Objectifs de l’étude Cette étude visait à évaluer les réponses IgE au pollen du cyprès, allergène majeur du bassin méditerranéen, comparativement à d’autres aéroallergènes courants, et à analyser les liens avec les profils cliniques et démographiques chez une population du sud du Maroc. Patients et méthodes Les données démographiques, cliniques et immunobiologiques de 515 patients atteints d’allergie respiratoire, colligées sur une période de deux ans, ont été analysées. Les IgE spécifiques au pollen de cyprès et aux principaux aéroallergènes, quantifiées par ImmunoCAP (Phadia250TM) selon les données cliniques et les prick tests, ont été corrélées aux caractéristiques cliniques et démographiques des patients. Résultats Parmi les 515 cas colligés, 427 (82,91 %) étaient sensibilisés à au moins un aéroallergène, dont 3,3 % spécifiquement au pollen de cyprès, avec un taux moyen des IgE spécifiques estimé à 2,6 ± 4,92 kUA/L. Les manifestations cliniques étaient représentées par l’asthme associé à la rhinoconjonctivite (50 %), suivies de la rhinoconjonctivite et de la rhinite isolée (21,4 % chacune). La polysensibilisation (92,9 %) impliquait surtout le pollen d’olivier (64,3 %), ambroisie et Dermatophagoides pteronyssinus (50 % chacun), Alternaria et Blomia tropicalis (28,6 % chacun), et Dermatophagoides farinae (21,4 %), avec des associations hautement significatives (p ≤ 0,001) entre le cyprès et Alternaria, ambroisie, Dermatophagoides pteronyssinus, et pollen d'olivier. Les IgE anti-cyprès étaient corrélées aux IgE de l’ambroisie, de la pariétaire et du blé (p ≤ 0,001). Conclusion La sensibilisation au pollen de cyprès est relativement peu fréquente dans le sud du Maroc et s’inscrit dans un profil de polysensibilisation, principalement associé à l’olivier, à l’ambroisie et à Dermatophagoides pteronyssinus.
Les communications EAACI 2026 consacrées à l’immunothérapie allergénique (ITA) décrivent un champ arrivé à maturité, mais traversé par un déplacement conceptuel important. Dans les principales indications respiratoires et dans l’immunothérapie aux venins, la discussion ne porte plus seulement sur la démonstration d’efficacité. Elle s’oriente vers la valeur clinique : réduction du fardeau thérapeutique, qualité de vie, sommeil, contrôle de l’asthme, recours aux soins, adhérence, sécurité, bénéfice après arrêt et pertinence des critères de jugement. Les données de vie réelle, les critères rapportés par les patients, les études de registres et les analyses de prescriptions occupent une place croissante. L’allergie alimentaire apparaît comme le domaine le plus dynamique, avec l’immunothérapie orale (ITO), l’immunothérapie épicutanée (EPIT), les tests de provocation orale seuil, les biologiques, la surveillance de l’œsophagite à éosinophiles et les biomarqueurs de tolérance persistante. Les biologiques, notamment l’omalizumab et le dupilumab, sont de plus en plus explorés comme facilitateurs ou partenaires de l’ITA dans des profils sélectionnés. La rémission émerge comme concept structurant, mais reste à définir de façon opérationnelle avant de devenir un critère stabilisé. Enfin, les biomarqueurs, l’IA, les omiques, les plateformes VLP, ARNm-LNP et les enjeux de standardisation dessinent un avenir plus précis, encore largement exploratoire. Cette synthèse propose une lecture hiérarchisée et orientée pratique des principaux signaux issus des abstracts EAACI 2026.
Study objective Animal-derived allergens are important contributors to respiratory allergic diseases. Although cats and dogs are the most common sources, pet birds may also induce IgE-mediated sensitization. However, data on budgerigar-related sensitization in children are limited. This study aimed to evaluate allergic sensitization among children living in households with budgerigars. Patients and methods Children aged 1–18years with household budgerigar exposure who underwent budgerigar-specific IgE testing between April 2023 and July 2025 were retrospectively evaluated. Clinical and laboratory findings were analyzed. Results A total of 516 children were included (median age 8.68years; 52.1% male). Budgerigar sensitization was detected in 19 children (3.7%), of whom 10 (52.6%) reported symptoms related to budgerigar exposure. Allergic rhinitis, indoor symptom exacerbation, and atopic dermatitis were significantly more frequent among budgerigar-sensitized children in the overall cohort. However, among aeroallergen-sensitized children, allergic rhinitis was no longer significantly different, whereas indoor symptom exacerbation and atopic dermatitis remained more frequent in those with budgerigar sensitization. Aeroallergen sensitization was present in 44.6% of the cohort. Eosinophil counts and total IgE levels were significantly higher in aeroallergen-sensitized children (P<0.001), but did not differ according to budgerigar sensitization status. Conclusion Budgerigar sensitization was identified in a small proportion of children with household budgerigar exposure. Indoor symptom exacerbation and atopic dermatitis were more frequent among budgerigar-sensitized children, including within the aeroallergen-sensitized subgroup. However, these associations may partly reflect underlying atopy rather than a direct causal effect of budgerigar exposure, and further studies are needed.
