Background: Anaphylaxis is an emergency that must be correctly recognized and treated by every health care professional. With the update of the World Allergy Organization (WAO) criteria in 2020, differences between the European Academy of Allergy and Immunology (EAACI)/The National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) and WAO criteria have come to the fore. Objective: The aim of our study is to compare the effectiveness of these 2 criteria in diagnosing anaphylaxis in pediatric patients. Methods: Patients aged 0-18 years who applied to Ankara Bilkent City Hospital Pediatric Immunology and Allergy Clinic between September 1, 2020 and September 1, 2023 due to systemic allergic reaction and were diagnosed with anaphylaxis were evaluated retrospectively. The clinical findings of the patients were re-evaluated accordingto WAO 2020 and NIAID/FAAN/ EAACI criteria. Results: Included in the study were 492 patients who met the inclusion criteria. Median age was 3.8 years (IQR: 0.9-11.4). The majority of patients were male (59.6%). There were 466 patients (94.1%) diagnosed with anaphylaxis according to both NIAID/FAAN/EAACI and WAO criteria. Three patients (0.6%) with isolated laryngeal involvement and 23 (4.7%) patients with isolated respiratory findings (bronchospasm) were diagnosed only according to WAO Criterion 2, for a total of 26 patients (5.3%). Conclusion: Although the majority of patients were diagnosed with both criteria, 5.3% were diagnosed only according to the WAO criteria. After contact with a suspected or known allergen, the presence of isolated respiratory or laryngeal findings without skin findings should be a warning before anaphylaxis progresses to more serious stages.

The diagnosis of IgE-mediated cow’s milk allergy (CMA) involves serum-specific IgE (spIgE), skin prick tests (SPT), and the gold standard oral food challenge (OFC). SpIgE levels are measured using methods such as ImmunoCAP and IMMULITE, with most cutoff data derived from ImmunoCAP. This study aims to determine IMMULITE-specific cutoff values to predict OFC positivity. Patients diagnosed with CMA via OFC between 2019 and 2023 were retrospectively analyzed. Data on demographics, eosinophil counts, total and specific IgE levels, and SPT results were collected. OFC was conducted using yogurt, milk-based formula, or milk-containing muffins. SPTs were performed with commercial extracts (Lofarma®) and pasteurized milk using the prick-to-prick method. SpIgE levels were measured with the Siemens® IMMULITE 2000 Immunoassay System, with values ≥0.35 kU/L considered positive. The study included 50 OFC-positive patients (60% males) and 50 age- and clinically matched controls without objective OFC reactions. The median age at diagnosis was 6 months (IQR: 3–21), and 52% presented with atopic dermatitis. OFC reactions occurred with yogurt in 42 patients (84%), muffins in 6, and milk in 2; 26% of reactions were anaphylaxis. IMMULITE-derived cutoff values were 3.13 kU/L (AUC: 0.776, 72% sensitivity, 72% specificity) for cow’s milk spIgE and 1.85 kU/L for casein. SPT enduration cutoffs were 4.25 mm for pasteurized milk and 3.5 mm for commercial extracts. This study provides critical IMMULITE-specific spIgE cutoffs to predict OFC outcomes, offering valuable reference ranges for clinical CMA diagnosis.

In the original article, the ORCID of one of the co-authors, Hatice Irmak ÇELİK, was incorrectly reported by the corresponding author. At the request of the authors, the ORCID has been corrected to reflect the accurate information. This correction does not affect the content or conclusions of the article. The authors apologize for this oversight. Link to the original article: https://doi.org/10.55730/1300-0144.5990

