Pediatric Allergy: Principles and Practice

Principles and Practice

4th Edition - October 19, 2020
Editors: Donald Y. M. Leung, Cezmi A Akdis, Leonard B. Bacharier, Charlotte Cunningham-Rundles, Scott H Sicherer, Hugh A. Sampson
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 7 4 6 2 - 1
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 7 4 6 3 - 8

With complete, concise coverage of prevention, indications, diagnosis, and treatment, Pediatric Allergy, 4th Edition, is your go-to resource for current, clinically-focused content… Read more

Pediatric Allergy: Principles and Practice

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With complete, concise coverage of prevention, indications, diagnosis, and treatment, Pediatric Allergy, 4th Edition, is your go-to resource for current, clinically-focused content in the rapidly changing field of allergies and immune-mediated diseases in children. This highly regarded reference fully covers immunology and origins of allergy, growth and development, pregnancy, infancy, and early, middle, and late childhood—all with a new, practical, clinical focus. You’ll find authoritative coverage of the full range of allergies in pediatric patients, from asthma and other common conditions to rare or uncommon allergies, providing a one-stop resource for clinicians across specialties who care for children.

Cover image
Title page
Table of Contents
Copyright
Contributors
Preface
Section A. General Concepts
1. Epidemiology of Allergic Diseases
Introduction
Prevalence of Childhood Asthma and Allergies
Time Trends in the Prevalence of Allergic Diseases
Environmental Risk Factors for Allergic Diseases
Gene-Environment Interactions
Conclusions
2. Natural History of Allergic Diseases and Asthma
Introduction
Allergic March of Childhood
Early Immune Development Underlying Allergies
Transient Wheezers and Persistent Asthma in Childhood
Asthma From Childhood to Adulthood
Risk Factors for Persistent Asthma
Asthma-Protective and Allergy-Protective Environments
Atopic Dermatitis
Allergic Rhinitis
Anaphylaxis
Allergy and Asthma Prevention
Conclusions
3. The Genetics of Allergic Disease and Asthma
Introduction
Why Undertake Genetic Studies of Allergic Disease?
Approaches to Genetic Studies of Complex Genetic Diseases
Allergy and Asthma as Complex Genetic Diseases
Phenotypes for Allergy and Allergic Disease: What Should We Measure?
The Heritability of Atopic Disease: Are Atopy and Atopic Disease Heritable Conditions?
Molecular Regulation of Atopy and Atopic Disease, I: Susceptibility Genes
Molecular Regulation of Atopy and Atopic Disease, II: Disease-Modifying Genes
Epigenetics and Allergic Disease
Conclusions
Section B. Immunologic Diseases
4. Approach to the Child With Recurrent Infections and Molecular Diagnosis
Introduction
Molecular Diagnosis
Treatment and Outcomes
Conclusions
5. Primary Antibody Deficiency
Introduction
Congenital Agammaglobulinemia
Hyper–Immunoglobulin M Syndromes
Common Variable Immunodeficiency
Immunoglobulin G Subclass Deficiency and Specific Antibody Deficiency
Selective Immunoglobulin A Deficiency
Conclusions
6. T Cell Immunodeficiencies
Introduction
Severe Combined Immunodeficiency
DiGeorge Syndrome
Syndromes With Significant T Cell Deficiency
Wiskott-Aldrich Syndrome and Other Related Disorders
Conclusions
Helpful Websites
7. Complement Deficiencies
Introduction
Cascade Component Deficiencies
Regulatory Component Deficiencies
Secondary Complement Deficiencies
Laboratory Assessment of Complement
Conclusions
8. Defects of Innate Immunity
Introduction
Severe Congenital Neutropenia
Cyclic Neutropenia/Cyclic Hematopoiesis
Warts, Hypogammaglobulinemia, Infections, and Myelokathexis (WHIM) Syndrome
Immune-Mediated Neutropenias
Defects of Granule Formation and Content
Neutrophil-Specific Granule Deficiency
Defects of Oxidative Metabolism
Myeloperoxidase Deficiency
Mucocutaneous Candidiasis
Conclusions
9. Congenital Immune Dysregulation Disorders
Introduction
Autoimmune Polyendocrinopathy, Candidiasis, Ectodermal Dystrophy
X-Linked Immune Dysregulation, Polyendocrinopathy, and Enteropathy