Nous rapportons le cas d’un homme de 20 ans ayant présenté une réaction d’hypersensibilité immédiate après l’injection de testostérone (forme à action prolongée formulée avec de l’huile de ricin). Le bilan allergologique, négatif, a permis d’exclure une cause IgE-médiée et suggère l’hypothèse d’une micro-embolie pulmonaire graisseuse, ou pulmonary oil micro-embolism (POME). Il s’agit d’un effet indésirable rare, associé aux injections de médicaments formulés avec des huiles. La clinique, brutale et brève, comporte avant tout des manifestations respiratoires, mais peut également s’accompagner de signes cutanés/neurologiques pouvant parfois « mimer » une anaphylaxie.
Introduction Mucopolysaccharidosis type IVA (Morquio A syndrome) is a rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase deficiency, leading to progressive multisystem involvement. Enzyme replacement therapy with elosulfase alfa is the only disease-specific treatment; however, hypersensitivity reactions may limit its use. Case report We describe an 18-year-old male with Morquio A syndrome who developed anaphylaxis during elosulfase alfa infusion, presenting with generalized urticaria, dyspnea, and wheezing requiring adrenaline administration. A 16-step desensitization protocol using four serial dilutions was implemented. During the initial attempt, urticarial lesions occurred at the final step, necessitating protocol adjustment with maintenance of a submaximal infusion rate. Subsequent infusions under premedication were well tolerated, allowing continuation of weekly therapy for 16 weeks without recurrence of hypersensitivity reactions. Conclusion Desensitization to elosulfase alfa can be successfully achieved even after anaphylaxis. Individualized protocol adjustments, particularly maintaining submaximal infusion rates, may improve safety and treatment continuity.
Objective Real-world preparedness for pediatric anaphylaxis often remains inadequate across home, school, and clinic settings despite guidelines. This study aimed to evaluate barriers to anaphylaxis management across the home–school–clinic triad in children prescribed epinephrine auto-injectors, focusing on caregiver competence, adolescent self-efficacy, and school preparedness. Methods This single-center cross-sectional study enrolled 125 pediatric patients with physician-diagnosed anaphylaxis and an active epinephrine auto-injector prescription. Parents/caregivers were interviewed during follow-up visits, and device availability at the visit was verified. Adolescents aged 12 years or older and teachers of school-attending children were interviewed. After a standardized demonstration using a training device, parents and adolescents rated confidence on a 5-point scale, and teachers reported willingness to administer epinephrine. Clinical data were retrieved from medical records. Results Post-diagnosis anaphylactic episodes occurred in 52/125 patients (41.6%), yet epinephrine was administered in only 10/52 episodes (19.2%). Although 60.8% of caregivers reported “always” carrying the device, it was available at the clinic visit in only 50/125 patients (40.0%). Most caregivers had training (92%), yet 71.3% last trained over a year ago. After demonstration, 50.4% of parents versus 16.7% of adolescents reported confident administration. In schools, 93.6% of teachers had no prior training, and 74.6% did not identify epinephrine as first-line treatment. After demonstration, 36.7% would administer confidently, while 25.3% would refrain due to legal concerns. Conclusion Epinephrine auto-injector prescription did not ensure preparedness. Low carriage, reduced adolescent self-efficacy, and substantial school-level knowledge and implementation barriers highlight the need for repeated practical training and clearer institutional procedures.
