Cap feia

Among patients referred to our immunology clinic from January 2010 to December 2021, patients fulfilling the 1990 ARA EGPA classification criteria were enrolled (Figure 1). Demographic, clinical and laboratory data were retrieved from their clinical records. The blood eosinophil count (BEC), total IgE (CAP-FEIA, ThermoFisher, Uppsala, Sweden), atopic status, eosinophil cationic protein (ECP, CAP-FEIA, ThermoFisher, Uppsala, Sweden) and ANCA (EUROPLUS Granulocyte Mosaic 25, IFA, Euroimmun, Lubeck, Germany; EliaTM MPOS, EliaTM PR3S, ThermoFisher, Uppsala, Sweden) were analyzed at the baseline. Atopy was defined as skin test positivity and/or documented serum-specific IgE for inhalant allergens. All patients underwent nasal endoscopy and a head computed tomography (CT) scan to investigate sino-nasal involvement at the baseline. Lung involvement was assessed with a chest CT scan at the baseline in all patients. All patients were screened for heart involvement by transthoracic echocardiography; more advanced heart assessments, such as cardiac magnetic resonance (MRI) or coronary angiography, were performed according to the patients’ clinical needs. All patients were screened for kidney involvement using laboratory (serum creatinine and urinalysis) and ultrasound assessment. Other clinical actions were physician-assessed.

Sera were obtained from European wheat food allergic patients (Austria n = 1; Finland: n = 3; Greece: n = 6; total: n = 10) aged 3–41 years (mean age 12 years). Patients were diagnosed on the basis of a case history demonstrating that allergic symptoms (airway symptoms, gastrointestinal symptoms, skin symptoms, systemic anaphylaxis) were unambiguously related to the ingestion of wheat or wheat-containing products. A grading of symptoms and definition of anaphylaxis was performed according to the international position paper and recommendations for the definition of anaphylaxis (Table 1). [20] (link) In six of the patients, open food challenge was performed and positive challenge results were obtained. Skin prick tests with wheat seed extract were performed and positive in each of the wheat allergic patients. For each patient IgE-mediated sensitization to wheat was confirmed by measurements of allergen-specific IgE (CAP-FEIA, Thermofisher, Uppsala, Sweden). Patients were further characterized for their reactivity to the two major wheat food allergens omega-5-gliadin (Tri a 19) and LMW glutenin (Tri a 36). [21] (link)