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2. Respiratory viruses: new challenges for old enemies

Author

Iovine, E., primary, Petrarca, L., additional, Conti, M.G., additional, Mancino, E., additional, Virgili, F., additional, Di Mattia, G., additional, Matera, L., additional, La Regina, D.P., additional, Pierangeli, A., additional, Midulla, F., additional, and Nenna, R., additional

Published
2023
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4. RSV circulation during SARS-CoV-2 pandemic era: what happened in Italy

Author

Matera, L, primary, Nenna, R, additional, Frassanito, A, additional, Conti, M G, additional, Di Mattia, G, additional, Petrarca, L, additional, Mancino, E, additional, La Regina, D P, additional, Marseglia, G L, additional, Licari, A, additional, Leonardi, S, additional, Manti, S, additional, Nosetti, L, additional, Pierangeli, A, additional, Scagnolari, C, additional, Di Jorgi, M, additional, Solco, A, additional, Moriano, C, additional, Crinò, S, additional, Bonci, E, additional, and Midulla, F, additional

Published
2022
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6. Covid-19 in children: disease spectrum and risk factors

Author

Mancino, E, primary, Nenna, R, additional, Di Mattia, G, additional, Matera, L, additional, Petrarca, L, additional, Conti, M G, additional, Frassanito, A, additional, La Regina, D P, additional, Iovine, E, additional, Fabrizio, V, additional, Spatuzzo, M, additional, Ialongo, S, additional, Bonci, F, additional, and Midulla, F, additional

Published
2022
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7. The BNT162b2 vaccine induces humoral and cellular immune memory to SARS-CoV-2 Wuhan strain and the Omicron variant in children 5 to 11 years of age

Author

Cinicola, B. L., Piano Mortari, E., Zicari, A. M., Agrati, C., Bordoni, V., Albano, C., Fedele, G., Schiavoni, I., Leone, P., Fiore, S., Capponi, M., Conti, M. G., Petrarca, L., Stefanelli, P., Spalice, A., Midulla, F., Palamara, A. T., Quinti, I., Locatelli, Franco, Carsetti, R., Locatelli F. (ORCID:0000-0002-7976-3654), Cinicola, B. L., Piano Mortari, E., Zicari, A. M., Agrati, C., Bordoni, V., Albano, C., Fedele, G., Schiavoni, I., Leone, P., Fiore, S., Capponi, M., Conti, M. G., Petrarca, L., Stefanelli, P., Spalice, A., Midulla, F., Palamara, A. T., Quinti, I., Locatelli, Franco, Carsetti, R., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

SARS-CoV-2 mRNA vaccines prevent severe COVID-19 by generating immune memory, comprising specific antibodies and memory B and T cells. Although children are at low risk of severe COVID-19, the spreading of highly transmissible variants has led to increasing in COVID-19 cases and hospitalizations also in the youngest, but vaccine coverage remains low. Immunogenicity to mRNA vaccines has not been extensively studied in children 5 to 11 years old. In particular, cellular immunity to the wild-type strain (Wuhan) and the cross-reactive response to the Omicron variant of concern has not been investigated. We assessed the humoral and cellular immune response to the SARS-CoV-2 BNT162b2 vaccine in 27 healthy children. We demonstrated that vaccination induced a potent humoral and cellular immune response in all vaccinees. By using spike-specific memory B cells as a measurable imprint of a previous infection, we found that 50% of the children had signs of a past, undiagnosed infection before vaccination. Children with pre-existent immune memory generated significantly increased levels of specific antibodies, and memory T and B cells, directed against not only the wild type virus but also the omicron variant.

Published
2022

10. First analysis of the Severe Paediatric Asthma Collaborative in Europe registry

Author

Liu, N.M., Lodrup Carlsen, K.C., Cunningham, S., Fenu, G., Fleming, L.J., Gappa, M. (Monika), Karadag, B., Midulla, F., Petrarca, L., Pijnenburg, M.W.H. (Mariëlle), Reier-Nilsen, T., Rutjes, N.W., Rusconi, F, Grigg, J., Liu, N.M., Lodrup Carlsen, K.C., Cunningham, S., Fenu, G., Fleming, L.J., Gappa, M. (Monika), Karadag, B., Midulla, F., Petrarca, L., Pijnenburg, M.W.H. (Mariëlle), Reier-Nilsen, T., Rutjes, N.W., Rusconi, F, and Grigg, J.

