B Cell Disorders in Children: Part II.

Purpose Of Review: B cell disorders result in decreased levels or function of immunoglobulins in an individual. Genetic mutations have been reported in a variety of B cell disorders. This review, in follow-up to a previous review, describes some rare B cell disorders as well as their known underlying genetic etiologies.

B Cell Disorders in Children-Part I.

Purpose Of Review: The advent of enhanced genetic testing has allowed for the discovery of gene defects underlying two broad categories of antibody deficiency in children: agammaglobulinemia and common variable immunodeficiency (CVID). This review describes the underlying gene defects and the clinical manifestations.

Recent Findings: Because novel monogenetic defects have been discovered in both categories, a strict dichotomous classification of B cell disorders as either X-linked agammaglobulinemia or common variable immunodeficiency is no longer appropriate.

Evaluation of Intranasal Corticosteroid Sensory Attributes and Patient Preference for Fluticasone Furoate for the Treatment of Allergic Rhinitis.

Purpose: Allergic rhinitis (AR) is a highly prevalent disease, affecting the quality of life of millions of Americans. Intranasal corticosteroids (INCs) are widely recommended as first-line therapy for moderate to severe AR. Although these drugs exhibit similar safety and efficacy, a potentially differentiating factor within this class is the varying sensory attributes associated with each INC.

The Child with Recurrent Mycobacterial Disease.

Purpose Of Review: Many genetic conditions predispose affected individuals to opportunistic infections. A number of immunodeficiency diseases, including genetic defects termed Mendelian susceptibility to mycobacterial disease (MSMD), permit infection from many different strains of mycobacteria that would otherwise not cause disease. These include tuberculous and nontuberculous mycobacteria, and bacille Calmette-Guérin vaccine (BCG).

Management of Allergic Rhinitis: A Review for the Community Pharmacist.

Purpose: Allergic rhinitis is a highly prevalent disease affecting the quality of life of millions of North Americans. The management of allergic rhinitis includes allergen avoidance, pharmacotherapy, and immunotherapy. Current pharmacologic options include oral and intranasal antihistamines, intranasal corticosteroids, oral and intranasal decongestants, oral and intranasal anticholinergics, and leukotriene receptor antagonists.

Chronic Candidiasis in Children.

Purpose Of Review: Healthy children may develop candidal infections as the result of exposure to antibiotics or corticosteroids, but chronic candidiasis in children after the newborn period is unusual. Chronic mucocutaneous candidiasis (CMC) refers to a group of conditions characterized by recurrent or persistent infections with Candida species, particularly Candida albicans. CMC is a phenotype observed in a spectrum of immunologic disorders, some with endocrinologic and autoimmune features.

Case report: acute facial swelling in a recreational technical diver.

A recreational scuba diver wore a second scuba regulator against his face during a scuba dive, attached by an elastic rubber cord necklace. After surfacing, the diver's left face became swollen. Through a process of elimination all other items of scuba equipment were excluded as potential causes.

The Perception of Asthma Severity in Children.

The ability to perceive the onset and severity of symptoms of worsening asthma is important, not only for initial diagnosis but also for early identification of an asthma exacerbation and prompt management. There are subjective and objective methods for identifying symptoms. Symptom perception is affected by multiple mechanisms, and not all patients can accurately perceive symptoms of airflow limitation.

Immunotherapy throughout the decades: from Noon to now.

Objective: To review major milestones in the development of subcutaneous allergen immunotherapy in 20-year segments.

Data Sources: Review of the literature available in textbooks and journals.

Study Selection: Articles and books addressing major achievements in the development of subcutaneous allergy immunotherapy were selected for inclusion in this review.

Cross-reactivity between cockroach and ladybug using the radioallergosorbent test.

Background: Home infestations from Harmonia axyridis (ladybug) occur throughout the United States. IgE-mediated sensitization with allergic disease has been reported. The prevalence of ladybug sensitization has been studied by questionnaire and allergy testing in patients diagnosed as having allergic disease.

Risk factors for allergic Aspergillus sinusitis.

Allergic Aspergillus sinusitis is a type of allergic fungal sinusitis (AFS), a form of chronic rhinosinusitis with pathological findings similar to those seen in allergic bronchopulmonary aspergillosis (ABPA). There are no evidence-based criteria for diagnosis or management, and the pathogenesis is unknown. Known risk factors are underlying chronic rhinitis, exposure to Aspergillus fumigatus, and the ability to make an IgE-mediated allergic response to that organism.

Antihistamine onset of action: the importance to the patient.

Although some older antihistamines have a relatively slow onset of action, modern agents indicate an efficacy between 1 and 3 hours of administration. For patients who use antihistamines regularly, a short onset of action is relatively unimportant. When antihistamines are used as needed, either because of poor compliance or in accordance with emerging therapeutic guidelines, antihistamines with a short onset of action are preferable.

A large kindred with familial cold autoinflammatory syndrome.

Background: Familial cold autoinflammatory syndrome (FCAS), formerly known as familial cold urticaria, is a rare condition characterized by fever, rash, and arthralgias elicited by exposure to cold. Recently, mutations responsible for FCAS were identified in a novel gene (CIAS1), making it possible to confirm the diagnosis in most patients.

Objective: We present a summary of clinical data from a large family with FCAS to further define the characteristics of the disorder and to validate previously proposed clinical criteria.

Sensitization to recombinant Aspergillus fumigatus allergens in allergic fungal sinusitis.

Background: Allergic bronchopulmonary mycosis is primarily caused by Aspergillus fumigatus. Despite similarities, allergic fungal sinusitis (AFS) is thought to be caused by various fungi.

Objective: Identify fungal elements in AFS allergic mucin and determine the prevalence of specific immunoglobulin (Ig)E to recombinant A.