Egil Bakkeheim

Paracetamol in early infancy: the risk of childhood allergy and asthma

Aim:  We investigated whether paracetamol exposure in pregnancy and until 6 months of age was associated with allergic disease in school children.

A case-control study of the relation between plasma selenium and asthma in European populations : a GAL2EN project

Background:  There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma.

Reduced basal salivary cortisol in children with asthma and allergic rhinitis

Aim:  Reduced basal cortisol is reported in allergic disease. We investigated if basal salivary cortisol levels were reduced in children with asthma or allergic rhinitis, controlling for inhaled corticosteroids (ICS) use.

Altered oxidative state in schoolchildren with asthma and allergic rhinitis

To cite this article: Bakkeheim E, Mowinckel P, Carlsen KH, Burney P, Lødrup Carlsen KC. Altered oxidative state in schoolchildren with asthma and allergic rhinitis. Pediatr Allergy Immunol 2011; 22: 178–185.

Maternal IgG anti-A and anti-B titres predict outcome in ABO-incompatibility in the neonate.

Aim:  To evaluate predictors for risk of severe hyperbilirubinaemia and kernicterus in ABO‐incompatible neonates with emphasize on maternal IgG anti‐A/‐B titres.

Implementation of newborn screening for cystic fibrosis in Norway. Results from the first three years

BACKGROUND Norway introduced newborn screening for cystic fibrosis (CF) March 1, 2012. We present results from the first three years of the national newborn CF screening program. METHODS Positive primary screening of immunoreactive trypsinogen (IRT) was followed by DNA testing of the Cystic fibrosis transmembrane conductance regulator (CFTR) gene. Infants with two CFTR mutations were reported for diagnostic follow-up. RESULTS Of 181,859 infants tested, 1454 samples (0.80%) were assessed for CFTR mutations. Forty children (1:4546) had two CFTR mutations, of which only 21 (1:8660) were confirmed to have a CF diagnosis. The CFTR mutations differed from previously clinically diagnosed CF patients, and p.R117H outnumbered p.F508del as the most frequent mutation. One child with a negative IRT screening test was later clinically diagnosed with CF. CONCLUSIONS The CF screening program identified fewer children with a conclusive CF diagnosis than expected. Our data suggest a revision of the IRT/DNA protocol.

Children hospitalised with bronchiolitis in the first year of life have a lower quality of life nine months later

Acute bronchiolitis increases the risk of asthma, and reduced quality of life (QoL) is reported in children with asthma and allergy. However, the impact of asthma risk factors on QoL is unclear. This study investigated whether bronchiolitis and common asthma risk factors in infancy had an influence on later QoL.

The severity of acute bronchiolitis in infants was associated with quality of life nine months later

Acute bronchiolitis in infancy increases the risk of later asthma and reduced health‐related quality of life (QoL). We aimed to see whether the severity of acute bronchiolitis in the first year of life was associated with QoL nine months later.

Paracetamol exposure during breastfeeding and risk of allergic disease

References 1. Bakkeheim E, Mowinckel P, Carlsen KH, Håland G, Carlsen KC. Paracetamol in early infancy: the risk of childhood allergy and asthma. Acta Paediatr 2011; 100: 90–6. 2. Persky V, Piorkowski J, Hernandez E, Chavez N, Wagner-Cassanova C, Vergara C, et al. Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life. Ann Allergy Asthma Immunol 2008; 101: 271–8. 3. Shaheen S, Potts J, Gnatiuc L, Makowska J, Kowalski ML, Joos G, et al. The relation between paracetamol use and asthma: a GA2LEN European case-control study. Eur Respir J 2008; 32: 1231–6.

17 Infants diagnosed clinically after false negative cystic fibrosis newborn screening may present with Pseudo-Bartter's-syndrome

Objective CF was added to the newborn screening (NBS) program in Norway on March 1 st 2012. Primary screening is performed by immunoassay of IRT. To reduce false positive screening results 2. and 3. tier genetic testing for CFTR mutations is implemented. We evaluated the NBS program during three years of screening with focus on NBS false negative infants. Methods Study population: Reported NBS positive and NBS false negative infants from March 1 st 2012 until Jan. 15 th 2015. Standard diagnostic work up was sweat chloride (SC) and fecal elastase (FE) measurements. Results 38 infants were reported as NBS positive with two CFTR-mutations. In the same period only one NBS negative infant was diagnosed with CF presenting with poor weight gain, failure to thrive and a hypochloremic (Cl 73 mmol/L); hypokalemic (K 2.5 mmol/L); metabolic alkalosis (pH 7.49) including hyponatremia (Na 128 mmol/L). Adequate nutrition did not correct the electrolyte disturbances. Low urine chloride levels ( CFTR mutations, p.F508del and p.R117C consistent with a CF diagnosis. FE was >500 mg/g. The original NBS screening sample showed a screening negative IRT value of 39.5 ng/ml (cut-off 59.4 ng/ml) and when analyzed the same mutations as listed above. Conclusion 38 infants were NBS positive for CF during almost three years of screening and until now only one NBS false negative infant was identified. The NBS false negative infant presented with pseudo-Bartters syndrome, which highlights an association between this feature and attenuated IRT levels.