Introduction:Ataxia-telangiectasia (AT) is an autosomal recessive neurodegenerative disease characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, humoral and cellular immunodeficiency, sensitivity to ionizing radiation, and a tendency to malignancy. The aim of this study was to evaluate the demographic characteristics, immunodeficiency status, laboratory findings, and prognosis of children with AT based on a single-center experience.Patients and Methods:Nineteen pediatric patients diagnosed with AT between 2003 and 2024 were retrospectively analyzed at a single tertiary center.Results:The study included 11 male and 8 female patients, with a mean follow-up duration of 72.6 ± 41.3 months. The mean ages at symptom onset and diagnosis were 30.47 ± 23.7 months and 82.32 ± 26.5 months, respectively. The most common presenting symptoms were gait instability, ocular telangiectasia, and recurrent respiratory tract infections. Immunological evaluation revealed IgA deficiency in 57.9% of the patients and IgG deficiency in 15.8%. A hyper-IgM AT phenotype was identified in two patients (10.5%). During follow-up, bronchiectasis and hepatosteatosis developed in 26.3% of the patients. One patient (5.2%) developed type 2 diabetes mellitus, and malignancy occurred in three patients (15.7%). Overall, 6 patients (31.5%) died during the follow-up period.Conclusion:Ataxia-telangiectasia is a rare multisystem disorder associated with significant morbidity and mortality. Early diagnosis, comprehensive multidisciplinary follow-up, regular malignancy surveillance, and preventive strategies for recurrent sinopulmonary infections are essential for improving clinical outcomes and prognosis in affected patients.

The aim of this study was to evaluate the nutritional status, especially calcium deficiency, of breastfeeding mothers of infants diagnosed with cow's milk food protein-induced allergic proctocolitis (FPIAP) on an elimination diet and to investigate the relationship between daily calcium intake and body composition of these mothers. Our prospective cohort study included 86 patients with cow's milk protein allergy (CMPA) and their mothers on an elimination diet. The mother's body fat, muscle, and water percentages were measured with the Bioelectrical Impedance Method (Tanita MC-580). All mothers were administered a diet containing an average of 2000 kcal (kilocalorie), 1000 mg of calcium, and 400 units per day of vitamin D. The final measurements were repeated 1 month later and the results of the first and second assessments were compared. The mean age of the patients included in the study was 3.8 ± 1.8 months, and the M/F (male to female) ratio was 18/17. In all, 54.3% of the patients had only CMPA, while 45.7% had multiple food allergies, including milk. A comparison of the mother's body measurements before and after the diet showed a significant decrease in fat but with an increase in calcium levels. In contrast, muscle and water ratios did not change (p < 0.001, p = 0.332, p = 0.189). Despite the recommendation of a 2000 kcal per day diet, the second evaluation found that calorie, fat, and protein ratios were significantly reduced (p = < 0.001, p = 0.011, p = 0.009, p < 0.05, respectively). The metabolic health of breastfeeding mothers who follow an elimination diet for CMPA is affected even with dietician support.

Background/Objectives: Inborn errors of immunity (IEI) are rare and complex pediatric disorders that create significant information gaps for families and non-specialist healthcare professionals. Large language models (LLMs) such as ChatGPT are increasingly used as on-demand health information resources; however, evidence on their performance in rare pediatric diseases remains limited. This study aimed to evaluate the reliability, quality, readability, understandability, reproducibility, and safety-related concerns of ChatGPT-4o responses to frequently searched questions about pediatric IEI posed by healthcare professionals and patients/caregivers. Methods: This cross-sectional evaluation used the publicly accessible ChatGPT-4o interface to generate responses to 20 frequently searched questions about pediatric IEI, equally distributed between healthcare professional (n = 10) and patient/caregiver queries (n = 10). Three pediatric allergy-immunology specialists independently evaluated response quality using the modified DISCERN (mDISCERN) and Global Quality Scale (GQS) tools, supplemented by a structured expert-based assessment of misinformation, safety-related concerns, suspected factual issues, missing disclaimers, and clinically meaningful inter-iteration inconsistency. Text readability was assessed using four validated indices (ARI, FRES, FKGL, GFR), comprehensibility using the Patient Education Materials Assessment Tool (PEMAT), and reproducibility using natural language processing methods. Results: ChatGPT-4o demonstrated strong overall performance, with median mDISCERN and GQS scores of 4 (IQR: 3-5) for both query types. Readability scores substantially exceeded recommended thresholds, with FKGL scores of 12.96 ± 0.69 and 10.83 ± 0.67 for professional and patient/caregiver queries, respectively. Mean PEMAT understandability scores were 71.80 ± 5.75% for professional queries and 80.80 ± 4.73% for patient/caregiver queries (p = 0.001). Reproducibility was high, with semantic similarity rates of 86.10 ± 3.84% and 87.30 ± 3.68%, respectively. Suspected factual issues were identified in 4 of 20 responses (20%), safety-related concerns in 3 (15%), clinically meaningful inter-iteration inconsistencies in 3 (15%), and missing medical disclaimers in all 20 responses (100%). Conclusions: ChatGPT-4o showed strong performance across validated quality metrics for pediatric IEI information support; however, its high reading level, universal absence of medical disclaimers, and occasional clinically meaningful inconsistencies limit its suitability as a standalone source for clinically sensitive guidance. These findings underscore the need for AI-driven patient education tools with improved readability, adaptive complexity adjustment, and safety-oriented communication.