STAT1 Gain-of-Function Disease
Defects in Interleukin 2 Signaling
Autoimmune Lymphoproliferative Syndrome
RAS-Associated Autoimmune Leukoproliferative Disorder
Protein Kinase C Delta Deficiency
Conclusions
10. Immunoglobulin Therapy
Introduction
Preparation of Intravenous Immunoglobulin
Dosage
Administration
Side Effects
Intravenous Immunoglobulin as an Immune-Modulating Agent in Patients With Autoimmune or Inflammatory Disorders
Conclusions
11. Hematopoietic Stem Cell Therapies
Introduction
Severe Combined Immune Deficiency
Transplantation for Other Severe Primary Immune Deficiencies
Gene Therapy
Section C. Diagnosis and Treatment of Allergic Disease
12. Diagnosis of Human Allergic Disease
Introduction
Immediate (Type 1) Hypersensitivity Response
Allergens
Diagnosis of Type 1 Hypersensitivity
Management of Type 1 Hypersensitivity
Conclusions
13. Outdoor Allergens
Introduction
General Principles of Allergen Aerobiology
Representative Pollens
Representative Fungi
Meteorologic Variables
Impact of Climate Change on Aeroallergens
Conclusions
14. Indoor Allergens
Introduction
Allergen Structure and Function
Clinical Significance of Indoor Allergens
Evaluation of Allergen Exposure
Monitoring Allergen Exposure as Part of Asthma Management
Conclusions and Future Directions
15. Environmental Control
Introduction
Dust Mites
Animal Allergens
Cockroach Allergen
Rodent Allergens
Mold Allergens
Indoor Air Pollution
Outdoor Allergens
Early-Life Allergen Exposure
Conclusions
Helpful Websites
16. Immunotherapy for Allergic Disease
Introduction
Principles of Immunotherapy
Mechanisms of Action
Specific Disease Indications
Practical Considerations
Future Directions
Conclusions
Section D. Upper Airway Disease
17. Allergic Rhinitis
Introduction
Epidemiology
Pathophysiology
Evaluation and Management
Evaluation and Management
Conclusions
18. Sinusitis
Introduction
Sinus Development in Childhood
Clinical Definitions of Sinusitis
Epidemiology and Health Burden
Etiology
Sinusitis Management
Sinusitis Treatment
Conclusions
19. Chronic Cough
Chronic Cough in Children
Pathophysiology
Differential Diagnosis
Diagnostic and Therapeutic Recommendations
Conclusions
Section E. Asthma
20. Immunology of the Asthmatic Response
Introduction
Mechanisms of Allergic Inflammatory Response
Adaptive Immune Responses: T Helper Cell Type 2 Cells and Cytokines
Conclusions
21. Lung Function Testing in Children
Introduction
Spirometry
Plethysmography
Bronchial Provocation
Conclusions
22. Infections and Asthma in Childhood
Introduction
Relationships Between Early Life Infections and Childhood Asthma Inception (Fig. 22.1)
Infections and Acute Exacerbations of Asthma
Mechanisms of Infection-Induced Wheezing Illnesses
Treatment of Infection-Induced Wheezing and Asthma
Use of Antibiotics in Asthma
Conclusions
23. Special Considerations for Infants and Young Children
Introduction
Phenotypes of Wheezing in Young Children
Predicting Who Is Likely to Develop Persistent Asthma
Differential Diagnosis or Possible Confounders
Diagnosis of Asthma in Young Children
Management
Management of Asthma Exacerbations in Young Children
Conclusion
Helpful Websites
24. Inner City Asthma: Strategies to Reduce Mortality and Morbidity
Introduction
Challenges to Asthma Management
Factors Contributing to Morbidity in Inner Cities (Table 24.1)
Interventions
Community-Wide Asthma Coalitions
Conclusions
25. Asthma in Older Children: Special Considerations
Epidemiology and Etiology
Natural History of Asthma
Management of Exercise-Induced Asthma and Bronchoconstriction
Management of Asthma Exacerbations
Conclusions
26. Collaborating With Schools to Support Children With Asthma
Introduction
Impact of Asthma on School Performance
The School Setting: Facilitators and Barriers of Asthma Management
Essential Components of an Asthma-Friendly School
Practical Tips for Providers to Support Asthma Management at School
School-Based Asthma Programs
Conclusions
27. Refractory Childhood Asthma: Assessment and Management
Introduction
Nomenclature
Approach to the Child With Problematic Severe Asthma
Summary and Conclusions
28. Promoting Adherence and Self-Management