Background: Allergic rhinitis (AR) is an IgE-mediated inflammatory condition of the nasal mucosa. Allergen immunotherapy (AIT) is the only treatment that can modify disease progression and provide long-term symptom control. This study evaluated symptom burden and health-related quality of life (HRQoL) during the pollen season in pediatric patients treated with subcutaneous pollen immunotherapy (SCIT).Material and Methods: This prospective, cross-sectional study included children aged 6–18 years who received ≥12 months of AIT between 2014 and 2022. All had isolated pollen allergy and were treated with SCIT. Symptom control was assessed using the Total Nasal Symptom Score (TNSS) and Visual Analog Scale (VAS), while HRQoL was measured using PRQLQ or RQLQ depending on age. Patients were grouped by treatment duration: <36 months and ≥36 months. Results: Forty-seven patients completed questionnaires at least two pollen seasons after their final SCIT dose. Compared with the <36-month group, patients treated for ≥36 months showed significantly lower nasal and ocular symptoms (P < 0.001). Mean TNSS scores were lower (5.42 vs. 9.57, P = 0.018), and more patients had mild symptoms (60.6% vs. 21.4%, P = 0.003). Good symptom control (VAS < 2) was also more frequent (36.4% vs. 14.3%, P = 0.022). HRQoL scores (PRQLQ/RQLQ) were significantly better in the ≥36-month group, particularly in social and school functioning.Conclusion: SCIT duration ≥36 months is associated with improved symptom control and HRQoL during the pollen season, supporting guideline recommendations of at least 3 years of AIT in pediatric AR.

Objective: This study aimed to determine the frequency of true wheat allergy among pediatric patients with wheat sensitivity detected by skin prick test (SPT) in our center and to evaluate the clinical features and prognosis of the patients. Material and Methods: This study was conducted with 63 patients who were found to have wheat sensitivity on skin prick test (SPT) between January 2017 and May 2023 in the Pediatric Allergy and Immunology Clinic of our hospital.Demographic and clinical characteristics, oral provocation tests (OPT) and prognosis of these patients were analyzed. Results: In 9432 food SPTs, wheat positivity was detected in 63 patients and the wheat sensitivity rate was found to be 0.6%. Sixty-one point nine percent of these patients were girls. In patients with wheat atopy, 55.5% were infants between 0-6 months of age. Out of 63 patients, six (9.5%) presented with a history suggestive of IgE-mediated reaction, while 57 (90.5%) presented with a history suggestive of atopic dermatitis. Among these patients with a history of atopic dermatitis, 34 (59.6%) were found to have cow’s milk and egg atopy in addition to wheat sensitivity. Eczema exacerbation was observed in three patients on OPT performed after 2-4 weeks of short term elimination. These patients were able to consume wheat without any reaction after 6-12 months of elimination diet. Conclusion: Wheat sensitivity not confirmed by oral provocation tests leads to unnecessary elimination of wheat, an essential nutrient. This shows the importance of OPT in patients with wheat atopy.

Background: Asthma is a prevalent chronic condition in children and has been associated with sleep disturbances. The aim of this study was to determine the prevalence of sleep disturbances in children with asthma and to identify the clinical predictors of impaired sleep quality. Methods: The study included children aged 6–16 years with asthma who were followed at the Pediatric Allergy and Immunology Department of Ankara Bilkent City Hospital. A control group of participants with comparable age and demographic characteristics and without any history of chronic, allergic, or psychiatric conditions was also recruited. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC), while asthma control was evaluated using the Childhood Asthma Control Test (C-ACT) or ACT. Asthma severity and treatment steps were categorized according to the Global Initiative for Asthma (GINA). Results: A total of 210 children diagnosed with asthma (mean age: 11.2 ± 3.4 years; 54.3% male) were included in the study. According to the SDSC, 45.2% of children with asthma had clinically significant sleep disturbances. Compared to healthy controls (n = 199), asthmatic children had significantly higher total SDSC scores [63 (IQR: 50–74) vs. 53 (46–61); p < 0.001] and all subscale scores (p < 0.001). Among asthmatic children, poor asthma control, GINA Step ≥3 treatment, and asthma exacerbations within the last six months were significantly associated with sleep disturbances. In multivariate logistic regression analysis, ACT/C-ACT scores were identified as independent predictors of sleep disturbance, with higher scores associated with lower odds of sleep disturbance (OR: 0.20; 95% CI: 0.11–0.35; p < 0.001). Conclusion: Poor asthma control was strongly associated with sleep impairment. Routine assessment of sleep quality could support asthma management in pediatric populations.