Published
2020
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11. ERS International Congress, Madrid, 2019: highlights from the Paediatric Assembly

Author

Nenna, R., Slaats, M., Ersu, R, Lo, D. (Danny), Seglani, S., Nissenbaum, C., Horsley, A.R., Proesmans, W. (Willem), Petrarca, L., Williams, E., Dassios, T., Ardura-Garcia, C., Duijts, L. (Liesbeth), Marczak, H., Snijders, D., Rottier, R.J. (Robbert), Chao, C.M., Pijnenburg, M.W.H. (Mariëlle), Grigg, J., Nenna, R., Slaats, M., Ersu, R, Lo, D. (Danny), Seglani, S., Nissenbaum, C., Horsley, A.R., Proesmans, W. (Willem), Petrarca, L., Williams, E., Dassios, T., Ardura-Garcia, C., Duijts, L. (Liesbeth), Marczak, H., Snijders, D., Rottier, R.J. (Robbert), Chao, C.M., Pijnenburg, M.W.H. (Mariëlle), and Grigg, J.

Abstract

In this article, the Group Chairs and the Early Career Members of the Paediatric Assembly of the European Respiratory Society (ERS) highlight some of the most interesting findings in the field of paediatrics presented at the 2019 ERS International Congress, which was held in Madrid, Spain. The main findings from each group are summarised at the end of each chapter.

Published
2020
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12. ERS International Congress, Madrid, 2019: highlights from the Paediatric Assembly

Author

Nenna, R, Slaats, M, Ersu, R, Lo, D, Seglani, S, Nissenbaum, C, Horsley, AR, Proesmans, M, Petrarca, L, Williams, E, Dassios, T, Ardura-Garcia, C, Duijts, Liesbeth, Marczak, H, Snijders, D, Rottier, Robbert, Chao, CM, Pijnenburg, Marielle, Grigg, J, Nenna, R, Slaats, M, Ersu, R, Lo, D, Seglani, S, Nissenbaum, C, Horsley, AR, Proesmans, M, Petrarca, L, Williams, E, Dassios, T, Ardura-Garcia, C, Duijts, Liesbeth, Marczak, H, Snijders, D, Rottier, Robbert, Chao, CM, Pijnenburg, Marielle, and Grigg, J

Published
2020

13. First analysis of the Severe Paediatric Asthma Collaborative in Europe registry

Author

Liu, NM, Lodrup Carlsen, KC, Cunningham, S, Fenu, G, Fleming, LJ, Gappa, M, Karadag, B, Midulla, F, Petrarca, L, Pijnenburg, Marielle, Reier-Nilsen, T, Rutjes, NW, Rusconi, F, Grigg, J, Liu, NM, Lodrup Carlsen, KC, Cunningham, S, Fenu, G, Fleming, LJ, Gappa, M, Karadag, B, Midulla, F, Petrarca, L, Pijnenburg, Marielle, Reier-Nilsen, T, Rutjes, NW, Rusconi, F, and Grigg, J

Published
2020

17. Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice

Author

Werkstetter, K.J. Korponay-Szabó, I.R. Popp, A. Villanacci, V. Salemme, M. Heilig, G. Lillevang, S.T. Mearin, M.L. Ribes-Koninckx, C. Thomas, A. Troncone, R. Filipiak, B. Mäki, M. Gyimesi, J. Najafi, M. Dolinšek, J. Dydensborg Sander, S. Auricchio, R. Papadopoulou, A. Vécsei, A. Szitanyi, P. Donat, E. Nenna, R. Alliet, P. Penagini, F. Garnier-Lengliné, H. Castillejo, G. Kurppa, K. Shamir, R. Hauer, A.C. Smets, F. Corujeira, S. van Winckel, M. Buderus, S. Chong, S. Husby, S. Koletzko, S. Socha, P. Cukrowska, B. Szajewska, H. Wyhowski, J. Brown, N. Batra, G. Misak, Z. Seiwerth, S. Dmitrieva, Y. Abramov, D. Vandenplas, Y. Goossens, A. Schaart, M.W. Smit, V.T.H.B.M. Kalach, N. Gosset, P. Kovács, J.B. Nagy, A. Lellei, I. Kőbányai, R. Khatami, K. Monajemzadeh, M. Dimakou, K. Patereli, A. Hansen, T.P. Kavalar, R. Bolonio, M. Ramos, D. Kogler, H. Amann, G. Kosova, R. Maglio, M. Janssens, E. Achten, R. Frűhauf, P. Skálová, H. Kirchner, T. Petrarca, L. Magliocca, F.M. Martínez, F. Morente, V. Thanner-Lechner, S. Ratschek, M. Gasparetto, M. Hook, L. Canioni, D. Wanty, C. Mourin, A. Laurila, K. Vornane, M. Friedler, V.N. Morgenstern, S.L. Amil Dias, J. Carneiro, F. João, H.S. Van Biervliet, S. Velde, S.V. Banoub, H. Sampson, S. Müller, A.M. Ene, A. Rafeey, M. Eftekhar Sadat, A.T. ProCeDE study group ProCeDE study group