OBJECTIVE:Asthma is the most common chronic disease of childhood, characterized by symptoms such as wheezing, shortness of breath, and coughing. With the advancement of technology, artificial intelligence (AI) applications are increasingly being used in various fields, among which ChatGPT is one of the most widely utilized. The aim of this study is to evaluate the reliability, quality, and readability of the answers provided by the ChatGPT-4o application to questions related to pediatric asthma. METHODS:The ChatGPT-4o application was used to record answers to 25 of the most frequently asked questions about asthma in children. To determine the quality and reliability of the answers, we used the Global Quality Scale and modified DISCERN tool. We tested readability using seven indices: Automated Readability Index, Flesch Reading Ease Score, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Readability Index, Simple Measure of Gobbledygook, Coleman-Liau Readability Index, and Linsear Write Formula. RESULTS:The answers provided by the ChatGPT-4o application to questions about childhood asthma were found to have good reliability (88% by the first evaluator and 84% by the second evaluator) and high quality (88% by both evaluators). The application scored 10.77 ± 1.58 on the FKGL scale, and in conjunction with the other indices, the results indicated that the answers required a high level of reading proficiency. CONCLUSIONS:Artificial intelligence can be a reliable tool for parents in providing information about pediatric asthma. However, these findings suggest that readability issues may hinder the clinical application of AI-generated content in asthma diagnosis and treatment.

Background/aim: The incidence of cat allergies in children has increased over the years. Children with cat allergies have mostly reported respiratory symptoms. The skin prick test (SPT) is the most preferred method to demonstrate sensitization to allergens. However, not all children who develop cat sensitization due to environmental exposure become allergic to cats. In our study, we aimed to determine the frequency of sensitization to cat and cat allergy, cat-related symptoms, and the cut-off value for the SPT that may indicate cat allergy. Materials and methods: Patients aged 2-18 years, who applied to the Health Sciences University İzmir Dr Behçet Uz Pediatrics and Surgery Training and Research Hospital and Balıkesir University Application and Research Hospital Pediatric Allergy outpatient clinics between January 01, 2019 and December 31, 2020, were included in the study. Patients who underwent SPT and found to be sensitized to cat allergen, were evaluated retrospectively. Clinical and laboratory findings of the patients were recorded. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value for the SPT. Results: Sensitization to cat was detected in 140 (4%) out of 3499 patients who underwent SPT. The median age of the patients was 12 years (min-max: 5-18) and 67.1% were male. Eighty-eight (62.9%) patients were symptomatic upon contact with cats, predominantly with nasal symptoms. These patients had significantly larger cat SPT wheal size than asymptomatic patients. The cut-off value was determined as 5.5 mm with a sensitivity of 72.7% and a specificity of 61.5% (95% CI, 60.5%-78.4%). Symptoms resolved in about half of our patients by reducing contact with cats. Conclusion: The present study is the first to report the frequency and clinical findings of cat sensitizations and allergies in Turkish children. For effective treatment, cat allergy must be diagnosed. In this regard, the use of a practical, readily accessible 5.5 mm cut-off point on the SPT may be helpful.

