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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
Database	MEDical Literature Analysis and Retrieval System OnLINE

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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: Hazelnut Allergy.

Calamelli, Elisabetta / Trozzo, Alessia / Di Blasi, Elisabetta / Serra, Laura / Bottau, Paolo

Medicina (Kaunas, Lithuania)

2021 Volume 57, Issue 1

MeSH term(s)	Corylus ; Europe ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/epidemiology ; Food Hypersensitivity/therapy ; Humans ; Immunoglobulin E ; Plant Proteins ; Pollen
Chemical Substances	Plant Proteins ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2021-01-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina57010067
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Article: Something Is Changing in Viral Infant Bronchiolitis Approach.

Bottau, Paolo / Liotti, Lucia / Laderchi, Eleonora / Palpacelli, Alessandra / Calamelli, Elisabetta / Colombo, Carlotta / Serra, Laura / Cazzato, Salvatore

Frontiers in pediatrics

2022 Volume 10, Page(s) 865977

Abstract: Acute Viral Bronchiolitis is one of the leading causes of hospitalization in the first 12-24 months of life. International guidelines on the management of bronchiolitis broadly agree in recommending a minimal therapeutic approach, not recommending the ... ...

Abstract	Acute Viral Bronchiolitis is one of the leading causes of hospitalization in the first 12-24 months of life. International guidelines on the management of bronchiolitis broadly agree in recommending a minimal therapeutic approach, not recommending the use of bronchodilators. Guidelines, generally, consider bronchiolitis as a "unique disease" and this runs the risk of not administering therapy in some patients who could benefit from the use of bronchodilators, for instance, in those who will develop asthma later in their life and face first episode in the age of bronchiolitis. Today, there is growing evidence that bronchiolitis is not a single illness but can have different "endotypes" and "phenotypes," based on age, personal or family history of atopy, etiology, and pathophysiological mechanism. There is evidence that some phenotypes of bronchiolitis are more strongly associated with asthma features and are linked to higher risk for asthma development. In these populations, possible use of bronchodilators might have a better impact. Age seems to be the main feature to suggest a good response to a bronchodilator-trial, because, among children > 6 months old with bronchiolitis, the presence of a subset of patients with virus-induced wheezing or the first episode of asthma is more likely. While waiting for new research to define the relationship between therapeutic options and different phenotypes, a bronchodilator-trial (using short-acting β2 agonists with metered-dose inhalers and valved holding chambers) seems appropriate in every child with bronchiolitis and age > 6 months.
Language	English
Publishing date	2022-04-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.865977
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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 ; 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
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Zs.A 3096: Show issues

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Article ; Online: Update on Interventions in Prevention and Treatment of Pediatric Asthma.

Calamelli, Elisabetta / Bottau, Paolo / Lanari, Marcello

Current medicinal chemistry

2017 Volume 25, Issue 16, Page(s) 1909–1919

Abstract: Background: Asthma represents a worldwide health problem with a strong morbidity and a major impact on the health care system. Multiple efforts have been made towards the development of new strategies for the prevention and treatment of this disorder. ... ...

Abstract	Background: Asthma represents a worldwide health problem with a strong morbidity and a major impact on the health care system. Multiple efforts have been made towards the development of new strategies for the prevention and treatment of this disorder. In the light of this the present review of the literature aimed at summarizing the latest advances in prevention and treatment of pediatric asthma with a focus on the most effective options of interventions during the first stages of life. Methods: References were identified by searches of PubMed. Search terms used in the search were "pediatric asthma", "treatment" and "prevention". We included only meta-analysis, randomized controlled trials, reviews and systematic review articles pertaining to humans and subjects aged 0-18 years. All the interventions have been classified as "non-pharmacological" and "pharmacological". Results: Non-pharmacological interventions have been focused in identifying the genetic and environmental factors underlying the pathogenesis of this disease, including the individual genetic susceptibility, the early allergic sensitization, the role of the environmental microbiome and the exposure to infections and to pollutants. Moreover, the optimization of the existing pharmacological strategies and the development of new treatment options have improved markedly the management of this disease, thereby reducing the health care costs and ameliorating the quality of life of patients. Conclusion: Childhood asthma prevention and treatment still represents a worldwide challenge. Future efforts should be aimed at identifying high risk target populations, minimizing the costs of each policy of intervention and increasing adherence to treatment strategies.
MeSH term(s)	Adolescent ; Antibodies, Monoclonal/therapeutic use ; Asthma/etiology ; Asthma/prevention & control ; Asthma/therapy ; Child ; Histamine Antagonists/therapeutic use ; Humans ; Immunotherapy ; Quality of Life ; Respiratory Tract Infections/drug therapy
Chemical Substances	Antibodies, Monoclonal ; Histamine Antagonists
Language	English
Publishing date	2017-03-20
Publishing country	United Arab Emirates
Document type	Journal Article ; Review
ZDB-ID	1319315-6
ISSN	1875-533X ; 0929-8673
ISSN (online)	1875-533X
ISSN	0929-8673
DOI	10.2174/0929867324666170303162651
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Article ; Online: COVID-19 Vaccines in Children with Cow's Milk and Food Allergies.

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

Nutrients

2021 Volume 13, Issue 8

Abstract: The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a ... ...

Abstract	The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow's milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow's milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.
MeSH term(s)	Adolescent ; Allergens/immunology ; Anaphylaxis/etiology ; Animals ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; COVID-19 Vaccines/immunology ; COVID-19 Vaccines/therapeutic use ; Child ; Female ; Food Hypersensitivity/immunology ; Humans ; Immunoglobulin E/immunology ; Male ; Milk/adverse effects ; Milk Hypersensitivity/immunology ; Polyethylene Glycols/adverse effects ; Polyethylene Glycols/therapeutic use ; SARS-CoV-2 ; Vaccination/adverse effects
Chemical Substances	Allergens ; COVID-19 Vaccines ; Immunoglobulin E (37341-29-0) ; Polyethylene Glycols (3WJQ0SDW1A)
Language	English
Publishing date	2021-07-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13082637
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: COVID-19 Vaccines in Children with Cow’s Milk and Food Allergies

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

Nutrients. 2021 July 30, v. 13, no. 8

2021

Abstract	The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.
Keywords	COVID-19 infection ; cows ; food allergies ; milk ; pandemic ; risk ; vaccination ; vaccines
Language	English
Dates of publication	2021-0730
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13082637
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Component-Resolved Diagnosis in Food Allergies.

Calamelli, Elisabetta / Liotti, Lucia / Beghetti, Isadora / Piccinno, Valentina / Serra, Laura / Bottau, Paolo

Medicina (Kaunas, Lithuania)

2019 Volume 55, Issue 8

Abstract: Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy ... ...

Abstract	Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.
MeSH term(s)	Allergens/analysis ; Allergens/immunology ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/immunology ; Humans ; Immunoglobulin E/blood ; Sensitivity and Specificity ; Skin Tests
Chemical Substances	Allergens ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2019-08-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina55080498
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