Purpose: Treatment responses to Mycoplasma pneumoniae (MP) pneumonia in children exhibit considerable variability.It is essential to identify predictive indicators and elucidate mechanisms associated with treatment responses.This study aimed to characterize the clinical, radiological, laboratory, and cytokine profiles associated with treatment responses in pediatric MP pneumonia.Methods: A retrospective analysis was performed in 85 children hospitalized with MP pneumonia between May 2019 and March 2020.Patients were categorized into the good response group (n=74) or the poor response group (n=11) based on clinical responses to step-wise treatment.Clinical characteristics, radiological findings, laboratory parameters, and serum levels of 27 cytokines obtained at admission were compared between the groups.Results: Compared to the good response group, the poor response group exhibited significantly longer fever duration (11.365.33 days vs. 5.773.95days, P=0.006), more frequent lobar consolidation (63.6% vs. 20.3%,P=0.043), and higher lactate dehydrogenase levels (1,146505 IU/L vs. 731231 IU/L, P=0.008) and MP-specific immunoglobulin M index (6.493.01 vs. 3.853.28,P=0.014).Among the cytokines assessed, IL-21, IL-22, and IL-31 levels were significantly elevated in the good response group.IL-17A levels were also higher in this group, albeit not statistically significant.Conclusion: Early identification of clinical, laboratory, and radiologic markers may facilitate early prediction of treatment response in pediatric MP pneumonia.Elevated IL-21, IL-22, and IL-31 levels in the good response group suggest a potential role for Th17-related cytokine activity in favorable treatment outcomes, warranting further investigation in larger cohorts.(

https://www.aard.or.kr 2(type 2, T2) , T2 (interleukin [IL]-4, IL-5, IL-13) , IL-5 , , . 1,2 , (inhaled corticosteroid, ICS)

Purpose: This study aimed to evaluate the feasibility, safety, and immunological outcomes of low-dose cow's milk oral immunotherapy (CM OIT) in school-aged children and adolescents with severe, persistent cow's milk allergy (CMA), a group typically considered at a high risk for OIT.Methods: We conducted a retrospective study involving 12 patients (median age, 11.4 years) with immunoglobulin E (IgE)-mediated CMA, who underwent individualized low-dose CM OIT in the outpatient setting at a single tertiary hospital.Baseline and longitudinal clinical and immunological data, including casein-specific IgE and immunoglobulin G4 (IgG4) levels, were analyzed.Patients were classified as either desensitized or unsuccessful based on treatment outcomes.Results: Of the 12 patients with severe CMA, 6 achieved desensitization up to the target dose, while the remaining 6 discontinued treatment because of intolerance or poor adherence.The desensitized and unsuccessful groups showed no significant differences in baseline age, OIT starting dose, or serum casein-specific IgE level.Immunological evaluation revealed a significantly greater increase in serum casein-specific IgG4 (0.87 vs. -0.37mg/L, P= 0.004) and a significantly lower natural log-transformed fold change in the IgE/IgG4 ratio (-1.38 vs. 0.44, P= 0.008) in the desensitized group.None of the patients required epinephrine during OIT, and adverse events were generally mild. Conclusion:In selected high-risk pediatric populations with severe CMA, outpatient-based low-dose OIT using individualized flexible protocols may provide a relatively safe approach that improves tolerability and adherence.Increased casein-specific IgG4 levels and a reduced casein-specific IgE/IgG4 ratio may serve as valuable biomarkers for treatment response.(

Local anesthetics, such as lidocaine, are widely used for numbing.Adverse drug reactions related to lidocaine are variable, unpredictable, and rarely reproducible, with the exception of some typical cases.A 42-year-old female who had shown a bizarre neurological reaction after lidocaine injection for dental procedures was referred for diagnosis and safe anesthetic alternatives.Within a few minutes after exposure to lidocaine, she was unable to move any extremities or to speak, while sensory and high cranial nerve functions were preserved.She was alert and able to communicate with eye blinks.These reactions were repeatedly reproduced after intradermal injection of 2% lidocaine, with complete recovery within 1 hour without treatment.No cross-reactivity with mepivacaine or bupivacaine was observed.This is the first report of immediate and transient generalized paralysis related to lidocaine.(Al-

(drug hypersensitivity) , , , , , - (Stevens-Johnson syndrome, SJS), (toxic epidermal necrolysis, TEN), Drug reaction with eosinophilia and systemic symptoms (DRESS) , (acute generalized exanthematous pustulosis, AGEP) . 1 Gell Coombs (1) I, IgE : , , , (2) II, IgG IgG (antibody-dependent cell-mediated cytotoxicity): , , (3) III , - (antigen-antibody complex) : (serum sickness), , / , , (4) IV, . 1,2IV Th1 IVa (, ), Th2 IVb (, DRESS ), CD8 + T IVc (SJS, TEN), IVd (AGEP) . 2 , , , . symmetric drug-related intertriginous and flexural exanthema (SDRIFE)

https:/

Purpose: Inhalant allergen sensitization is a well-known risk factor for asthma and allergic rhinitis (AR).However, there are few recent data on the prevalence of allergic sensitization in the general population of preschool Korean children.This study assessed the association between early-life sensitization and respiratory allergic diseases.Methods: This study analyzed data from the COCOA (COhort for Childhood Origin of Asthma and allergic diseases) cohort including 1,925 children at age 3 and 988 children at age 7. New-onset allergic diseases were defined as those not diagnosed before age 6 and diagnosed after age 7. Skin prick tests and serum specific IgE tests were performed at ages 3 and 7. Provocholine challenge test was performed at age 7. Results: House dust mite (HDM) was the most frequently sensitized allergen at both ages 3 and 7 (Dermatophagoides pteronyssinus 13.1%, Dermatophagoides farina 14.4%; 33.8%, 39.3%, respectively).Sensitization to indoor allergens at ages 3 and 7 increased risks for new-onset AR (adjusted odds ratio [aOR], 2.80; 95% confidence interval [CI], 2.05-3.84 and aOR, 5.70; 95% CI, 3.13-10.29),asthma (aOR, 2.89; 95% CI, 1.65-5.03and aOR, 2.68; 95% CI, 1.10-6.51)and bronchial hyperresponsiveness (BHR) (aOR, 2.14; 95% CI, 1.45-3.14and aOR, 1.69; 95% CI, 1.25-2.30).Early persistent sensitization to HDM was a risk factor for new-onset AR (aOR, 5.25; 95% CI, 1.69-16.30),asthma (aOR, 4.07; 95% CI, 1.19-13.87)and BHR (aOR, 2.82; 95% CI, 1.80-4.43). Conclusion:Early persistent sensitization to HDM is associated with increased risk of new-onset AR, asthma and BHR.Early-life assessment of sensitization is important in predicting future respiratory allergic disease development.