Objective To evaluate the sleep quality of children diagnosed with allergic rhinitis before and after treatment, and to investigate the relationship between allergic rhinitis treatment and sleep quality. Patients and methods This cross-sectional study included 167 patients aged 8–18 years, diagnosed with allergic rhinitis at the Pediatric Allergy and Immunology Outpatient Clinic of the University of Health Sciences Ümraniye Training and Research Hospital between March and July 2023. Patients with comorbid conditions or a pre-existing diagnosis of sleep disorder were excluded. Sleep quality was assessed using the Pittsburgh Sleep Quality Index before the initiation of treatment and again one month later. Symptom severity was measured using the Total Nasal Symptom Score. Results Of the 167 participants, 84 (50.3%) were female; the median age was 11 years. Sensitization to at least one allergen was detected in 129 patients (77.2%). After treatment, total nasal symptom scores decreased significantly compared with baseline (P<0.001). A strong and statistically significant reduction was observed in total Pittsburgh Sleep Quality Index scores, together with a marked improvement in sleep quality (P<0.001). Before treatment, 139 patients (83.2%) had poor sleep quality, decreasing to 9 patients (5.4%) after treatment. A significant correlation was identified between the reduction in symptom severity and the improvement in sleep quality (P<0.001). Conclusion Appropriate treatment improves sleep quality in children with allergic rhinitis. Clinicians should therefore routinely assess sleep quality in pediatric patients with allergic rhinitis, both before and after treatment.
Les atteintes cutanées liées aux chlorofluorocarbones (CFC), notamment au fréon, sont rares et le plus souvent limitées à des lésions de contact telles que xérose, dermatite ou engelures. Les éruptions diffuses demeurent exceptionnelles et peu décrites. Nous rapportons un cas original d’exanthème intertrigineux symétrique survenu dans un contexte d’intoxication aiguë accidentelle au fréon. Un homme de 38 ans a présenté des symptômes neurologiques et respiratoires au décours d’une exposition domestique à un réfrigérateur défectueux. Quatre jours après l’exposition est apparue une éruption prurigineuse débutant aux plis des coudes et axillaires, puis s’étendant aux flancs et aux régions inguinales. L’examen clinique objectivait des placards érythémateux intertrigineux surmontés de pustules non folliculaires, bilatéraux et symétriques, respectant le visage, les paumes, les plantes et les muqueuses. Le bilan biologique était normal et aucune prise médicamenteuse récente n’était rapportée. Le diagnostic d’exanthème intertrigineux symétrique secondaire à une intoxication aiguë au fréon a été retenu sur des arguments anamnestiques et évolutifs. L’éviction du toxique, associée à un traitement par dermocorticoïdes topiques et antihistaminiques, a permis une résolution complète en quatre jours. Ce cas souligne qu’une intoxication aiguë au fréon peut induire des éruptions cutanées atypiques mimant une toxidermie médicamenteuse et doit être reconnue comme une étiologie exceptionnelle d’exanthème d’origine environnementale.
Background: Local anesthetics (LAs) are widely used in pediatric surgical and dental procedures and are generally regarded as safe. Nevertheless, children are frequently referred to pediatric allergy clinics because of suspected allergic reactions following LA exposure, despite the rarity of true IgE-mediated hypersensitivity. Objective: To evaluate the clinical characteristics and diagnostic testing outcomes of pediatric patients referred for suspected immediate-type hypersensitivity reactions to local anesthetics. Methods: We retrospectively evaluated children with a history of suspected immediate-type hypersensitivity reactions to LAs and who underwent diagnostic testing. A guideline-based diagnostic algorithm including skin prick testing, intradermal testing, and drug provocation testing was applied. Follow-up was conducted by telephone to assess tolerance during subsequent real-life exposure to local anesthetics. Results: A total of 43 children were evaluated (26 girls; median [IQR] age, 8.3 [6.6-13.5] years). The most frequently tested local anesthetics were lidocaine (n = 15; 34.9%) and articaine (n = 13; 30.2%). Three patients (6.9%) had positive intradermal test results suggestive of hypersensitivity, whereas no reactions were reported during subsequent exposure in patients with negative diagnostic test results. Conclusion: In this cohort, suspected immediate-type hypersensitivity to local anesthetics was rarely supported by diagnostic testing. A structured diagnostic approach allowed identification of a tolerated local anesthetic in most children, facilitating safe use when needed.
Introduction L’angioedème histaminique isolé représente un motif rare de consultation. L’objectif de ce travail est d’étudier les caractéristique épidémio-cliniques de l’angioedème histaminique isolé à Casablanca. Méthodes Nous avons colligé les cas d’angioedème histaminique isolé, pris en charge au sein du service de dermatologie du CHU de Casablanca, sur une période allant de mars 2021 à septembre 2024. Résultats On a retrouvé sept patients présentant un angioedème histaminique isolé. L’âge moyen était de 32,8ans (extrêmes : 18–47ans), avec un sex-ratio de 2/5. Cinq patients ne rapportaient aucun antécédent d’atopie. Tous les patients avaient eu recours à une automédication chronique par corticoïdes et AINS avant leur prise en charge. Aucun cas n’était associé à une urticaire superficielle, à des manifestations laryngées ou respiratoires, ni à des douleurs abdominales. La durée moyenne d’évolution des symptômes était de 2ans, avec des épisodes d’angioedème d’une durée inférieure à 72heures. Le traitement par antihistaminiques a permis une évolution favorable chez l’ensemble des patients, et cinq d’entre eux ont bénéficié en complément d’anti-leucotriènes, ce qui a contribué à un contrôle rapide et efficace des épisodes. Conclusions Le caractère isolé de l’angioedème histaminique chez nos patients pose essentiellement un problème de diagnostic différentiel avec l’angioedème bradykinéque d’où l’intérêt de l’histoire clinique et du dosage de C1 estérase inhibiteur.
