Annamaria Bianchi - Academia.edu (original) (raw)

Papers by Annamaria Bianchi

Discovery Medicine, Dec 31, 2023

Italian Journal of Pediatrics, Jul 6, 2018

Journal of Investigational Allergology and Clinical Immunology, Jun 20, 2016

Journal of Clinical Medicine, Jun 1, 2022

Medicina-lithuania, Apr 5, 2022

Acta bio-medica : Atenei Parmensis, Nov 29, 2021

Hypersensitivity reactions to polyethylene glycol (PEG) is an emerging challenge and the interest... more Hypersensitivity reactions to polyethylene glycol (PEG) is an emerging challenge and the interest about this disease is growing since PEG is considered one of the possible causes of coronavirus disease 2019 (COVID 19) vaccine-associated anaphylaxis. PEG is used in a wide variety of pharmaceutical, medical, industrial, cosmetic, and food products and can be an active ingredient or used as an excipient. PEG is present in several medications, and it may or may not be present in different formulations and dosages of the same drug. Lack of standardization nomenclature, inadequate labelling of products and lack of knowledge about PEG involvement in hypersensitivity reactions expose patients at risk of presenting multiple reactions before a diagnosis could be made. In this review we describe the main cases published in literature and propose an allergy work-up and management.

Medicina

Hypersensitivity reactions to radiocontrast media seem to be rare in children. Furthermore, the u... more Hypersensitivity reactions to radiocontrast media seem to be rare in children. Furthermore, the use of radiocontrast media in children remains quite safe in terms of the severity of reactions. Since pediatric guidelines are lacking, the diagnostic workup employed in adults could be adapted to children, taking into account that results have not yet been validated in this age group. Specific protocols for risk stratification and management of severe reactions have been proposed so far.

Nutrients, 2021

The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination agai... more The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.

Acta bio-medica : Atenei Parmensis, 2021

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergy (FA) chara... more Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergy (FA) characterized by delayed and severe gastrointestinal symptoms that typically occurs within the first year of life. Many aspects of this pathology are currently unclear. FPIES is classified as a non-IgE immune-mediated FA in which the immune response is thought to act mainly through cell-mediated mechanisms. In patients with FPIES, the symptom pattern is determined by the frequency and dose of food allergen in the diet. Diagnosis of FPIES may be difficult, mainly due to the lack of specific biomarkers to confirm or exclude the diagnosis. FPIES is a clinical diagnosis, mainly based on clinical features which, although not specific, are reproducible every time the patient takes the food. Different diagnostic criteria of FPIES were published over time in the literature. The present narrative review aims to analyze the current clinical evidence in epidemiology, pathophysiology, diagnosis, and mana...

Acta Bio Medica : Atenei Parmensis, 2021

We report the case of a 15-year-old boy who developed eosinophilic esophagitis (EoE) during cow’s... more We report the case of a 15-year-old boy who developed eosinophilic esophagitis (EoE) during cow’s milk oral immunotherapy (CM-OIT). In order to not completely invalidate OIT benefits, baked milk-containing foods were allowed instead of a strict CM-free diet. However, histological remission of EoE was reached only after a strict cow’s milk-free diet, not associated to pharmacological treatment. Nevertheless, given the limited data on real incidence of food OIT related EoE and potential beneficial treatment for this condition, we highlight the need of prospective studies aimed to evaluate if a strict CM free diet in OIT related EoE is always necessary to obtain remission of the disease or similarly to CM EoE, baked milk-containing foods” diet could be abeneficial treatment also in these patients. (www.actabiomedica.it)

PLOS ONE, 2020

The use of mobile communication devices in health care is spreading worldwide. A huge amount of h... more The use of mobile communication devices in health care is spreading worldwide. A huge amount of health data collected by these devices (mobile health data) is nowadays available. Mobile health data may allow for real-time monitoring of patients and delivering ad-hoc treatment recommendations. This paper aims at showing how this may be done by exploiting the potentialities of fuzzy clustering techniques. In fact, such techniques can be fruitfully applied to mobile health data in order to identify clusters of patients for diagnostic classification and cluster-specific therapies. However, since mobile health data are full of noise, fuzzy clustering methods cannot be directly applied to mobile health data. Such data must be denoised prior to analyzing them. When longitudinal mobile health data are available, functional data analysis represents a powerful tool for filtering out the noise in the data. Fuzzy clustering methods for functional data can then be used to determine groups of pat...

Italian Journal of Pediatrics, 2020

BackgroundDigital health technologies carry the great potential of assisting physicians in making... more BackgroundDigital health technologies carry the great potential of assisting physicians in making well-informed diagnostic and therapeutic decisions. In allergy care, electronic clinical diaries have been recently used to prospectively collect patient data and improve diagnostic precision.ObjectiveThis review summarizes the clinical and scientific experience we gathered over 10 years of using a digital platform for patients suffering from seasonal allergic rhinitis.MethodsThe mobile application and back-office of AllergyMonitor (TPS software production, Rome, Italy) enable patients to record their daily allergy symptoms as well as drug and immunotherapy intake plus possible side effects in a customizable way. The results can be accessed by the patient and attending physician as concise reports via a smartphone or computer. This technology has been used in several clinical studies and routine practice since 2009.ResultsOur studies showed that A) the etiological diagnosis of SAR may b...