Adherence to Asthma Treatment
Impact of Nonadherence
Communication Strategies to Change Patient Behavior
A Four-Step Communication Strategy for Changing Patient Behavior
Conclusions
29. Strategies for the Primary Prevention of Asthma
Introduction
Primary Prevention and the Natural History of Asthma
Asthma and the House Dust Mite
Conclusions
Section F. Food Allergy
30. Mucosal Immunology: An Overview
Introduction
Structure of the Gastrointestinal Associated Lymphoid Tissue
Mechanisms of Antigen Sampling in the Intestinal Mucosa
The Role of Intestinal Dendritic Cells and Macrophages in Oral Tolerance and Immunity
Environmental Factors and the Regulation of the Mucosal Immunity
Conclusions
31. Evaluation of Food Allergy
Introduction
Prevalence
Immunoglobulin E–Mediated Symptoms
Non–Immunoglobulin E Immune-Mediated Reactions to Food
Nonimmunologic Reactions
Psychological Reactions
Evaluation
Food Challenges
Conclusions
32. Approach to Feeding Problems in the Infant and Young Child
Introduction
Feeding and Developmental Readiness
Picky Eating Versus Problematic Feeding and Eating
Food Allergy Impact on Feeding
Why Do Feeding Problems Matter?
Treatment Options
33. Enterocolitis, Proctocolitis, and Enteropathies
Introduction
Epidemiology
Celiac Disease
Differential Diagnosis
Evaluation and Management
Food Protein–Induced Enterocolitis Syndrome
Conclusions
34. Eosinophilic Gastrointestinal Diseases
Introduction
Food Allergy or Hypersensitivity
Conclusions
35. Management of Food Allergy
Introduction
Avoidance Diets: General
Nutrition
Common Allergen Elimination Diets of Early Childhood
Conclusions
36. Prevention of Food Allergy
Introduction
The Importance and Timing of Early Intervention
Vitamin D
Modulation of the Maternal and Infant Microbiome
Targeting and Individualizing Prevention Strategies: Considering Phenotypic, Environmental, and Genotypic Risk
Conclusions and Future Directions
37. Immunotherapeutic Approaches to the Treatment of Food Allergy
Introduction
Allergen-Specific Immunotherapy
“Next-Generation” Therapies for Food Allergy
Probiotics
Chinese Herbal Formulas
Conclusions
Section G. Allergic Skin Diseases
38. Evaluation and Management of Atopic Dermatitis
Introduction
Symptoms and Signs
Differential Diagnosis
Hydration and Skin Barrier Protective Measures
Topical Antiinflammatory Therapy
Education of Patients and Caregivers
Wet Wrap Therapy
Multidisciplinary Approach to Atopic Dermatitis
Investigational or Unproven Therapy
Interferon-Gamma
Conclusions
Helpful Websites
39. Urticaria and Angioedema
Introduction
Classification of Urticaria and Angioedema
Acute Urticaria and Angioedema
Chronic Urticaria and Angioedema
Isolated Angioedema
Conclusion
Helpful Websites
40. Contact Dermatitis
Introduction
Epidemiology
Pathogenesis
Evaluation and Management
Diagnosis of Contact Dermatitis
Patch Testing
Allergens of Particular Importance in Children
Special Considerations
Treatment and Prevention
Conclusions
Helpful Websites
Section H. Other Allergic Diseases
41. Allergic and Immunologic Eye Disease
Introduction
Eye Anatomy, Histology, and Immune Function
Differential Diagnosis
History
Eye Examination
Allergic Disorders
Immunologic Disorders
Treatment
New Directions and Future Developments45
Conclusions
42. Drug Allergy
Introduction
Epidemiology: Prevalence, Manifestations, and Culprit Drugs
Particular Aspects of Drug Allergy Workup in Children
Nonsteroidal Antiinflammatory Drugs
Vaccines
Multiple Drug Hypersensitivity Syndrome
Conclusions
43. Insect Sting Allergy
Introduction
The Insects
Epidemiology and Etiology
Classification of Reactions
Natural History
Diagnosis and Detection of Venom Specific Immunoglobulin E
Therapy
Prevention of Acute Systemic Sting Reaction
44. Anaphylaxis: Assessment and Management
Introduction
Epidemiology
Patients at Increased Risk of Severe Anaphylaxis
Pathologic Mechanisms in Anaphylaxis
Triggers
Diagnosis
Treatment of the Acute Anaphylactic Episode
Long-Term Management of Anaphylaxis
Conclusions
45. Mast Cell Disease and Hypereosinophilic Diseases
Introduction
Mastocytosis
Hypereosinophilic Diseases
Index