Objective: In a large group of patients with primary immunodeficiency (PID), immunoglobulin replacement therapy is critical for infection control. There are two main methods of immunoglobulin replacement intravenous (IVIG) and subcutaneous (SCIG). The aim of this study was to determine the efficacy of SCIG by comparing IgG levels and frequency of infections obtained during SCIG replacements in patients with PID with those obtained during IVIG administration. Method: Immunoglobulin levels of 28 patients who were followed up in our clinic with a diagnosis of PID and who started IVIG replacement and switched to SCIG replacement after follow-up, were evaluated retrospectively. Serum IgG levels and frequency of infections before starting immunoglobulin treatment, the previous year of IVIG before starting SCIG replacement, and during the first six months, second six months, and second year of SCIG replacement were compared. Results: The mean age of all the patients that received SCIG was 10.5 years (min 15 months, max 23 years) and eleven of the patients were female. The mean serum IgG level of the patients before starting immunoglobulin replacement was 701±383 mg/dl, and for the final year they received IVIG replacement before switching to SCIG replacement it was calculated to be 900±342 mg/dl. The mean value was found to be 1082±312 mg/dl in the first six months after the initiation of SCIG, 1102±287 mg/dl in the second six months, and 1145±311 mg/dl in the second year. Serum IgG levels of the patients were significantly higher during IVIG and SCIG replacement than before treatment (p<0.05). Serum IgG levels during the first six months, second six months, and second year of SCIG treatment were significantly higher than levels during IVIG treatment (p=0.000, p=0.003, and p=0.002, respectively). Conclusion: Compared to IVIG replacement, significantly higher and more stable serum IgG levels can be obtained with SCIG replacement. This is expected to ensure improved outcomes in the management of infections in PID patients.

A 4-year-old boy presented with acute-onset autoimmune cytopenia with severe, persistent lymphopenia, autoimmune thyroiditis, elevated IgE and glucose 6-phosphate dehydrogenase enzyme deficiency. In immunologic evaluation, lower T, B and natural killer cells and higher levels of adenosine deaminase (ADA) metabolites were observed. The compound heterozygous novel ADA gene mutations causing ADA deficiency were detected. Successful immunologic and metabolic cure was achieved with enzyme replacement therapy, followed by reduced intensity conditioning hematopoietic stem cell transplantation from a matched unrelated donor. An interesting aspect of this patient is the detection of novel compound heterozygous mutations without consanguinity and a secondary outcome is the recovery of glucose 6-phosphate dehydrogenase deficiency after hematopoietic stem cell transplantation.

Background. - Cold urticaria (ColdU) is a subtype of chronic inducible urticaria. Although cold urticaria is rare in children, it has a special importance because it can result in anaphylaxis. Since it is difficult to protect patients from cold for many years, the prognosis of the disease is curious.Objective. - We aimed to evaluate the clinical features and prognosis of children with cold urticaria.Methods. - Patients with cold urticaria who were followed up in our pediatric allergy and immunology clinic between 2006 and 2020 were retrospectively evaluated. The reaction was divided into three groups according to the severity of symptoms: type 1; urticaria and/or angioedema at the contact site; type 2; diffuse urticaria and/or angioedema without other systemic symptoms; and type 3; other systemic reactions compatible with anaphylaxis.Results. - Our study included 21 patients, 52.4% of whom were male, with a mean age at diagnosis of 10.8 & PLUSMN; 4.3 years (4-18 years). The median follow-up period of the patients was 36 months (24-62 months). Localized cold urticaria was detected in 57.1% of the cases. Type 2 reaction was found in 14.3% of the cases and Type 3 reaction was found in 28.6%. In 6 cases, there was a history of anaphylaxis (Type 3). Remission developed in four (19%) patients, symptoms decreased in 6 (28.6%) patients, and symptoms persisted in 9 (42.9%) patients.Conclusion. - Children with cold urticaria are at high risk of systemic reactions and unfortunately the disease tends to persist. Detailed guidelines are needed for follow-up and treatment considering that elimination is very difficult in children.& COPY; 2022 Elsevier Masson SAS. All rights reserved.

