House dust mite is the most important causative allergens of childhood asthma and its positive rate of allergy skin test reaches up to 80% in atopic asthmatic children in Korea. Although the mite sensitization is more significant in older children(>4 years), it is also important in some younger(<4 years) asthmatic children. To identify the major allergens in Korean atopic asthmatic children and find the variations of IgE binding pattern to Dermatophagoides pteronyssinus(Dp) in younger and older age groups, we conducted IgE immunoblot. Sera were collected in 25 children with Dp-sensitive atopic asthma : GroupI(younger children aged 1-3), Goup molder children aged 442). Using our own-made crude Dp extract, we conducted IgE-immunoblot (biotin-avidine-phos-phatase system). In the group I, the 15KD protein was significantly bound by 69.2%(9/13) of sera and 98KD, 59KD, 311KD, 25KD components were bound by 8-16% of sera, respectively. In the group II, the 15KD and 25KD proteins were significant1y bound Immunob1ot by 100% and 67% of sera, and 18KD, 94KD by 33%, 98KD by 25%, 45KD by 8% of sera, respectively. In conclusion, the 15KD protein is the most prevalent IgE-binding antigen in all age groups, on the other hands, IgE-sensitization to 25KD component is confirmed mainly in the cases of older age group in this study.
Allergens ; Asthma ; Child* ; Dermatophagoides pteronyssinus* ; Hand ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Korea ; Mites ; Pyroglyphidae* ; Skin Tests

There has been continued controversy as to the safety of egg-based MMR vaccine in egg-allergic children. Many studies have dealt with MMR administrations to egg-allergic patients focusing on the systemic side reactions. It has been found that most egg-allergic patients do not react to MMR vaccine but to other vaccine components. Therefore, most authors conclude that if an individual can eat eggs without ill effects, he or she can take the MMR vaccine without skin testing. In this regard, this study describes two cases of systemic side reactions after injection of MMR vaccine to egg-allergic patients. In a case with a history of systemic reaction from egg ingestion, it is still recommended that skin testing with the vaccine be carried out. If the skin test result shows positive, incremental doses of the vaccine in every 15-20 minutes are suggested.
Child* ; Eating ; Egg Hypersensitivity* ; Eggs ; Humans ; Measles-Mumps-Rubella Vaccine* ; Ovum* ; Skin Tests

OBJECTIVES: This study was performed to investigate the factors related to HRQOL, and a correlation between occupational stress and HRQOL among municipal fire officers. METHODS: In November 2005, 341 male municipal fire officers submitted to the following tests: A general questionnaire, a medical questionnaire, the Korean Occupational Stress Scale Short Form(KOSSSF), and the SmithKline Beecham quality of life scale (SBQOL). RESULTS: Back pain (OR=3.54, 95% C.I.=1.81-6.93) and occupational stress (OR=6.33, 95% C.I.=3.12-12.83) were significantly related to poor HRQOL scores among municipal fire officers, and there is negative relationship between KOSS-SF score and SBQOL score. Logistic regression analysis indicated that the medium occupational stress group (OR=2.21, 95% C.I.=1.04-4.71) and the high occupational stress group (OR=6.33, 95% C.I.=3.12-12.83) were more significantly associated with poor HRQOL than low occupational stress group. CONCLUSIONS: Among municipal fire officers, back pain and occupational stress were found to be related to their HRQOL. Based on this study, we suggest that the management of back pain and occupational stress are instrumental to improving the HRQOL among municipal fire officers.
Back Pain ; Fires ; Humans ; Logistic Models ; Male ; Quality of Life ; Questionnaires