Background and objective: This cross-sectional survey represents the first study to systematically quantify pollen-food allergy syndrome (PFAS) awareness and clinical management approaches among actively practising dentists. Methods: Seventy-seven dentists in Istanbul, Turkey participated (mean age 34.4 +/- 7.9 years; 72.7% female) in this cross-sectional, descriptive survey. The survey was distributed via an open link through professional messaging and social media platforms; accordingly, a response rate could not be calculated. Results: Nearly all participants (97.4%) had received no postgraduate allergy training, and 94.8% reported in adequate or absent PFAS awareness. A critical recognition-application gap was identified: 62.3% selected the correct definition from multiple-choice options, yet only 37.7% correctly interpreted an equivalent clinical sce nario involving raw versus cooked food reactions-and notably, 41.7% of those who correctly identified the definition still failed this scenario. More strikingly, 93.5% had never considered PFAS in differential diagnosis despite 54.5% reporting encounters with oral mucosal complaints in the preceding year. PFAS knowledge sho wed no association with professional experience, specialty, or prior patient encounters (all P > 0.05), indicating a systemic educational deficit rather than an experience-dependent gap. Conversely, 71.4% correctly identified allergy and immunology as the appropriate referral specialty, and 81.8% rated their educational need at the highest level. Conclusions: These findings reveal that PFAS remains a diagnostically invisible syndrome in dental practice. Given dentists' frontline position in encountering oral mucosal symptoms-the hallmark presentation of PFAS-inte gration of allergic syndromes into dental curricula, structured allergist-dentist referral pathways, and practical screening protocols are urgently needed.
Introduction: Isolated histaminergic angioedema is an uncommon reason for medical consultation. The aim of this study was to investigate the epidemiological and clinical characteristics of isolated histaminergic angioedema in Casablanca. Methods: We collected cases of isolated histaminergic angioedema managed in the Department of Dermatology at the University Hospital Center of Casablanca between March 2021 and September 2024. Results: Seven patients presenting with isolated histaminergic angioedema were identified. The mean age was 32.8 years (range: 18-47 years), with a male-to-female ratio of 2:5. Five patients reported no history of atopy. All patients had previously engaged in chronic self-medication with corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) prior to medical management. None of the cases were associated with superficial urticaria, laryngeal or respiratory involvement, or abdominal pain. The mean duration of symptom progression was two years, with angioedema episodes lasting less than 72 hours. Treatment with antihistamines resulted in a favorable outcome in all patients. Additionally, five patients received adjunctive anti-leukotriene therapy, which contributed to rapid and effective control of the episodes. Conclusions: The isolated presentation of histaminergic angioedema in our patients primarily raises the issue of differential diagnosis with bradykinin-mediated angioedema, highlighting the importance of a thorough clinical history and the measurement of C1 esterase inhibitor levels.
Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, including palbociclib, have transformed the management of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer. While their adverse effects such as neutropenia, diarrhea, and fatigue are well documented, cutaneous toxicities remain less well recognized and are likely underestimated. We report the case of a 34-year-old woman treated with palbociclib for metastatic invasive breast carcinoma who developed an eczematous eruption with a pseudo-metameric distribution mimicking herpes zoster, five months after treatment initiation. This case highlights the importance of early recognition of cutaneous manifestations to avoid diagnostic errors or unwarranted treatment discontinuation and underscores the need for close collaboration between oncologists and dermatologists.
