Carla / Saretta, Francesca / Liotti, Lucia / Caminiti, Lucia / Klain, Angela / Gelsomino, Mariannita / Del Giudice, Michele Miraglia / Novembre, Elio

Italian journal of pediatrics

2024 Volume 50, Issue 1, Page(s) 36

Abstract: Imported allergens are involved in many allergic reactions, with unexpected and unusual implications. They can be involved in developing asthma, allergic rhinoconjunctivitis, Hymenoptera venom allergies and food allergies. Imported allergens can be ... ...

Abstract	Imported allergens are involved in many allergic reactions, with unexpected and unusual implications. They can be involved in developing asthma, allergic rhinoconjunctivitis, Hymenoptera venom allergies and food allergies. Imported allergens can be implied in respiratory allergies attributable to commercial practices and accidental diffusion through air currents that have introduced non-native species in new geographical contexts. Ambrosia artemisiifolia L., a plant native to North America and currently in the western part of Lombardy, represents an example. Moreover, a variation in the pollen concentration in the Northwest Tuscany area and Trentino Alto-Adige was observed. Cannabis sativa is another imported allergen used frequently by adolescents. Regarding potential imported food allergens, there is no validated list. Imported food allergens derive from ethnic foods, referring to Mexican/Latin American, Chinese/Japanese, Southeast Asian, Arab/Middle Eastern and African cuisine. Four insect flours were recently introduced to the European and Italian markets (Acheta domesticus, Alphitobius diaperinus, Tenebrio molitor and Locusta migratoria). The association between the accidental introduction through commercial traffic, climate change, and the absence of natural enemies in the destination ecosystem is related to the introduction of a specific Hymenoptera, Vespa velutina, in Italy and Europe. External events attributable to human activities, such as climate change and the introduction of non-native plants, foods and Hymenoptera through trade, have contributed to the issue of imported allergens. Making the correct diagnosis and guiding the diagnostic and therapeutic path in this particular context represent the concerns of the pediatric allergist.
MeSH term(s)	Adolescent ; Humans ; Child ; Allergens ; Ecosystem ; Hypersensitivity ; Italy/epidemiology ; Europe
Chemical Substances	Allergens
Language	English
Publishing date	2024-03-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-024-01595-z
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Article ; Online: Exercise-induced bronchoconstriction, allergy and sports in children.

Klain, Angela / Giovannini, Mattia / Pecoraro, Luca / Barni, Simona / Mori, Francesca / Liotti, Lucia / Mastrorilli, Carla / Saretta, Francesca / Castagnoli, Riccardo / Arasi, Stefania / Caminiti, Lucia / Gelsomino, Mariannita / Indolfi, Cristiana / Del Giudice, Michele Miraglia / Novembre, Elio

Italian journal of pediatrics

2024 Volume 50, Issue 1, Page(s) 47

Abstract: Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma ( ... ...

Abstract	Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.
MeSH term(s)	Humans ; Child ; Bronchoconstriction ; Hypersensitivity ; Sports ; Asthma, Exercise-Induced/diagnosis ; Asthma, Exercise-Induced/drug therapy ; Asthma, Exercise-Induced/epidemiology ; Exercise ; Hypersensitivity, Immediate
Language	English
Publishing date	2024-03-13
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-024-01594-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Fatal food anaphylaxis in adults and children.

Novembre, Elio / Gelsomino, Mariannita / Liotti, Lucia / Barni, Simona / Mori, Francesca / Giovannini, Mattia / Mastrorilli, Carla / Pecoraro, Luca / Saretta, Francesca / Castagnoli, Riccardo / Arasi, Stefania / Caminiti, Lucia / Klain, Angela / Del Giudice, Michele Miraglia

Italian journal of pediatrics

2024 Volume 50, Issue 1, Page(s) 40

Abstract: Anaphylaxis is a life-threatening reaction characterized by the acute onset of symptoms involving different organ systems and requiring immediate medical intervention. The incidence of fatal food anaphylaxis is 0.03 to 0.3 million/people/year. Most fatal ...

Abstract	Anaphylaxis is a life-threatening reaction characterized by the acute onset of symptoms involving different organ systems and requiring immediate medical intervention. The incidence of fatal food anaphylaxis is 0.03 to 0.3 million/people/year. Most fatal food-induced anaphylaxis occurs in the second and third decades of life. The identified risk factors include the delayed use of epinephrine, the presence of asthma, the use of recreational drugs (alcohol, nicotine, cannabis, etc.), and an upright position. In the United Kingdom (UK) and Canada, the reported leading causal foods are peanuts and tree nuts. In Italy, milk seems to be the most common cause of fatal anaphylaxis in children < 18 years. Fatal food anaphylaxis in Italian children and adolescents almost always occurs outside and is characterized by cardiorespiratory arrest; auto-injectable adrenaline intramuscular was available in few cases. Mortality from food anaphylaxis, especially in children, is a very rare event with stable incidence, but its risk deeply impacts the quality of life of patients with food allergy and their families. Prevention of fatal food anaphylaxis must involve patients and their families, as well as the general public, public authorities, and patients' associations.
MeSH term(s)	Adolescent ; Adult ; Child ; Humans ; Anaphylaxis/diagnosis ; Anaphylaxis/epidemiology ; Anaphylaxis/etiology ; Quality of Life ; Epinephrine/therapeutic use ; Arachis ; Asthma
Chemical Substances	Epinephrine (YKH834O4BH)
Language	English
Publishing date	2024-03-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-024-01608-x
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ab Jg. 2022: Lesesaal (EG)

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Article: Venom immunotherapy protocols in the pediatric population: how to choose?