PURPOSE: The aim of this study was to assess the clinical usefulness and added diagnostic value of specific IgE antibodies to wheat, gluten, and ω-5 gliadin in diagnosing wheat allergy and distinguishing wheat anaphylaxis. METHODS: This study included 196 children who visited Ajou University Hospital for suspicious food allergy. The subjects were divided into 2 groups: the wheat allergy (WA) and non-wheat allergy (non-WA) groups. Patients with wheat allergy were further divided into 2 subgroups according to their symptoms: the wheat allergy with anaphylaxis (WA(Ana)) and wheat allergy without anaphylaxis (WA(Non-Ana)) groups. Serum concentrations of total IgE and specific IgE antibodies to wheat, gluten and ω-5 gliadin were measured. RESULTS: The median values of specific IgE antibodies to wheat, gluten and ω-5 gliadin were significantly higher in the WA group than in the non-WA group, and the positive decision points (95% specificity) were at 3.12, 2.61, and 0.21 kUA/L, respectively. The combination of specific IgE antibodies to wheat and ω-5 gliadin resulted in the highest accuracy of 93.9% in diagnosing wheat allergy. In differentiating the WA(Ana) group from the WA(Non-Ana) group, only specific IgE antibody to ω-5 gliadin showed a significant difference at the optimal cutoff point of 1.56 kUA/L. CONCLUSION: Our results show that the individual levels of specific IgE antibodies to wheat, gluten or ω-5 gliadin may have a considerably high accuracy in diagnosing wheat allergy and that specific IgE antibody to ω-5 gliadin may be particularly useful in predicting wheat anaphylaxis.
Anaphylaxis ; Antibodies ; Child* ; Food Hypersensitivity ; Gliadin* ; Glutens* ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Triticum* ; Wheat Hypersensitivity*

Food allergy (FA) is a serious health problem, and severe FA such as food-induced anaphylaxis can often be life threatening. The incidence of FA has been increasing especially in children. They usually develop early in life and affect up to 10% of children. The 2 most common food allergens worldwide are milk and eggs, while the third one varies depending on the countries: peanuts in the United States and Switzerland, wheat in Germany and Japan, tree nuts in Spain, sesame in Israel, and walnuts in Korea. These common food allergens are different and difficult to identify because of differing study methodologies, population, geography, age, and dietary exposure patterns. The current management of FA relies on the strict avoidance of culprit allergens, the prompt treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis, monitoring, and education to prevent further reactions. Newer approaches for tolerance induction to FA and FA immunotherapy have been under investigation but are not yet ready for real-world application. Thus, consistent and systematic education of patients, caregivers, and food-handling people is of primary importance for the management and prevention of FA reactions. This review assesses and compares IgE-mediated FA in children in Korea and other countries, with a focus on summarizing the prevalence, common triggers, and management of FA.
Allergens ; Anaphylaxis ; Arachis ; Caregivers ; Child* ; Education ; Eggs ; Epinephrine ; Food Hypersensitivity* ; Geography ; Germany ; Humans ; Hypersensitivity ; Immunotherapy ; Incidence ; Israel ; Japan ; Juglans ; Korea ; Milk ; Nuts ; Ovum ; Patient Education as Topic ; Prevalence* ; Sesamum ; Spain ; Switzerland ; Trees ; Triticum ; United States

PURPOSE: Buckwheat allergy is one of the most severe types of food allergy in some countries, especially among children. However, few studies have investigated this condition. The aim of this study was to report the clinical and laboratory findings in Korean children with buckwheat allergy. METHODS: Thirty-seven subjects, aged 1 to 14 years, were enrolled by retrospective medical record review from January 2000 through May 2015 at the Department of Pediatrics in Ajou University Hospital. The demographic profile, previous exposure to buckwheat pillows, clinical symptoms, and laboratory findings of each subject were recorded. RESULTS: Twenty-six of the 37 children had immediate-type allergic symptoms to buckwheat, while 11 subjects were tolerant to buckwheat. Seventeen out of 26 buckwheat allergic children (65.4%) had anaphylaxis. The median buckwheat specific IgE level in the buckwheat allergic group (7.71 kU(A)/L) was significantly higher (P<0.001) than in the buckwheat tolerant group (0.08 kU(A)/L) with an optimal cutoff value of 1.27 kU(A)/L (sensitivity 84.6%, specificity 100%). When adjusted for age, the difference between the 2 groups showed no statistical significance (P=0.063). In subjects who had anaphylaxis, buckwheat-specific IgE levels ranged from 0.37 to 100 kUA/L. CONCLUSION: Almost two-thirds of buckwheat-allergic children had anaphylaxis, and a wide-range of buckwheat specific IgE levels were observed in these children. Anaphylaxis occurred in a subject with a remarkably low IgE level (0.37 kU(A)/L).
Anaphylaxis ; Asian Continental Ancestry Group ; Child ; Fagopyrum* ; Food Hypersensitivity ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Medical Records ; Pediatrics ; Retrospective Studies ; Sensitivity and Specificity ; Tertiary Care Centers*

