Characteristics of cow’s milk allergy and sensitization in Chinese patients

Globally,the prevalence of food allergy in children is estimated to be approximately 4%to 10%.[1]Food allergy usually begins early in the allergic march,and cow's milk allergy(CMA)is one of the most common food allergens in infants and children.In Europe,the overall incidence of challenge-proven CMA is 0.54%,and in the United States,the overall prevalence is 0.4%and pediatric prevalence is 1.9%.[2–4]In China,the prevalence of oral food challenge(OFC)-confirmed CMA is 0.83%to 3.5%in various cities.[5]Double-blind placebo-controlled food challenge is not applied widely in clinical practice because of its complex process and the risk of anaphylaxis for patients that receive the test.Allergen-specific IgE(sIgE)is usually used as a critical assessment method for food allergy.

Diagnostic accuracy and safety of Dermatophagoides pteronyssinus extracts used for skin prick test

Background:Dermatophagoides pteronyssinus is a common allergen causing allergic diseases in China.The aim of this study was to evaluate the efficacy and safety of D.pteronyssinus extracts produced by Peking Union Medical College Hospital(PUMCH)for the skin prick test(SPT)in the diagnosis of D.pteronyssinus allergy.Methods:A total of 910 subjects with allergic diseases were prescribed D.pteronyssinus SPT and specific sIgE(sIgE)test among the Outpatients of Department of Allergy,PUMCH from August 10,2015 to August 30,2017.Receiver operating characteristic curve(ROC)analysis was performed according to the results of D.pteronyssinus-sIgE detection.The accuracy of D.pteronyssinus extracts used for SPT in the diagnosis of D.pteronyssinus allergy was evaluated under different cutoff values.Adverse events after SPT were recorded to evaluate safety.Results:There were 796 and 618 subjects in the full analysis set(FAS)and the per protocol set(PPS),respectively.The areas under the curve of FAS and PPS were 0.871 and 0.873,respectively.According to the ROC of PPS,the optimal and 95%specificity diagnostic cutoff values of D.pteronyssinus SPT mean wheal diameter were 3.25 and 3.75 mm,respectively.No adverse events occurred.Conclusion:The extracts of D.pteronyssinus for SPT were simple,highly accurate,and safe and should be considered for recommendation in the clinical diagnosis of D.pteronyssinus allergy.

Long-term prophylaxis of hereditary angioedema with danazol

To the Editor:Hereditary angioedema(HAE)is a rare genetic disorder that is characterized by recurrent attacks of subcutaneous or submucosal swelling.[1]HAE may lead to life-threatening conditions,with a mortality rate of 9.6%to 11.5%in those who develop laryngeal edema.[2,3]The fundamental abnormality of HAE types 1 and 2 is the deficiency or dysfunction of C1 inhibitor(C1-INH),a multifunctional serine protease inhibitor,caused by mutation in its coding gene,SERPING1.[1]These two types are collectively referred to as C1-INH-HAE.