Abstract

Background & Aims The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. Methods We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries. Local centers recorded symptoms; measurements of total IgA, TGA, and EMA; and histopathology findings from duodenal biopsies. Children were considered to have malabsorption if they had chronic diarrhea, weight loss (or insufficient gain), growth failure, or anemia. We directly compared central findings from 16 antibody tests (8 for TGA-IgA, 1 for TGA-IgG, 6 for IgG against deamidated gliadin peptides, and 1 for EMA, from 5 different manufacturers), 2 HLA-DQ2/DQ8 tests from 2 manufacturers, and histopathology findings from the reference pathologist. Final diagnoses were based on local and central results. If all local and central results were concordant for celiac disease, cases were classified as proven celiac disease. Patients with only a low level of TGA-IgA (threefold or less the ULN) but no other results indicating celiac disease were classified as no celiac disease. Central histo-morphometry analyses were performed on all other biopsies and cases were carefully reviewed in a blinded manner. Inconclusive cases were regarded as not having celiac disease for calculation of diagnostic accuracy. The primary aim was to determine whether the nonbiopsy approach identifies children with celiac disease with a positive predictive value (PPV) above 99% in clinical practice. Secondary aims included comparing performance of different serological tests and to determine whether the suggested criteria can be simplified. Results Of 803 children recruited for the study, 96 were excluded due to incomplete data, low level of IgA, or poor-quality biopsies. In the remaining 707 children (65.1% girls; median age, 6.2 years), 645 were diagnosed with celiac disease, 46 were found not to have celiac disease, and 16 had inconclusive results. Findings from local laboratories of TGA-IgA 10-fold or more the ULN, a positive result from the test for EMA, and any symptom identified children with celiac disease (n = 399) with a PPV of 99.75 (95% confidence interval [CI], 98.61–99.99); the PPV was 100.00 (95% CI, 98.68–100.00) when only malabsorption symptoms were used instead of any symptom (n = 278). Inclusion of HLA analyses did not increase accuracy. Findings from central laboratories differed greatly for patients with lower levels of antibodies, but when levels of TGA-IgA were 10-fold or more the ULN, PPVs ranged from 99.63 (95% CI, 98.67–99.96) to 100.00 (95% CI, 99.23–100.00). Conclusions Children can be accurately diagnosed with celiac disease without biopsy analysis. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide. HLA analysis is not required for accurate diagnosis. Clinical Trial Registration no: DRKS00003555. © 2017 AGA Institute

Published
2017

21. Anti-transglutaminase autoantibodies in saliva. Usefulness of the radioimmunological test in coeliac children and adolescents: A multicenter study

Author

Bonamico, M., primary, Nenna, R., additional, Tiberti, C., additional, Lucantoni, F., additional, Montuori, M., additional, Mennini, M., additional, Bavastrelli, M., additional, Petrarca, L., additional, Mastrogiorgio, G., additional, Florio, M., additional, Polimeni, A., additional, Carroccio, F., additional, Iacono, G., additional, and Giuliana, G., additional

Published
2013
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27. PO43 GASTRIC FINDINGS IN COELIAC CHILDREN AND ADULTS

Author

Petrarca, L., primary, Nenna, R., additional, Luparia, R.P.L., additional, Mastrogiorgio, G., additional, Mennini, M., additional, Pontone, S., additional, Pietropaoli, N., additional, Brighi, M., additional, Florio, M., additional, Magliocca, F.M., additional, and Bonamico, M., additional

Published
2012
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28. PO29 COELIAC SALIVARY SCREENING: L'AQUILA EXPERIENCE

Author

Caloisi, C., primary, De Stefano, M., additional, Nenna, R., additional, Bavastrelli, M., additional, Petrarca, L., additional, Mastrogiorgio, G., additional, Tiberti, C., additional, Bonamico, M., additional, and Gentile, T., additional

Published
2012
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31. PP36 THE COELIAC ICEBERG IN ITALY

Author

Nenna, R., primary, Petrarca, L., additional, Mennini, M., additional, Luparia, R.P.L., additional, Bavastrelli, M., additional, Mastrogiorgio, G., additional, Pietropaoli, N., additional, Lucantoni, F., additional, Montuori, M., additional, Magliocca, F.M., additional, Tiberti, C., additional, and Bonamico, M., additional