Saretta, Francesca / Giovannini, Mattia / Pessina, Benedetta / Barni, Simona / Liccioli, Giulia / Sarti, Lucrezia / Tomei, Leonardo / Fazi, Camilla / Pegoraro, Francesco / Valleriani, Claudia / Ricci, Silvia / Azzari, Chiara / Novembre, Elio / Mori, Francesca

Frontiers in pediatrics

2023 Volume 11, Page(s) 1192081

Language	English
Publishing date	2023-09-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2023.1192081
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Article ; Online: Hypersensitivity reactions to vaccines in children: from measles to SARS-CoV-2.

Caffarelli, Carlo / Liotti, Lucia / Bianchi, Annamaria / Bottau, Paolo / Caimmi, Silvia / Crisafulli, Giuseppe / Franceschini, Fabrizio / Paglialunga, Claudia / Saretta, Francesca / Mori, Francesca

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

2022 Volume 33 Suppl 27, Page(s) 58–60

Abstract: Allergic individuals at risk for hypersensitivity reactions to measles vaccine marketed for a long time are well established. On the other hand, risk factors for hypersensitivity reactions to the new mRNA COVID-19 vaccines currently include a history of ... ...

Abstract	Allergic individuals at risk for hypersensitivity reactions to measles vaccine marketed for a long time are well established. On the other hand, risk factors for hypersensitivity reactions to the new mRNA COVID-19 vaccines currently include a history of allergy, allergy to excipient of the vaccine, or hypersensitivity reactions to the first dose of COVID-19 vaccine. In the last two cases, the recipient should be assessed by an allergist before vaccination to share a decision on the choice of vaccination. Studies on skin testing accuracy and desensitization protocols to the COVID-19 vaccines and the efficacy of potential alternatives in patients with confirmed hypersensitivity reactions to the first COVID-19 vaccine are necessary to improve the safety of COVID-19 vaccines.
MeSH term(s)	COVID-19 ; COVID-19 Vaccines ; Child ; Humans ; Hypersensitivity/etiology ; Measles/prevention & control ; SARS-CoV-2 ; Vaccination/adverse effects ; Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2022-02-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.13631
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Drugs and Vaccines Hypersensitivity in Children with Mastocytosis.

Mori, Francesca / Crisafulli, Giuseppe / Bianchi, Annamaria / Bottau, Paolo / Caimmi, Silvia / Franceschini, Fabrizio / Liotti, Lucia / Paglialunga, Claudia / Saretta, Francesca / Caffarelli, Carlo

Journal of clinical medicine

2022 Volume 11, Issue 11

Abstract: Mastocytosis, a heterogeneous mastcell disease, include three different entities: cutaneous mastocytosis, systemic mastocytosis (SM) and mast-cell sarcoma. Tryptase levels can differentiate cutaneous mastocytosis from SM. In mastocytosis, quick onset ... ...

Abstract	Mastocytosis, a heterogeneous mastcell disease, include three different entities: cutaneous mastocytosis, systemic mastocytosis (SM) and mast-cell sarcoma. Tryptase levels can differentiate cutaneous mastocytosis from SM. In mastocytosis, quick onset drug hypersensitivity reactions (DHRs) that are facilitated by mastcell mediators, are investigated in adults. Due to the limited number of children with mastcell disease and increased serum tryptase levels, the role of drugs in this age group is less studied. In this review, we critically assessed relevant papers related with immediate DHRs in children with mastocytosis and discuss practical issues of the management. In childhood mastocytosis, anaphylaxis is frequently idiopathic, and elevated level of basal tryptase, and high burden of disease may increase the risk. Among drugs, antibiotics, NSAIDs and opioids can potentially induce anaphylaxis, anyway avoidance should be recommended only in case of previous reactions. Moreover, vaccinations are not contraindicated in patients with mastocytosis. The risk of severe systemic reactions after drugs intake seems to be extremely low and in general lower in children than in adults. Anyway, studies on this topic especially focusing on children, are missing to state final recommendations.
Language	English
Publishing date	2022-06-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11113153
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Article: Latex Allergy in Children.

Arasi, Stefania / Barni, Simona / Caminiti, Lucia / Castagnoli, Riccardo / Giovannini, Mattia / Liotti, Lucia / Mastrorilli, Carla / Mori, Francesca / Pecoraro, Luca / Saretta, Francesca / Gelsomino, Mariannita / Klain, Angela / Miraglia Del Giudice, Michele / Novembre, Elio

Journal of clinical medicine

2023 Volume 13, Issue 1

Abstract: Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and ... ...

Abstract	Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition.
Language	English
Publishing date	2023-12-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13010124
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