Donald Y. M. Leung

Affiliations and expertise

Head, Division of Pediatric Allergy/Immunology, National Jewish Medical and Research Center, Denver CO, USA Professor of Pediatrics, University of Colorado Health Sciences Center, Denver CO, USA

Cezmi A Akdis

Affiliations and expertise

Professor of Immunology, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland

Leonard B. Bacharier

Affiliations and expertise

Vanderbilt University, Doctors' Office Tower

Charlotte Cunningham-Rundles

Affiliations and expertise

Professor of Clinical Immunology and Pediatrics Icahn School of Medicine Mt Sinai Hospital New York, New York

Scott H Sicherer

Scott H. Sicherer, M.D., is the Elliot and Roslyn Jaffe professor of allergy, immunology and pediatrics at the Icahn School of Medicine at Mount Sinai and the Director of the Jaffe Food Allergy Institute. He is Chief of the Division of Pediatric Allergy and Immunology, and Medical Director of the Institution’s Clinical Research Unit. Sicherer received his medical degree from the Johns Hopkins University School of Medicine. He is board-certified in allergy and immunology and specializes in food allergies. His research interests include gastrointestinal manifestations, epidemiology, psychosocial and quality of life issues, diagnostics, prevention, genetics and treatments. He has published over 275 articles and 75 book chapters in major pediatric and allergy textbooks and journals, and has been consistently recognized as among the top 1% of researchers in his field.

Affiliations and expertise

Clinical Professor of Pediatrics, Chief, Pediatrics Allergy and Immunology, Medical Director, General Clinical Research Center, Jaffe Food Allergy Institute, Mount Sinai Medical Center, New York NY, USA

Hugh A. Sampson

Hugh A Sampson, MD, is the Kurt Hirschhorn Professor of Pediatrics, the Dean for Translational Biomedical Sciences, PI and Director of Conduits; Institutes for Translational Sciences (CTSA), and the Director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Sampson completed his allergy/immunology fellowship training at Duke University in 1980 and was a faculty member in the Division of Allergy/Immunology at Duke University and then Johns Hopkins University before coming to Mount Sinai. Dr. Sampson’s research interests have focused primarily on food allergic disorders including the immunopathogenic role of food hypersensitivity in atopic dermatitis and anaphylaxis, characterization of food allergens, and improved diagnostic tests and immunotherapeutic strategies for treating food allergies. Dr. Sampson is the PI of the NIH-sponsored Consortium on Food Allergy Research and an AADCRC program project conducting a number of clinical trials investigating novel therapies for the treatment of food allergy and investigating basic immunologic mechanisms associated with desensitization and the eventual development of tolerance. He has published over 400 articles and 60 book chapters on food allergic disorders and co-edited four books, and was elected to membership in the Institute of Medicine of the National Academies in 2003 for his research in food allergies. Dr. Sampson is past chairman of the Section on Allergy & Immunology of the American Academy of Pediatrics and the past-president of the American Academy of Allergy, Asthma and Immunology.

Affiliations and expertise

Mount Sinai School of Medicine, New York, NY, USA