Published
2011
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34. CO3 DEFECTIVE MUCOSAL PRODUCTION OF IL-17A IN PEDIATRIC CELIAC DISEASE

Author

La Scaleia, R., primary, Barba, M., additional, Montuori, M., additional, Di Nardo, G., additional, Barrella, G., additional, Nenna, R., additional, Oliva, S., additional, Mennini, M., additional, Valitutti, F., additional, Petrarca, L., additional, Di Camillo, C., additional, Mastrogiacomo, G., additional, Barbato, M., additional, Cucchiara, S., additional, Bonamico, M., additional, Piccoli, M., additional, Mainiero, F., additional, and Palmieri, G., additional

Published
2010
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45. Subclinical synovitis detected by ultrasound in children affected by coeliac disease: A frequent manifestation improved by a gluten-free diet

Author

Iagnocco, A., Ceccarelli, F., Maurizio Mennini, Rutigliano, I. M., Perricone, C., Nenna, R., Petrarca, L., Mastrogiorgio, G., Valesini, G., and Bonamico, M.

Subjects
Male, Chi-Square Distribution, Synovitis, ultrasound, coeliac disease, subclinical synovitis, Adolescent, Infant, Ultrasonography, Doppler, Severity of Illness Index, Celiac Disease, Diet, Gluten-Free, Treatment Outcome, Predictive Value of Tests, Risk Factors, Child, Preschool, Asymptomatic Diseases, Humans, Female, Joints, Child
Abstract

Coeliac disease (CD) is a chronic autoimmune disease of the small intestine caused by the ingestion of gluten, in which musculoskeletal manifestations may occur. Aim of this study was to evaluate the prevalence and severity of joint involvement in paediatric patients with CD using musculoskeletal ultrasound (US).Consecutive paediatric CD patients were enrolled and underwent US evaluations at level of knees, hips and ankles. The presence of joint effusion (JE), synovial hypertrophy, power Doppler signal and structural damage lesions (bone irregularities and erosions) was registered. Inflammatory abnormalities were scored on a semi-quantitative scale (0-3), and structural damage lesions on a dichotomous scale (0-1).Seventy-four CD children (mean age: 7.6 years; range: 1-14.2; M/F 24/50) were enrolled. Thirty-eight were on a gluten-containing diet (GCD) and 36 on a gluten-free diet (GFD). US showed the presence of abnormalities in 23 patients overall (31.1%); JE was the most frequently observed change (23/23). US abnormalities were observed in 19 patients (50.0%) of GCD group and in 4 of GFD group (11.1%, p=0.007). Interestingly, 12/23 (52.2%) patients with US-detected changes were asymptomatic.This is the first US study demonstrating joint involvement in children with CD. JE, the most frequent manifestation, was present also in asymptomatic patients and was reduced in those on GFD. These findings may indicate that, also at joint level, an inflammatory response represented by the appearance of JE may be induced by exposure to gluten.

48. Outbreak of paediatric myocarditis associated with parvovirus B19 infection in Italy, January to October 2024.

Author

Poeta M, Moracas C, Calò Carducci FI, Cafagno C, Buonsenso D, Maglione M, Sgubbi S, Liberati C, Venturini E, Limongelli G, Nunziata F, Petrarca L, Mandato C, Colomba C, and Guarino A

Subjects
Humans, Italy epidemiology, Child, Male, Female, Child, Preschool, Infant, Adolescent, Erythema Infectiosum epidemiology, Erythema Infectiosum diagnosis, Myocarditis virology, Myocarditis epidemiology, Myocarditis diagnosis, Parvovirus B19, Human isolation & purification, Disease Outbreaks, Parvoviridae Infections epidemiology, Parvoviridae Infections diagnosis, Immunoglobulins, Intravenous therapeutic use
Abstract

Acute myocarditis has risen among paediatric patients in Italy, with 65 clinically suspected cases reported by 12 centres in 2024, 32 linked to parvovirus B19 (B19V) infection. In 11 cases, B19V was not ruled out despite a concurrent European outbreak. Twenty-nine children required intensive care; eight fatalities occurred. While effective for both severe B19V infection and myocarditis, intravenous immunoglobulins were given in only one-third of cases. These findings highlight the need for timely diagnosis, stronger surveillance, and standardised treatment protocols.

Published
2024
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49. Bacterial-like inflammatory response in children with adenovirus leads to inappropriate antibiotic use: a multicenter cohort study.