Objective: As a primary immunodeficiency X-linked agammaglobulinemia (XLA) that develops due to Bruton tyrosine kinase signal transduction protein deficiency which progresses with antibody deficiency was firstly described by an American pediatrician Ogden Bruton. In our study, we have aimed to evaluate the demographic, clinical, immunological, genetic characteristics and follow-up findings of patients diagnosed with XLA in our tertiary care Pediatric Immunology Clinic. Method: Twelve patients diagnosed with XLA between 2003-2022 in our pediatric immunology clinic we're included in our study. The patient's age, sex, age at symptom onset and diagnosis, family history, laboratory findings at the time of diagnosis, complications observed during clinical follow-up and treatment modalities used were evaluated retrospectively. Results: The median age of the patients at diagnosis was 36 [interquartile range (IQR) 10.2-69.0] months. While the median age of the patients without a family history at the time of diagnosis was 66 ( IQR 41.2-66.0) months which was found to be significantly higher compared to the patients with a family history [11.5 (IQR 2.5-30.0) months] (p=0.004). Recurrent respiratory tract infections were the most common indications for admission. Agammaglobulinemia was detected in all patients except two cases. A significant decrease in B cells was detected by flow cytometry in all patients. The diagnoses were confirmed by genetic analysis for nine patients. Bronchiectasis was observed in four, arthritis in three, and inflammatory bowel disease in one case. In one patient, metaplasia was detected in the cytologic examination of the biopsy specimen obtained during endoscopy performed for the diagnosis of inflammatory bowel disease. Conclusion: Early diagnosis, treatment and regular follow-up convey critical importance in terms of preventing complications in patients with XLA.

Objective: Hereditary Angioedema (HAE) is a rare but life-threatening disease. It is aimed to present data on the clinical characteristics of our pediatric patients with HAE, whose symptoms usually start in childhood, but the delay in diagnosis is still a serious problem. Method: Clinical and laboratory findings, family histories, and clinical characteristics of 14 patients with HAE diagnosed in our clinic between 1998-2019 were analyzed. Results: Half of our patients diagnosed with HAE were girls, 78.5% of them were diagnosed with HAE type 1, and 21.4% were HAE type 2. All our patients had a family history, and 10 of them were diagnosed based on their family history. The mean age at diagnosis was 9.7±4.4 years and the mean age at the onset of the first angioedema symptom was 5.3±1.8 years. The delay in diagnosis was 4.4±4.1 years. The swollen areas included extremities (78.5%), abdominal attacks (71.4%), facial edema (57.1%), and laryngeal edema (21.4%). C4 levels were low in all patients. The mean C1 esterase inhibitor level was 0.69±0.08 g/l for HAE type 2 and 0.08±0.04 g/l for HAE type 1. The mean C1 esterase inhibitor functional activity level was 18.6±10.4% in HAE type 2. Conclusion: Early diagnosis of the disease is critical for reducing morbidity and mortality due to attacks. There are very few studies in Türkiye that focus exclusively on pediatric HAE patients. Sharing our patients’ clinical findings and treatment plans for this rare disease is crucial for bringing the disease to light and raising awareness.

Objective: Atopic dermatitis (AD) is a chronic, itchy, recurrent, and recurrent inflammatory skin disease that affects 2-20% of the population, especially in childhood. Its pathophysiology is complex and occurs as a result of genetic, immunological, and environmental factors, especially epithelial-barrier dysfunction. We determined the frequency of food sensitization and vitamin D deficiency in patients with AD.Methods: This cross-sectional retrospective study was conducted by examining the files of patients who were admitted to the pediatrics allergy and immunology outpatient clinic with AD. A total of 72 patients with eczema were included in the study.Results: 37.5% (n=27) of the patients were girls. The mean age was 3.8 +/- 3.6 years. Food sensitization was proven in 40.2% (n=29) of all cases included in the study. Vitamin D deficiency was found in 30.6% (n=22) of the cases. Serum 25-hydroxyvitamin D3 levels were found to be lower in the patient group than in the control group. The limitation of our study is that it was retrospective and blood tests could not be re-evaluated after treatment in all patients.Conclusion: In patients with AD, serum vitamin D levels were significantly lower. We examined vitamin D deficiency in AD patients who applied to us as a clinical team. According to our study, we can say that both food sensitization and vitamin D deficiency should be investigated in AD patients.

Intravenous immunoglobulin (IVIG), which is primarily immunoglobulin G (IgG), is used in the treatment of many diseases. While it is generally well tolerated, some adverse effects may be seen in different systems during IVIG treatment. The adverse effects of IVIG infusion are typically mild and related to the infusion rate. The formation of the immunoglobulin aggregates that lead to the activation of the complement system can be prevented by decreasing the infusion rate, and mild adverse effects may be overcome. In rare cases, however, severe life-threatening adverse effects may develop, such as anaphylaxis, cardiac dysrhythmia, bronchospasm, changes in consciousness, aseptic meningitis, colitis and thromboembolism. We report here on a case diagnosed as unclassified antibody deficiency that developed a clinical picture of “diarrhea” due to IVIG treatment. The treatment was switched to the subcutaneous application (SCIg), and diarrhea was prevented.

