Browsing by Author "Silva, I"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
- Drug Provocation Tests to Betalactam Antibiotics: Experience in a Paediatric SettingPublication . Chambel, M; Carreiro-Martins, P; Silva, I; Palma Carlos, S; Romeira, AM; Leiria-Pinto, PBackground: Few studies have been performed in children withs uspected betalactam allergy.We aimed to assess the role of the drug provocation test(DPT)with betalactams in a paediatric setting and to study the association between allergy to betalactam antibiotics and other allergic diseases. Methods:We included all the patients under 15 years old who were consecutively referred to the Immunoallergy Department, Dona Estefânia Hospital,Portugal(January 2002 to April 2008)for a compatible history of allergic reaction to betalactam. All were submitted to a DPT.Children were proposed to performs kintests(ST)to betalactam antibiotics followed by DPT. If they decline ST,a DPT with the culprit drug was performed. Results: We studied 161 children,60%were boys,with a median age of 5years old at the time of the DPT.Thirty-three patients(20.5%)had an immediate reaction and 33(20.5%)a non-immediate reaction. These verity of there porte dreactions was low in most cases. Skin tests to betalactams were performed in 47 children and were positive in 8.DPT was positive inonlyone(3.4%)of the patients skin tested and in 11(13.4%)of those not skin tested. These verity of the DPT reaction was low.Asthma and food allergy were associated with a positive DPT in the later group. Conclusions: DPT seems a safe procedure even in the absence of ST in non-severe cases. This could be a practical optionin infants and pre-school children,where ST are painful and difficult to perform.Additional caution should be taken in children with asthma and food allergy.
- Mastocytosis: a Rare Case of Anaphylaxis in Paediatric Age and Literature ReviewPublication . Silva, I; Carvalho, S; Leiria-Pinto, P; Machado, S; Rosado-Pinto, JThe term “mastocytosis” denotes a heterogeneous group of disorders characterised by abnormal growth and accumulation of mast cells (MC) in one or more organ systems. Symptoms result from MC chemical mediator’s release, pathologic infiltration of neoplastic MC in tissues or both. Multiple molecular, genetic and chromosomal defects seem to contribute to an autonomous growth, but somatic c-kit D816V mutation is more frequently encountered, especially in systemic disease. We present a literature review of mastocytosis and a rare case report of an 18 month-old-girl with a bullous dermatosis, respiratory distress and anaphylaxis, as clinical manifestations of mastocytosis. The developments of accepted classification systems and novel useful markers allowed a re-evaluation and updating of the classification of mastocytosis. In paediatric age cutaneous forms of disease prevail and may regress spontaneously. SM is more frequently diagnosed in adults and is a persistent(clonal) disease of bone marrow. The clinical course in these patients is variable.Today diagnostic criteria for each disease variant are reasonably well defined. There are, however, peculiarities, namely in paediatric age, that makes the diagnostic approach difficult. Systemic disease may pose differential diagnostic problems resulting from multiple organ systems involvement. Coversly, the “unexplained” appearance of those symptoms with no skin lesions should raise the suspicion of MC disease. This case is reported in order to stress the clinical severity and difficult diagnostic approach that paediatric mastocytosis may assume.
- Síndroma Ovo-Ave na Criança:Um Caso ClínicoPublication . Silva, I; Romeira, AM; Leiria-Pinto, P; Bartolomé, BA síndroma ovo -ave é uma entidade clínica rara, em especial em idade pediátrica. Descreve -se o caso de criança de sexo masculino, 5 anos, que habita zona rural, com clínica sugestiva de alergia ao ovo e à carne de frango desde os 7 meses. Aos 2,5 anos apresenta queixas de asma brônquica, rinite alérgica e eczema atópico. Os testes cutâneos foram positivos para extractos de clara e gema de ovo. Dosearam -se IgE específi cas para clara e gema de ovo (>100 kU/L), carne de frango (1,0 kU/L), α -livetina (0,7 kU/L), penas de frango (15,3 kU/L). O estudo de immunoblotting evidenciou ligação de IgE a bandas com peso molecular entre 30-66 kDa e 32-45 kDa para clara e gema, respectivamente, 38/39/42 kDa para carne de frango e 33-45 kDa para penas de frango. Em doentes com alergia a carne de aves, expostos a factores ambientais de risco e sensibilização elevada a gema de ovo, dever -se -á suspeitar da síndroma ovo-ave.