Introduction: A patient was presented with a history of idiopathic recurrent anaphylaxis after administration of Pfizer BioNTech mRNA vaccine, and the attacks were controlled with omalizumab. To our knowledge, this is the first reported case of recurrent idiopathic anaphylaxis (IA) after administration of Pfizer BioNTech mRNA vaccine. Case Presentation: A 52-year-old man with recurrent episodes of IA after COVID-19 vaccination presented to our adult Allergy and Immunology Clinic. In the patient, urticaria and anaphylaxis episodes could not be controlled with high-dose antihistamine and systemic steroid treatment, and complete control was achieved with omalizumab treatment and anaphylaxis attacks completely regressed. Conclusion: In cases of unexplained or recurrent anaphylaxis in adult patients, COVID-19 vaccination and timing should be questioned, and its association with anaphylaxis might be considered.

Background: Data on tuberculosis, a leading cause of infectious disease mortality, in patients with inborn errors of immunity (IEI) are limited. Objective: This study aimed to evaluate the burden of tuberculosis and the diagnostic utility of the tuberculin skin test (TST) in patients with IEI and to propose a tuberculosis screening strategy. Methods: Evaluation comprised a comprehensive exposure history, symptom assessment, TST (which was repeated after 1–4 weeks if the initial result was 0–4 mm), and chest imaging including radiography and computed tomography where available. Patients underwent standard clinical assessment for tuberculosis, followed by appropriate treatment and follow-up. Results: Among 117 patients with IEI [median age = 35 years, interquartile range (IQR) = 26–45.5 years], antibody deficiencies were the most common subgroup (82.1%). All patients had previously received a Bacillus Calmette–Guérin (BCG) vaccination. Of the 105 patients who underwent TST, 19 had a history of tuberculosis, the majority of whom had pulmonary involvement (59.1%), and three had recurrent disease. Three patients diagnosed with pulmonary, gastrointestinal, and lymph node tuberculosis had TST values of 22, 9, and 9 mm, respectively. Two patients with TST measurements of 12 and 6 mm were diagnosed with non-tuberculous mycobacterial lung disease. The median TST was 9 mm (IQR = 1.5–14.25 mm) in patients with tuberculosis and was 4 mm (IQR = 0–10.5 mm) in those without. Conclusion: This study represents the first comprehensive evaluation of tuberculosis screening and TST assessment in patients with IEI. Pulmonary tuberculosis was the most common site of involvement. In BCG-vaccinated patients with IEI who developed tuberculosis, the TST responses remained below the conventional 15-mm threshold, highlighting the need for revised cutoff values in this population, similar to those recommended for patients with HIV.

Background: Hereditary angioedema (HAE) is a rare, potentially life-threatening condition that requires accessible and reliable information. YouTube has emerged as a significant source of health-related content, offering valuable insights while posing the risk of misinformation that warrants caution among users. The aim of this study was to evaluate the popularity, reliability, understandability, actionability, and overall quality of YouTube videos related to HAE. Method: A search was conducted on YouTube using the term “hereditary angioedema.” Videos were categorized based on their origin (health or nonhealth) and content type (medical professional education (MPE), patient education (PE), patient experience, or awareness). The quality, reliability, understandability, and actionability of the videos were assessed via the Global Quality Scale (GQS), the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), and the Quality Criteria for Consumer Health Information (DISCERN) tool. Three independent allergists evaluated the videos. Results: Out of 135 reviewed videos, 111 met the inclusion criteria. The health group presented significantly higher scores than did the nonhealth group in several metrics: PEMAT-A/V understandability (83, IQR: 56–92, p = 0.001), total DISCERN score (37, IQR: 3–45, p < 0.001), reliability (23, IQR: 19–26, p < 0.001), treatment (15, IQR: 8–21, p = 0.007), and modified DISCERN score (3, IQR: 2–4, p = 0.002). Health videos were uploaded more recently (p = 0.006), while awareness videos tended to be older than more recent MPE videos (p = 0.002). The MPE videos had the longest duration, whereas the awareness videos had the shortest duration (p < 0.001). Video quality scores, assessed via the GQS, were higher in both the MPE and PE groups (scores: 3, 4, and 5; p = 0.005). Compared with the other groups, the MPE group also had significantly higher PEMAT-A/V understandability scores (91, IQR: 70.75–92, p < 0.001), total DISCERN scores (40, IQR: 30.75–49.5, p < 0.001), reliability scores (24, IQR: 21–27.25, p < 0.001), and overall scores for moderate to high quality (83, 74.8%, p = 0.002). Conclusion: YouTube videos on HAE uploaded by health care professionals generally offer higher-quality information, but their overall reliability remains suboptimal. There is a pressing need for higher-quality, trustworthy content, particularly from professional medical organizations, to address this gap.

Background: Biologic therapies targeting the interleukin-5 (IL-5) pathway improve asthma control and chronic rhinosinusitis with nasal polyposis (CRSwNP) in patients with non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD). However, their effect on NSAID tolerance remains insufficiently characterized. Objective: This study aimed to investigate whether anti-IL-5/IL-5 receptor (IL-5R) treatments could improve NSAID tolerance in patients with NERD and Blended Reactions (BRs). Method: Clinical parameters, including the Asthma Control Test (ACT), 22-item Sino-Nasal Outcome Test (SNOT-22), visual analog scale (VAS) scores for quality of life, nasal polyp grade, and inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) dose, were compared before and after biologic therapy. ASA provocation tests were repeated during biologic treatment and compared with prior challenge results; outcomes were also compared between the biologic-treated group and the biologic-naive comparison group. Results: Patients who received biological treatments showed significant improvements compared to baseline, with eosinophil counts decreasing from 695 (590–892.5) to 50 (30–60), ACT scores increasing from 12 (8.7–18) to 24 (20.7–24.2), SNOT-22 scores declining from 56 (51–73) to 16 (5.7–28.7), and VAS scores improving from 1 (0–2.2) to 9 (7–10), all with p=0.001. ASA provocation positivity decreased to 28.5% (p=0.002), and all patients stepped down from high-dose to medium/low-dose ICS/LABA. Among the four patients who remained intolerant, reactions occurred at higher cumulative doses, with delayed onset and milder symptoms. Conclusion: Our study indicated that blockade of IL-5 pathway significantly improved clinical outcomes and reduced ASA hypersensitivity in patients with NERD/BRs, highlighting their potential role in modifying disease phenotype beyond asthma control.