Introduction Exposure to household tobacco smoke among children with asthma remains a relevant public health concern. However, the direct impact of secondhand smoke exposure on asthma control is still debated, and causal relationships cannot be clearly established based on current evidence. This study aimed to describe the prevalence and reporting patterns of household smoking exposure among children with asthma and to explore its associations with sociodemographic factors and asthma care characteristics. Methods In this cross-sectional study, the SHS exposure of 188 children with asthma was compared to that of a healthy control group without any chronic disease. “Childhood Asthma Control Test” and “Asthma Control Test” were administered to children diagnosed with asthma, and the effects of SHS on disease control were examined. Results It was found that 45.7% of asthmatic children and 63.2% of the healthy control group were exposed to SHS in their home environment (P<0.01). Asthmatic children with a larger household size and living in extended families were exposed to passive smoke at a higher rate. The rate of well-controlled asthma was higher in asthmatic children who were not exposed to passive smoking (97.1 vs. 60.5%, P<0.01). In asthmatic children, the rate of uncontrolled asthma was higher when the mother was a smoker (P<0.01), whereas no difference was found between the two groups when asthma control levels were evaluated according to the father's smoking status (P>0.05). Conclusion Household tobacco smoke exposure is commonly reported among children with asthma. These reports reflect not only environmental exposure but also broader sociodemographic conditions and characteristics of asthma care. Within the limitations of this observational design, no causal inferences regarding the relationship between household smoking exposure and asthma control can be made. Nevertheless, the high prevalence of reported exposure underscores the importance of systematically addressing household smoking within the comprehensive clinical assessment of pediatric asthma.
Study objective Drug hypersensitivity reactions are often perceived as medically threatening events, yet death anxiety remains poorly characterized. We compared anxiety, depressive symptoms, and death anxiety in adults with a history consistent with immediate-type drug hypersensitivity reactions versus allergic rhinitis controls without drug allergy. Patients and methods Clinic-based case-control study (January 23-August 30, 2024). Ninety-six adults with a physician-recorded history consistent with drug hypersensitivity reactions and 96 allergic rhinitis controls without drug allergy were enrolled. Drug hypersensitivity reactions were classified based on structured clinical history supported by medical and emergency department records, considering prior allergy testing when available. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale, and death anxiety with the Templer Death Anxiety Scale. Group comparisons were performed using the Mann-Whitney U test. Adjusted analyses used general linear models controlling for age, sex, education, marital status, employment status, chronic/additional disease, and smoking/alcohol use. Results Compared with controls, the drug hypersensitivity group had higher anxiety and higher death anxiety (both P < 0.05), whereas depressive symptoms did not differ (P = 0.455). Adjusted differences remained significant for anxiety (adjusted mean difference 1.35; P = 0.009) and death anxiety (1.04; P = 0.028) but not for depression (P = 0.962). Conclusion Adults with a history consistent with drug hypersensitivity reactions had higher anxiety and death anxiety than controls, independent of key covariates. Incorporating brief psychological screening and targeted counseling into drug allergy evaluation may help address persistent fear and avoidance.
Les inhibiteurs des kinases dépendantes des cyclines 4 et 6 (CDK4/6), dont le palbociclib, ont transformé la prise en charge du cancer du sein métastatique à récepteurs hormonaux positifs (RH+) et au récepteur 2 du facteur de croissance épidermique humain négatif (HER2–). Bien que leurs effets indésirables soient bien documentés (neutropénie, diarrhée, fatigue), les toxicités cutanées sont moins connues et probablement sous-estimées. Nous rapportons le cas d’une patiente de 34 ans, traitée par palbociclib pour un carcinome mammaire infiltrant métastatique, ayant développé une éruption eczématiforme à disposition pseudo-métamérique mimant un zona, cinq mois après le début du traitement. Ce cas illustre l’intérêt d’une reconnaissance précoce des manifestations cutanées afin d’éviter des erreurs diagnostiques ou un arrêt injustifié de traitement, et souligne l’importance d’une collaboration entre oncologues et dermatologues.
Oral immunotherapy (OIT) represents a major advance in the management of IgE-mediated food allergies. The principle of food scales is based on the gradual and controlled introduction of modified forms of the allergen. However, their use is not standardized and requires significant support from parents. We propose a Moroccan food ladder for milk and eggs, with each ladder comprising four stages. Food ladders are a less restrictive and less anxiety-inducing alternative to oral immunotherapy for children and their families.
Peanut allergy (PA) is one of the main food allergies in children in France, with significant clinical, psychosocial, and organizational impact. It is predominantly mediated by IgE mechanisms, except for rare cases of food protein-induced enterocolitis syndrome (FPIES). Diagnosis relies on a comprehensive approach combining a detailed medical history, skin tests (prick tests), measurement of specific IgE levels, molecular diagnostics (Ara h 1, 2, 3, 6, 8, 9), and sometimes cellular tests (basophil activation tests) and oral food challenges (OFC). Each tool has specific diagnostic performance characteristics and limitations, which must be interpreted within the overall clinical context. An integrated diagnostic approach, combining clinical, biological, and functional tests, optimizes diagnostic accuracy for peanut allergy, limits the indication for oral food challenges, and improves individualized patient management, while reducing the burden of the disease.