Food allergy (FA) has become more common in recent decades, and it is a serious health problem in children. FA is divided into immunoglobulin E (IgE)-mediated and non-IgE-mediated FA based on its mechanism. FA most often develops early in life, affecting up to 10% of children, and increasing concerns have been raised regarding severe FA including food-induced anaphylaxis, especially in young children. The 2 most common food allergens worldwide are milk and eggs, while the third most common allergen varies among countries. In addition to a detailed and convincing history of diverse symptoms (involving the skin, gastrointestinal, respiratory, cardiovascular, and neurologic systems) after exposure to culprit foods, the following tools can be useful in the diagnosis of FA: the skin prick test, measurement of serum food-specific IgE antibodies, and the elimination or provocation test with suspected foods. The current recommended management of FA relies on the strict avoidance of causative foods; the immediate treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis; and education to prevent further reactions. Emerging approaches for tolerance induction to FA, such as food immunotherapy, have been investigated, but concrete evidence for clinical application is lacking. This review presents a detailed overview of the pathogenesis of FA, its prevalence, common culprit foods, and its diagnosis and management, and additionally shares recent data on common causative foods in Korean infants and children.
Allergens ; Anaphylaxis ; Antibodies ; Child* ; Diagnosis ; Education ; Eggs ; Epinephrine ; Food Hypersensitivity* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Immunotherapy ; Infant ; Milk ; Ovum ; Prevalence ; Skin

No abstract available.
Prevalence* ; Urticaria*

Food allergies continue to increase exponentially and therapies that can modify the natural course of disease is a recent top priority of the research. IgE-mediated food allergy represents both a promising and an intriguing disease of application for allergen specific immunotherapy. In particular, oral immunotherapy (OIT) may offer a novel effective therapeutic modality for persistent and severe forms of food allergies. In such patients, avoidance of the causative foods only may be insufficient because of the risk of unplanned exposure to causative foods. In patients with cow's milk, hen's egg, and peanut allergies, several recently published studies, including meta-analysis, confirmed the overall benefit of OIT. However, the definitive evidence of efficacy and safety with long-term therapeutic or disease-modifying effects is limited. In current protocols, entry indications, and initial-escalating-maintenance doses, the form of antigens, durations, and follow-up periods await to be standardized. Most of the clinical trials of OIT demonstrate effective desensitization, but the ability for inducing long-term tolerance remains to be improved, and the ratio of risks versus benefits of OIT should be considered in detail. The ultimate goal is extending OIT to primary care practice, but at this time, OIT remains within the purview of allergy specialists in terms of associated risk-benefit ratios, related safety, and long-term tolerance induction.
Food Hypersensitivity* ; Humans ; Hypersensitivity ; Immunotherapy* ; Milk ; Ovum ; Peanut Hypersensitivity ; Primary Health Care ; Specialization

Anaphylaxis is a serious, life-threatening hypersensitivity reaction that is rapid in onset and might cause death when not treated promptly. Recently, the prevalence of anaphylaxis has been increasing worldwide, especially in children, and food-induced anaphylaxis is rapidly increasing. With the establishment of the Korean Academy of Pediatric Allergy and Respiratory Disease in 1987, awareness of anaphylaxis has been heightened in Korea as well. Initially, it was considered a clinical form of food or drug hypersensitivity, but not a single disease entity. After the second symposium on anaphylaxis in 2006 and the World Allergy Organization guideline on anaphylaxis in 2011, research more focused on anaphylaxis is ongoing. The study of anaphylaxis in Korean children was initially restricted to case reports due to novel triggers. Thereafter, research on the age-specific prevalence of anaphylaxis was conducted using the national big data and more recently, a large-scale hospital-based multicenter study was conducted. Also, reliable data on food-induced anaphylaxis have been attained through a large-scale multicenter case study and a population-based epidemiological study on food allergy and currently, a prospective multicenter anaphylaxis registry has been launched funded by Korea Centers for Disease Control and Prevention. These series of studies have contributed to the international competitiveness in pediatric anaphylaxis research. However, there are still unmet needs such as diagnosis, severity, treatment or intervention of anaphylaxis, education for the prevention of recurrence, and establishment of policies for social safety. Further studies addressing these issues will contribute to improvement of quality of life and overcoming of the disease.
Anaphylaxis* ; Centers for Disease Control and Prevention (U.S.) ; Child* ; Diagnosis ; Drug Hypersensitivity ; Education ; Epidemiologic Studies ; Financial Management ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Korea ; Prevalence ; Prospective Studies ; Quality of Life ; Recurrence