Acute asthma exacerbations (AAE) are episodes characterized by potentially life-threatening and rapidly deteriorating asthma symptoms. Viral respiratory infections are one of the major triggers in the pathophysiology of childhood asthma exacerbations. In this study, we aimed to determine the distribution of viral agents among pediatric AAE patients. One hundred and three AAE patients, aged 5 or older, hospitalized between from February 2017 through February 2020 at Pediatric Immunology and Allergic Diseases Unit were included in this study. Fifty patients (48.5%) were female, and the mean age of the patients was 108.2 months. Viruses were detected in 58 (%56.3) of the patients, in 5 of whom more than one virus type was detected. The most commonly detected virus was human rhinovirus (n=43, 67.1%). Other types included respiratory syncytial virus (n=8; 12.5%), influenza (n=6; 9.3%), human metapneumovirus (n=4; 6.2%), adenovirus (n=1; 1.5%), enterovirus (n=1; 1.5%), and parainfluenza (n=1; 1.5%). Viral agents were detected in 29 out of the 47 patients with allergic asthma, with human rhinoviruses comprising the majority (18 patients). The mean length of hospital stay was 7.89 days. Human rhinovirus is the most common virus that triggers AAE, with similar distributions in allergic and non-allergic asthma. We found no correlation between virus type and the length of hospital stay.

Doğal ve Kazanılmış Bağışıklık Koray Ayar Mhc Ve Antijen Sunumu Dilek Tezcan Hücresel İmmünite Emel Yantır Hümoral İmmünite Yahya Gül İmmüntolerans ve Otoimmünite Selime Ermurat Aşırı Duyarlılık Reaksiyonları Şefika İlknur Kökcü Karadağ Primer İmmün Yetmezlikler ve Güncel Tedavileri Güzin Özden Tümör İmmünolojisi Şeyhan Kutluğ Deri Prick Testleri Yurda Şimşek Deri Yama Testleri Şule Kızıltaş Alerjide Bileşene Bağlı Testler Özlem Sancaklı Alerjen Spesifik İmmünglobulin Testleri Halime Dağgez Besin Alerjenlerinde Bileşene Bağlı Testler (Alex, Isac) Gizem Geçgel Aras Bazofil Aktivasyon Testi Barış Boral Alerjik Rinit ve Tedavisi Banu Taşkıran Tatar Alerjik Astım ve Tedavisi Abdullah Şimşek Nazal Poliple Seyreden Kronik Rinosinüzit Ve Tedavisi Selver Seda Mersin İmmünoterapi Cevriye Kübra Cenkçi Ağır Astımlı Olgularda Biyolojik Ajanlarla Tedavi Eylem Yıldırım Latekse Bağlı Gelişen Alerjik Reaksiyonlar Mutlu Güneş Lateks Alerjisinde Tanı İlke Taşkırdı Lateksle Çapraz Reaktif Gıda Alerjileri Tuba Vural Sağlık Çalışanlarında Lateks Alerjisi Eylem Yıldırım Lateks Alerjisi Yönetimi ve Tedavisi Tuba Vural İlaç Alerjisinde İn Vitro Tanı Testleri Öznur Doğar İlaç Alerjilerinde İnvivo Tanı Testleri Ayşe Şenay Şaşihüseyinoğlu Ürtiker, Anjioödem, Serum Hastalığı Benzeri Bulgular Özge Kangallı Boyacıoğlu Vezikülobüllöz Reaksiyonlar Özge Kangallı Boyacıoğlu Makülopapüler Döküntüler, Fiks İlaç Erüpsiyonları ve Dress Türkan Zeynep Fendoğlu İlaç Provokasyon Testleri Papatya Bayrak Değirmenci İlaç Desensitizasyonu Ayşe Kırmızıtaş Aydoğdu Erişkinde Gıda Alerjileri Huriye Aybüke Koç Besin Alerjilerinde Tanı Hülya Poyraz Efe Besin Alerjilerinde Desensitizasyon Sanem Eren Akarcan Akut Ürtiker Ve Anjioödem Selma Erol Aytekin Akut Ürtikerde Etyoloji Özge Atay Akut Ürtiker Ve Anjiyoödemde Tedavi Kübra Aşık Cansız Kronik Spontan Ürtiker-Anjiyoödem Aylin Kont Özhan Kronik Ürtiker Ve Anjioödem Etyoloji Melike Şener Ürtiker Tanı Testleri Metin Keren Kronik Ürtikerde Güncel Tedaviler Ve Biyolojik Ajanlarla Tedavi Tuğba Songül Tat İlaçlara Bağlı Anjioödem Neyran Şerbetçi Lenfoma Ve Diğer Malignitelerin Seyri Sırasında Görülen Anjiyoödemler Selver Seda Mersin Herediter Anjioödem Ayşe Kırmızıtaş Aydoğdu Herediter Anjiyoödemde Güncel Tedaviler Esra Nur Bülbül Mastositoz Sinan Mersin Anafilaksi Nedir? Etiyolojik Faktörler Nelerdir? Fevzi Demirel Anafilakside Deri Bulguları Emel Atayık Anafilaksinin Sistemik Bulguları Buket Baran Akdeniz Anafilakside Korunma Nasıl Olmalı? Nurullah Yekta Akçam Anafilaksi Tanı Ve Tedavisinde Güncel Gelişmeler Zübeyde Dinçer Anafilaksi Tedavisinde Komorbid Durumlar Murat Aras Perioperatif Anafilaksi Nurullah Yekta Akçam Ahmet Sencer Yurtsever Arı Alerjilerinde Tanı Ve Bileşene Bağlı Tanı Yöntemleri Meltem Cömert Arı Alerjisinde Koruyucu Önlemler Ve Adrenalin Otoenjektör Kullanımı Tuğba Güler Venom İmmünoterapisi Dilek Öksüzer Çimşir Atopik Dermatitte Tanı ve Fenotipler Tuğba Yülek Atopik Dermatitte Ayırıcı Tanı Şeyhan Kutluğ Genel Önlemler, Nemlendiriciler, Islak Pansuman Gülşah Ayçin Atopik Dermatitte Topikal ve Sistemik Tedaviler Derya Üstün Eroğlu