Author

Moracas C, Poeta M, Grieco F, Tamborino A, Moriondo M, Stracuzzi M, Diana A, Petrarca L, Marra S, Licari A, Linsalata S, Albano C, Condemi A, Del Tufo E, Di Fraia T, Punzi L, Ardia E, Lo Vecchio A, Bruzzese E, Colomba C, Giacomet V, Midulla F, Marseglia GL, Galli L, and Guarino A

Abstract

Purpose: To compare the clinical severity of Human Adenovirus (HAdV) infection with other viral diseases in a cohort of children, evaluating presentation, therapy, and outcome., Methods: We conducted a retrospective multicenter cohort study in Italian children hospitalized from January to December 2023 for respiratory symptoms. The study included children with HAdV infection presenting primarily with respiratory symptoms. Patients with isolated gastrointestinal involvement or coinfection with bacteria were excluded., Results: A total of 171 children were enrolled: 98 with HAdV infection (age 44.3 ± 37.9 months) and 73 with other viruses (age 20.4 ± 27.2 months). In the first group, 57.1% had a coinfection with one or more additional viruses. The most common symptoms were fever (89.8%), cough (73.5%) and sore throat (52%). Respiratory distress and hypoxemia were more frequent in the non-HAdV group. Children with HAdV infection demonstrated significantly higher C-reactive protein levels (50.8 ± 54.2 vs. 16.5 ± 33.8 mg/L, p < 0.001), experienced a longer duration of fever (4.9 ± 3.6 vs. 3.4 ± 2.3 days, p = 0.009) and were more likely to receive antibiotic treatment (77.6% vs. 27.4%, p < 0.001). No differences were observed in hospitalization stay, rate of complications, and ICU admission., Conclusions: Interestingly, our data suggests that HAdV-infected children exhibit a more pronounced inflammatory response despite experiencing less severe respiratory symptoms compared to other viruses. The presence of prolonged fever and a strong inflammatory response often leads to antibiotic overuse during the initial phase, when the viral etiology is yet to be confirmed. Early and accurate identification of HAdV infection is crucial to optimize treatment strategies and minimize unnecessary antibiotic use., (© 2024. The Author(s).)

Published
2024
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50. The role of respiratory function tests in infants with stridor: diagnosis at glance and follow-up.

Author

Bloise S, Nenna R, Petrarca L, Conti MG, Di Mattia G, Matera L, Mancino E, La Regina DP, Lubrano R, Bonci E, Moretti C, and Midulla F

Subjects
Humans, Infant, Male, Female, Follow-Up Studies, Case-Control Studies, Bronchoscopy, Infant, Newborn, Airway Obstruction diagnosis, Airway Obstruction physiopathology, Respiratory Sounds diagnosis, Respiratory Sounds physiopathology, Respiratory Function Tests
Abstract

Background: Recently, the development of advanced, noninvasive methods has allowed the study of respiratory function even in uncooperative infants. To date, there is still little data on the application of this technique in infants with suspected airway obstruction., The Aims of Our Study Were: - To evaluate the role of respiratory function testing (PFR) in the diagnosis and follow-up of infants with stridor - To evaluate the differences between patients with inspiratory stridor and expiratory stridor. - To evaluate the concordance between PFR and endoscopy., Methods: We enrolled infants aged < 1 year with a diagnosis of inspiratory and/or expiratory chronic stridor and a group of healthy controls. For each patient we performed PFR at diagnosis (T0) and for cases at follow-up, at 3 months (T1), 6 months (T2), 12 months (T3). At T0, all patients were classified according to a clinical score, and at follow-up, stature-ponderal growth was assessed. When clinically indicated, patients underwent bronchoscopy., Results: We enrolled 48 cases (42 diagnosed with inspiratory stridor and 6 expiratory stridor) and 26 healthy controls. At T0, patients with stridor had increased inspiratory time (p < 0.0001) and expiratory time (p < 0.001) than healthy controls and abnormal curve morphology depending on the type of stridor. At T0, patients with expiratory stridor had a reduced Peak expiratory flow (p < 0.023) and a longer expiratory time (p < 0.004) than patients with inspiratory stridor. We showed an excellent concordance between PFR and endoscopic examination (k = 0.885, p < 0.0001). At follow-up, we showed a progressive increase of the respiratory parameters in line with the growth., Conclusions: PFR could help improve the management of these patients through rapid and noninvasive diagnosis, careful monitoring, and early detection of those most at risk., (© 2024. The Author(s).)

Published
2024
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