C. Karila

Anaphylaxis during anesthesia: results of a 12-year survey at a French pediatric center

Background:  Following adverse reactions to anesthesia, tests are carried out to determine the mechanism of the reaction and to identify the agent responsible. No specific data are available in France concerning such skin tests in children.

Allergic rhinitis in children with asthma: a questionnaire‐based study

Background Allergic rhinitis (AR) and asthma frequently coexist but has rarely been evaluated in children.

Hypersensitivity reactions to paracetamol in children: a study of 25 cases

Background:  Allergic‐like reactions to paracetamol (acetaminophen) are rare. Paracetamol allergic and nonallergic hypersensitivity (HS) has been diagnosed in a few patients with skin and/or respiratory symptoms, immediate and accelerated urticaria, and angioedema especially. Most patients with HS to paracetamol were also hypersensitive to anti‐inflammatory drugs (i.e. acetylsalicylic acid, ASA), suggesting that their reactions resulted from a nonallergic HS. However, anaphylactic reactions, and potentially harmful toxidermias, such as acute generalized exanthematic pustulosis and toxic epidermal necrolysis, have been related to specific paracetamol allergic HS, with tolerance to anti‐inflammatory drugs.

Familial interstitial disease with I73T mutation: A mid‐ and long‐term study

To describe the long‐term course and the management in children of chronic interstitial lung disease associated with I73T mutation.

Hypersensitivity to cyclooxygenase inhibitory drugs in children: a study of 164 cases

Hypersensitivity to cyclooxygenase (COX) inhibitors is rare in children. We studied 164 children reporting 213 reactions to paracetamol, ibuprofen and/or acetylsalicylic acid (ASA). Most reactions were cutaneous, either isolated or associated with respiratory symptoms and/or anaphylaxis. Based on a convincing clinical history or positive responses in challenges with the drug(s), hypersensitivity to one or several drug(s) was diagnosed in 49.4% of the children (60, 76.5 and 23.2% of the children reporting reactions to ASA, ibuprofen and paracetamol respectively). Cross-reactivity between nonsteroidal anti-inflammatory drugs (NSAIDs) was frequent (69.1%), but only 10.6% of the NSAID-sensitive children reacted to paracetamol. In contrast, all paracetamol-sensitive children reacted to NSAIDs. Anaphylaxis, immediate and accelerated reactions, atopy, older age and chronic/recurrent urticaria were risk factors for hypersensitivity and/or cross-reactivity between ASA, ibuprofen and paracetamol. In conclusion, hypersensitivity to COX inhibitors was frequent, especially in children reporting severe and/or immediate and accelerated reactions, and in older and atopic children. Cross-reactivity was frequent, suggesting that most reactions resulted from a non allergic hypersensitivity linked to the pharmacological properties of the drugs. However, in a few children, the reactions may result from allergic hypersensitivity to selective (families of) drugs, with tolerance to other drugs.

Activité physique et réentraînement à l’effort du patient atteint de mucoviscidose

In France patients with cystic fibrosis benefit from a multidisciplinary follow-up in Cystic Fibrosis Centres. In this follow-up, despite the numerous therapeutic benefits of exercise in this disease, little emphasis is placed on the promotion of physical activity. The aim of this article is to improve this aspect of management, giving advice from a working group of experts, based on the medical literature and clinical experience. These proposals include quantification of physical activity, evaluation of exercise, training and rehabilitation programs and finally, modification of behaviour to include physical activity in the overall cystic fibrosis treatment strategy. It is intended to set up multicentre studies to evaluate the impact of these proposals.

The lung is involved in juvenile dermatomyositis.

Juvenile dermatomyositis (JDM) is the main cause of chronic idiopathic inflammatory myopathy of autoimmune origin in children. The aim of this multicenter prospective study was to describe respiratory status and treatment of children followed for JDM.

Cross‐sectional assessment of exertional dyspnea in otherwise healthy children

Exertional dyspnea during sport at school in children with asthma or in otherwise healthy children is commonly attributed to exercise‐induced asthma (EIA), but when a short‐acting beta agonist (SABA) trial fails to improve symptoms the physician is often at a loose end.

Mucoviscidose : du bon usage des explorations fonctionnelles respiratoires

Resume Introduction Le depistage neonatal de la mucoviscidose permet de proposer aux patients atteints un suivi multidisciplinaire dedie et precoce. Etat des connaissances L’exploration fonctionnelle respiratoire est un outil obligatoire de cette surveillance clinique. Le but de cet article est de decrire les anomalies les plus frequemment observees et de faire le point des recommandations en fonction du type d’examen, de l’âge du patient et des principales situations cliniques. Perspectives Il apparait que seule la frequence d’utilisation de la spirometrie, avec ses limites d’interpretation, fait l’objet d’un large consensus. Conclusion L’effort d’evaluation de la riche panoplie des tests fonctionnels respiratoires doit donc se poursuivre dans le cadre de la mucoviscidose, en particulier chez le petit enfant.

L' enfant asthmatique en milieu scolaire : difficultés rencontrées, solutions envisagées…

Among a child out of ten is asthmatic. School absenteeism is frequent, due to an insufficient control of asthma. This insufficient control is especially evident at school where the usual risk factors of asthma are present. Allergenic risk with animals danders carried by other children, or regular practice of sports, are difficult situations for the asthmatic child. Controlling asthma, informing school and communicating with teachers, using the individualized care project, should avoid this absenteeism, which is responsible of school backwardness and difficulties in choosing careers.