Medicina, 2019

Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated... more Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated food allergy. It is usually conducted to make diagnosis, to monitor for resolution of a food allergy, or to identify the threshold of responsiveness. Clinical history and lab tests have poor diagnostic accuracy and they are not sufficient to make a strict diagnosis of food allergy. Higher concentrations of food-specific IgE or larger allergy prick skin test wheal sizes correlate with an increased likelihood of a reaction upon ingestion. Several cut-off values, to make a diagnosis of some food allergies (e.g., milk, egg, peanut, etc.) without performing an OFC, have been suggested, but their use is still debated. The oral food challenge should be carried out by experienced physicians in a proper environment equipped for emergency, in order to carefully assess symptoms and signs and correctly manage any possible allergic reaction. This review does not intend to analyse comprehensively all...

Italian Journal of Pediatrics, 2018

Italian journal of pediatrics, Jan 12, 2017

The diagnosis of IgE-mediated cow's milk allergy is often based on anamnesis, and on specific... more The diagnosis of IgE-mediated cow's milk allergy is often based on anamnesis, and on specific IgE (sIgE) levels and/or Skin Prick Tests (SPT), which have both a good sensitivity but a low specificity, often causing positive results in non-allergic subjects. Thus, oral food challenge is still the gold standard test for diagnosis, though being expensive, time-consuming and possibly at risk for severe allergic reactions. The aim of the present study was to perform a systematic review of the studies that have so far analyzed the positive predictive values for sIgE and SPT in the diagnosis of allergy to fresh and baked cow's milk according to age, and to identify possible cut-offs that may be useful in clinical practice. A comprehensive search on Medline via PubMed and Scopus was performed August 2017. Studies were included if they investigated possible sIgE and/or SPT cut-off values for cow's milk allergy diagnosis in pediatric patients. The quality of the studies was evalua...

Allergy, Jan 20, 2017

Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in ... more Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. We examined 1120 children (age 4-18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™ ). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by high...

Pediatric Allergy and Immunology, 2016

BackgroundMany different symptom (medication) scores are nowadays used as measures of allergic rh... more BackgroundMany different symptom (medication) scores are nowadays used as measures of allergic rhinoconjunctivitis severity in individual patients and in clinical trials. Their differences contribute to the heterogeneity of the primary end‐point in meta‐analyses, so that calls for symptom (medication) score harmonization have been launched.ObjectiveTo prospectively compare six different severity scores for allergic rhinitis (AR) against pollen counts at both population and individual levels.MethodsTwo groups of children with seasonal AR and grass pollen sensitization were recruited in Ascoli, Italy (n = 76) and Berlin, Germany (n = 29). Symptoms and drug intake were monitored daily for 40 and 30 days of the grass pollen season in 2011 (Ascoli) and 2013 (Berlin), respectively, through an Internet‐based platform (AllergyMonitor™, TPS Production srl, Rome, Italy). From the gathered data, the informatics platform automatically generated one symptom score (RTSS) and five symptom–medicati...

International Archives of Allergy and Immunology, 2015

Background: Little is known about the prevalence and clinical relevance of hypersensitivity to th... more Background: Little is known about the prevalence and clinical relevance of hypersensitivity to the plant panallergen profilin in children. Objectives: The present study aimed to investigate prevalence, risk factors and clinical relevance of profilin sensitization in a large cohort of Italian children of different ages living in different geographic areas. Methods: Children with pollen allergy enrolled by 16 pediatric outpatient clinics sited in three main geographic areas of Italy were studied. SPT were carried out with commercial pollen extracts and a commercial purified date palm pollen profilin. IgE specific for allergenic pollen molecules, Phl p 12 (grass profilin) and Pru p 3 (peach lipid transfer protein) were tested by ImmunoCAP FEIA. Results: IgE to Phl p 12 (≥0.35 kU/l) was observed in 296 of the 1,271 participants (23%), including 17 of the 108 (16%) preschool children. Profilin SPT was positive (≥3 mm) in 320/1,271 (25%) participants. The two diagnostic methods were conco...

Pediatric Allergy and Immunology, 2015

Pediatr Allergy Immunol Background. The diagnosis of IgE-mediated egg allergy lies both on a comp... more Pediatr Allergy Immunol Background. The diagnosis of IgE-mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of the present paper is to systematically review the literature in order to identify, analyze and synthesize the predictive value of SPT and specific IgEs both to egg white and main egg allergens and to review the cut-offs suggested in the literature. Methods. A total of 37 articles were included in this systematic review. Studies were grouped according to degree of cooking of the egg used for OFC, age and type of allergen used to perform the allergy work-up. Results. In children < 2 years, raw egg allergy seems very likely when SPTs with egg white extract are ≥ 4 mm or specific IgEs are ≥ 1.7 kU A /L. In children ≥ 2 years, OFC could be avoided when SPTs with egg white extract are ≥10 mm or Prick by Prick with egg white are ≥14 mm or specific IgE are ≥ 7.3 kU A /L. Likewise, heated egg allergy can be diagnosed if SPTs with egg white extract are > 5 mm and > 11 mm in children < 2 years and ≥ 2 years, respectively. Conclusions. Further and better-designed studies are needed to determine the remaining diagnostic cut-off of specific IgE and SPT for heated and baked egg allergy.