Background: It is known that platelets play an important role in inflammatory diseases. Atopic dermatitis (AD) is a chronic, itchy, recurrent inflammatory skin disease that affects 2%-30% of the population, especially in childhood. Aims: We investigated the role of platelet count and mean platelet volume (MPV) as biomarkers in children with AD. Methods: This cross-sectional retrospective study examined the medical reports of patients who were referred to the Pediatric Allergy and Immunology Outpatient Clinic of the Medical Faculty Hospital, Istanbul Biruni University and the Pediatric Immunology and Allergy Diseases Outpatient Clinics of the Izmir S.B.U Tepecik Training and Research Hospital, for AD. A total of 167 children with AD and 170 healthy children were included in the study. Results: Among all participants, 36.5% (n = 61) and 31.8% (n = 54) were female in the patient and control groups, respectively. The mean age was 2.8 ± 2.8 and 3.3 ± 2.5 years in the patient and control groups, respectively. MPV was statistically significantly higher in the patient group than in the control group (P =0.003). Mean platelet to neutrophil ratio and mean absolute lymphocyte count values were significantly higher in the patient group (P <.0001 for both values). However, the mean absolute neutrophil count was lower in the patient group than in the control group and it was considered statistically significant (P <.0001). Conclusion: In conclusion, we found significantly higher platelet counts in patients with AD. The decrease in the neutrophil to lymphocyte ratio rate was remarkable. However, there was no significant difference in the MPV values between the patient and control groups.

Amaç: Astım, çocukluk çağı kronik hastalıkları arasında en sık görülen ve reversibl hava yolu obstrüksiyonu ile karakterize enflamatuvar bir hastalıktır.Çalışmamızda astım tanısı kesinleştirilen çocukların ilk kez astım semptomlarının hangi yaşta başladığının

