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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

Medical Journal Reviews

November 2014

Articles are selected for their importance to clinicians who care for patients with asthma and allergic/immunologic diseases by Juan Carlos Ivancevich, MD, WAO Web Editor-in-Chief, and John J. Oppenheimer, MD - FACAAI - FAAAAI, WAO Reviews Editor.

1. Real-world frequency of new reports of cephalosporin-associated “allergies” or serious adverse drug reactions.

Macy E and Contreras R. Adverse reactions associated with oral and parenteral use of cephalosporins: A retrospective population-based analysis. Journal of Allergy and Clinical Immunology 2014; published online ahead of print, 25 September. (doi:http://dx.doi.org/10.1016/j.jaci.2014.07.062)

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Editor’s comment:  New reports of cephalosporin “allergy” are more frequent for women than for men and are more common with oral than with parenteral exposure. Physician-documented cephalosporin-associated anaphylaxis is rare, even among individuals with a history of penicillin allergy. The most frequent serious cephalosporin-associated adverse drug reactions are C difficile infection within 90 days, nephropathy within 30 days, and “all-cause death” within 1 day, and all are unrelated to drug allergy history.

2. Daily application of moisturizer reduces the risk of atopic dermatitis (AD)/eczema in infants.

Horimukai K, Morita K, Narita M, Kondo M, Kitazawa H et al. Application of moisturizer to neonates prevents development of atopic dermatitis. Journal of Allergy and Clinical Immunology 2014; 134(4): 824 – 830. (doi:http://dx.doi.org/10.1016/j.jaci.2014.07.060)

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Editor’s comment: The authors performed a prospective, randomized controlled trial and demonstrated that a daily application of emollient reduces the risk of AD/eczema by 32 weeks. The authors also found an association between AD and development of sensitization (based on sIgE to egg white), but did not find protection in those who developed AD who applied emollients and development of allergic sensitization.

3. Prenatal exposure to Bisphenol A (BPA) is associated with diminished lung function and the development of persistent wheeze in children.

Spanier AJ,  Kahn RS, Kunselman AR, Schaefer EW, Hornung R, Xu Y, Calafat AM, and Lanphear BP. Bisphenol A Exposure and the Development of Wheeze and Lung Function in Children Through Age 5 Years. JAMA Pediatr 2014; published online before print, 6 October. (doi:10.1001/jamapediatrics.2014.1397)

Abstract

Editor’s comment: The authors found that prenatal BPA exposure, measured using maternal urinary BPA concentrations at 2 time points during gestation was associated with a decrease in children’s lung function at age 4 years but not at age 5 years; while the child’s BPA concentrations were not associated with decrease in lung function at either age.

4. Only a small proportion of children follow trajectory profiles resembling the atopic march.

Belgrave DCM, Granell R, Simpson A, Guiver J, Bishop C, Buchan I, Henderson AJ, and Custovic A. Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies. PLoS Med 2014; 11(10): e1001748. (doi:10.1371/journal.pmed.100174)

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Editor’s comment: These researchers mined data from two UK birth cohorts (9,801 children in total) and explored individual profiles/progression of eczema, wheeze, and rhinitis via use of disease oriented validated questionnaires. They found that the developmental profiles of eczema, wheeze, and rhinitis were heterogeneous, with the progression of symptoms fitting the profile of the atopic march occurring in fewer than 7% of children with symptoms.

5. Evidence-based advice on the diagnosis and management of drug allergy in adults, children and young people.

National Clinical Guideline Centre. Drug allergy: diagnosis and management of drug allergy in adults, children and young people. National Institute for Health and Care Excellence 2014.

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Editor’s comment: This drug allergy guideline has been developed for use by all levels of healthcare professionals and offers best practice advice regarding the diagnosis, documentation, and communication of drug allergy in adults, children and adolescents.