Background: Multiple food allergies (MFAs) affect 30% of the child population with food allergy. The current treatment is the exclusion diet, which frequently affects the quality of life for these patients. The objective of the study was to describe the effect of omalizumab treatment in children diagnosed with MFAs who experienced frequent anaphylactic reactions and the impact on their quality of life.Material and methods: A descriptive observational study. Patients with severe food restrictions and high-risk due to multiple episodes of anaphylaxis were included. The allergy was confirmed by compatible clinical, skin tests, positive specific IgE and oral food challenges (OFCs). Omalizumab treatment was initiated and the impact on the life quality of patients and their families was assessed using the validated Food Allergy Quality of Life Questionnaire-Parent Form.Results: Five patients with an average age at diagnosis of 3.58 years (range between 1.5–7.9 years), were diagnosed with MFAs. All patients presented with anaphylaxis. All patients were treated with omalizumab between 2013 and 2019. Omalizumab treatment was initiated at a mean age of 6.05 years (range between 4.5–8.25 years). All patients have undergone OFC to reintroduce food successfully. 2 patients had their dose of omalizumab reduced by half, and 1 patient has had the time interval extended between administrations due to the maintenance of food tolerance. No immediate local or systemic adverse reactions were documented. Two patients have commenced omalizumab administration at home without incident.Conclusions: Children with MFAs who are treated with omalizumab do not show reactions in response to most of the foods to which they previously had anaphylaxis. Consequently, these patients were able to significantly expand the variety of their diet, improving the life quality and avoid anaphylaxis following the inadvertent intake of these foods.

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA) is a systemic small-to-medium-sized vasculitis associated with asthma and eosinophilia. Histologically EGPA presents tissue eosinophilia, necrotizing vasculitis, and granulomatous inflammation with eosinophil tissue infiltration. EGPA commonly involves the upper airway and lung parenchyma, peripheral neuropathy, cardiac disorders, and skin lesions. The anti-neutrophil cytoplasmic antibodies (ANCA) are positive in 40% of cases, especially in those patients with clinical signs of vasculitis. The pathogenesis of EGPA is multifactorial. The disease can be triggered by exposure to a variety of allergens and drugs, but a genetic background has also been described, particularly an association with HLA-DRB4. Th2 response is of special importance in the upregulation of different interleukins such as IL-4, IL-13, and IL-5. Th1 and Th17 responses are also of significance. Activated eosinophils have a prolonged survival and probably cause tissue damage by releasing eosinophil granule proteins, while their tissue recruitment can be regulated by chemokines such as eotaxin-3 and CCL17. Humoral immunity is also abnormally regulated, as demonstrated by excessive responses of IgG₄ and IgE. EGPA has a good respond to glucocorticoids, although the combination of glucocorticoids and immunosuppressants (e.g., cyclophosphamide, azathioprine) is needed in most of cases. Newer treatment options include anti-IL-5 antibodies (mepolizumab), whose efficacy has been described in clinical trials, and anti-CD-20, a B cell-depleting agent (rituximab), reported in several case series.

Background: Allergic rhinitis, conjunctivitis and asthma are prevalent IgE‐mediated respiratory diseases that frequently coexist and impair quality of life. Allergen immunotherapy (AIT) has clinical benefits and potential disease‐modifying effects. Until recently, standardised definitions of disease control and remission were lacking in routine clinical practice, particularly for allergic rhinitis and conjunctivitis. This study aimed to propose preliminary definitions of control and remission in patients receiving AIT and to assess expert consensus using the Delphi methodology. Methods: A scientific committee developed a survey based on a literature review and expert input, addressing symptoms, medication use, quality of life, exacerbations and tools for objective and subjective assessment. Forty allergists participated in a two‐round Delphi study. Consensus was predefined as ≥ 70% agreement on a 9‐point Likert scale. Results: Consensus was achieved for all items after two rounds. The panel agreed on proposed definitions of disease control and clinical remission for allergic rhinitis, conjunctivitis and asthma in the context of AIT, integrating symptom severity, medication use, validated questionnaires and objective measures. Conclusions: This study presents preliminary expert‐consensus definitions of control and remission in allergic rhinitis, conjunctivitis and asthma in patients undergoing AIT. These definitions should not be interpreted as validated clinical criteria or endpoints. As a preliminary proposal, they aim to provide a structured approach for assessing treatment response in clinical practice by integrating symptom burden, medication use, patient‐reported outcomes and objective measures. They should be regarded as an initial conceptual step, and further prospective studies are needed to validate these criteria and confirm their relevance, feasibility and applicability.