PurposeAllergy to legumes and tree nuts (TNs) is one of the most important causes of fatal and near-fatal food-induced allergic reactions. However, our knowledge of the clinical features of legumes and TNs allergies in children is limited. In this study, we aim to identify clinical characteristics, development of tolerance, risk factors of legumes and TNs allergies in children.MethodsThis retrospective study was designed at two cities at the west part of Turkey. Fifty-seven children with legumes and TNs diagnosed at Clinic of Pediatric Allergy of Balikesir University and Dr Behcet Uz Children Hospital for 2014–2018 years were examined. Current age, gender, age of onset of the legumes and/or TN allergy, the type of the allergic reactions, family history of atopy, results of skin prick test (SPT), and/or oral challenge test and presence of concomitant food allergies, tolerance development and cross reactions were recorded.ResultsIn total, 83 allergies related with legumes and TNs were determined in 57 patients. Mean age of patients was 18.75±13 months and 40.4% were girl. Fifty-two of these reactions were related with legumes (62.6%) and 29.9% of patients had reaction with more than one. Peanut allergy was most common in legumes allergy (53.8%) and walnut allergy was most common in TNs allergy (54.8%). Urticaria was most common type of allergic reaction (56.6%), 28.9% of reactions were anaphylaxis. No statistically significant difference was found between legumes and TNs in terms of the frequency of development of anaphylaxis (P=0.062). Concomitant food allergy was present 80.7% of patients. Patients with legume allergy had significantly high hazelnut and walnut allergy (P=0.04, P<0.001, respectively). Significantly, high peanut and lentil allergy were detected in patients with TNs allergy (P=0.01, P=0.026, respectively). There was co-sensitization and co-allergy between legumes and TNs in children as expected. Tolerance development was shown in 12.2% of patients.ConclusionsIn addition to other food allergies, legumes/TNs allergies are also observed to occur with increasing frequency in children. Co-sensitization and co-allergy between legumes and TNs are frequent. Tolerance development for legumes/TNs allergies is expectedly low.

Study objective:The lockdown imposed on children due to the COVID-19 pandemic and their inability to attend school increased their exposure to indoor allergens by causing them to spend more time indoors. In this study, the aim was to reveal the effect of the pandemic and increased exposure to indoor aeroallergens on the symptom severity of school-age children with house dust mite-sensitized allergic rhinitis (AR).Patients and methods:Patients between the ages of 6-18-years old, who were followed-up with the diagnosis of perennial AR sensitized to only mites were questioned about their sinonasal symptoms. The Total Nasal Symptom Score (TNSS) questionnaire was performed. The clinical findings, drug usage, frequency of infections and attacks were evaluated and compared during COVID-19 lockdown and the same time frame in 2019.Results:Sixty-five patients had AR, and 33 patients (50.8%) had AR with asthma. TNSS of the patients improved during the pandemic (P < 0.001) and their medication scores decreased significantly (P < 0.001). The frequency of respiratory tract infections and asthma attacks decreased significantly (P < 0.001). In multivariate analysis, risk factors were evaluated for the 'group with worsening TNSS' and coal/wood burning was detected to be an independent risk factor (P = 0.006; OR = 10.09 (95% CI: 1.97-51.87)).Conclusion:Although the increased stay at home, it is surprising that nasal symptoms improved in our patients. This result suggests that whereas allergen sensitivity is responsible for the pathogenesis of AR, exposure to pollution and viral infections which are reduced by masking and social distance may also play an important role in the pathogenesis.

INTRODUCTION AND OBJECTIVESThe purpose of this study was to evaluate patients diagnosed with 22q11.2 deletion syndrome and determine the clues directing to diagnosis and evaluation of immunological findings for excellent management of the disease.MATERIAL AND METHODSThirty-three pediatric patients with 22q11.2 deletion syndrome diagnosed between 1998 and 2019 at Pediatric Immunology Division of Ege University Faculty of Medicine and SBU Izmir Dr Behcet Uz Children's Education and Research Hospital were evaluated.RESULTSThis study includes the largest case series reported from Turkey. Congenital cardiac anomalies were the most common pathology associated with the syndrome (90.9%). Hypocalcemic symptoms were observed in 13 patients (40%). Twenty-two of the 33 (66.6%) patients were diagnosed before two years of age. Autoimmune diseases, dysmorphic facial findings, recurrent infections, growth retardation, and speech impairment were other clues for diagnosis in older patients. Clinical spectrum and immunological abnormalities of this syndrome are quite variable. All T-cell subset counts were less than 5th percentile below median by age in one patient (3%) and 10 patients had normal all T-cell subset counts (30.3%). Overall, 69.6% of the patients had normal IgG, IgA, and IgM levels and two patients had panhypogammaglobulinemia. Recurrent infections were revealed in 75.7% of the patients during follow-up.CONCLUSIONSPresence of cardiac anomaly is more helpful in the diagnosis, especially under two years of age. Patients with immunologically high or standard risk did not show any difference in terms of numbers and severity of infections and autoimmunity.