Search

Aim: This study assessed the prevalence, clinical presentation and outcome of lymphocytic colitis (LC) and eosinophilic gastrointestinal disease (EGID) in children with severe, recurrent abdominal pain (RAP), by describing the predominant symptoms, diagnostic approaches and treatment options.Methods: We performed a retrospective follow-up study at a Danish regional hospital by reviewing the histology reports of the children who had undergone gastrointestinal endoscopy for RAP. Data were retrieved from the medical records of those who met the diagnostic criteria for LC and, or, EGID from 2011 to 2016. The study population comprised 381 patients who underwent a diagnostic process to clarify RAP.Results: A total of 74 patients (39 females) aged 2-17 years, with severe RAP as the most predominant symptom underwent gastrointestinal endoscopy. This identified 16/74 (21.6%) with LC (n = 6) and, or, EGID (n = 11), which equated to 4.2% with RAP. No biochemical patterns of abnormalities were found. Medical treatment and, or, diet generally induced and maintained clinical remission.Conclusion: We found 16 children with LC and, or, EGID. The predominant symptom was severe RAP. All patients had a macroscopically normal mucosa at endoscopy, a specific histopathological feature and no characteristic biochemical findings. Endoscopy should be considered in these cases. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis to corticosteroids can be a challenging diagnosis as corticosteroids are used in the treatment of dermatitis. The prevalence of contact allergy to corticosteroid varies between previous studies., Objective: To study the prevalence of sensitization to budesonide, tixocortol-21-pivalate and hydrocortisone-17-butyrate in a Danish patient population from 2006-2020, cross-sensitization, risk factors and clinical relevance., Methods: A retrospective analysis of patch test data and MOAHLFA index was performed among 6823 patients consecutively patch tested with TRUE test as part of the baseline series., Results: A positive patch test for corticosteroids was found in 185 patients (1.2% budesonide, 1.6% tixocortol-21-pivalate, 1.0% hydrocortisone-17-butyrate) without gender difference. For women, the prevalence of tixocortol-21-pivalate sensitization increased significantly from 1.3% in 2006-2008 to 2.9% in 2018-2020. Tixocortol-21-pivalate sensitization had more frequently clinical relevance in women (61.3%) compared to men (34.5%). Age above 40 years was positively associated to corticosteroid sensitization. Budesonide and hydrocortisone-17-butyrate accounted for 67.7% of co-sensitizations., Conclusions: The prevalence of corticosteroid sensitization was 2.7%. Age was the only risk factor for corticosteroid sensitization. The frequency of corticosteroid sensitization was stabile over time except for tixocortol-21-pivalate sensitization for women. About one third of sensitized patients had co-sensitizations to other corticosteroid groups., (© 2022 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.)

Corticosteroids are used to treat dermatoses, including allergic contact dermatitis, but can also cause contact allergy. The frequency of corticosteroid allergy varies between studies and is influenced by treatment traditions and availability. To estimate the prevalence of tixocortol-21-pivalate, budesonide and hydrocortisone-17-butyrate allergy in a Danish patch test population and characterize individuals with corticosteroid allergy. Three thousand five hundred and ninety-four patients were patch tested with tixocortol-21-pivalate, budesonide, and hydrocortisone-17-butyrate. Characterization was performed according to the MOAHLFA index and duration of disease. Two per cent had a steroid allergy: 0.8% had a tixocortol-21-pivalate allergy, 1% a budesonide allergy, and 1% a hydrocortisone-17-butyrate allergy. Tixocortol-21-pivalate and budesonide allergy were associated with atopic dermatitis in crude analyses, but only tixocortol-21-pivalate allergy and atopic dermatitis remained associated in adjusted analyses. Leg dermatitis was uniquely associated with tixocortol-21-pivalate allergy. Hydrocortisone-17-butyrate allergy was associated with duration of disease in both crude and adjusted analyses. Chronic dermatoses (atopic dermatitis and leg dermatitis) were identified as risk factors for group A corticosteroid allergy, probably because of more pronounced exposure to group A steroids resulting from ease of access that is exploited by patients with a chronic dermatosis. The duration of disease rather than the dermatosis itself seemed to be important for group B and D2 corticosteroid allergy. [ABSTRACT FROM AUTHOR]

A follow-up study on 180 patients treated for the first time for nasal polyps was performed. The follow-up period was from 1 to 8 years with a median of 57 months. The majority of patients had postoperative topical steroid treatment. 65.6% of patients had one polypectomy, 17.8% had two polypectomies, 10% had 3, 2.8% had 4, and 3.9% of patients had 5-10 polypectomies performed during the follow-up period. Patients without asthma, acute recurrent or chronic sinusitis, acetylsalicylic acid intolerance, or allergy had fewer polypectomies and less topical steroid treatment than patients with these characteristics. The recurrence profile between the first and second polypectomy described with the life-table method showed a slow decline in the number of patients with only one polypectomy. The time span needed before significant clinical symptoms occurred after the first polypectomy indicates that not all primary polyp patients are prone to recurrence. Nasal polyps is probably a manifestation of different clinical and aetio-pathogenetic entities. Further identification of such entities is needed to improve treatment strategy.

Glucocorticoid sprays are increasingly used for the treatment of allergic rhinitis and asthma. This therapy is highly effective, and side effects are few and mild. It was the aim of the present study to evaluate a physiological nasal inhalation technique, which results in airway deposition of the steroid molecule similar to that of inhaled allergen particles. Thirty adults with grass pollen-induced rhinitis and asthma inhaled the steroid molecule budesonide through the nose from a pressurized aerosol attached to a spacer device. Compared with inhalation of placebo, the treatment resulted in a significant reduction of nasal symptoms (P = 0.005), of bronchial symptoms (P = 0.005), but not of eye symptoms. In addition, nasal peak inspiratory flow (P = 0.0003) and oral peak expiratory flow (P = 0.02) increased. There was no difference between budesonide and placebo with regard to local side effects, such as nose bleeding, hoarseness, and irritation in mouth and throat. It is concluded that nasal inhalation of a steroid from a spacer offers effective therapy of pollen rhinitis and asthma without significant local side effects. This therapeutic modality may have advantages over the ordinarily used nasal and bronchial spray treatment in patients with both rhinitis and asthma, especially when conventional spray therapy is associated with local side effects.