We have established generalizable reference ranges for respiratory impedance and defined cut-offs for a positive bronchodilator response using the FOT in healthy children.

Chronic urticaria is a distressing condition with high costs. The aim of this literature review was to assess the relative frequency of causes of chronic urticaria in childhood and to provide guidance on which laboratory tests should be performed. Using PubMed, EMBASE and Cochrane databases, the literature from 1966 to 2010 (week 25) was systematically reviewed. Data from studies conducted on children who had had urticaria for at least 6 weeks, and assessing at least 3 different causes of urticaria, were analysed by reviewers using independent extraction. Six studies, all of low quality, met the inclusion criteria. Idiopathic and physical urticaria were common. Infections, autoimmunity and allergy were also reported. We conclude that children with chronic urticaria not caused by physical stimuli should undergo tests for allergy or infections only when there is a history of cause-effect correlation. High-quality trials are warranted to evaluate the causes of chronic urticaria in childhood.

The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic. Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.

non-IgE and mixed gastrointestinal food allergies present various specific, well-characterized clinical pictures such as food protein-induced allergic proctocolitis, food protein-induced enterocolitis and food protein-induced enteropathy syndrome as well as eosinophilic gastrointestinal disorders such as eosinophilic esophagitis, allergic eosinophilic gastroenteritis and eosinophilic colitis. The aim of this article is to provide an updated review of their different clinical presentations, to suggest a correct approach to their diagnosis and to discuss the usefulness of both old and new diagnostic tools, including fecal biomarkers, atopy patch tests, endoscopy, specific IgG and IgG4 testing, allergen-specific lymphocyte stimulation test (ALST) and clinical score (CoMiss).

Summary. Objective: To define normal values for respiratory resistance (R rs ) and reactance (X rs ) and bronchodilator response (BDR) in a population of healthy Italian preschool children using a commercially available forced oscillation device. Methods: R rs and X rs were measured in kindergartens in Viterbo, Italy. Regression analysis was performed taking into account height, weight, age, gender, and reference equations calculated. The coefficient of repeatability (CR) between two tests performed 15 min apart was calculated in a subset of children. BDR was assessed by repeating the measurements 15 min after the administration of 200 mg of inhaled salbutamol and calculated as an absolute change in R rs and X rs at 8 Hz, as a percent change in baseline, and as a change in Z-score calculated from the reference equations. Results: Lung function was attempted in 175 healthy children and successful in 163 (81 male, median age 4.8, range 2.9-6.1 years). R rs and X rs at 6, 8, and 10 Hz were related to height but not other variables. The CR was 1.53 hPa s L À1 for R rs8 and 0.91 hPa s L À1 for X rs8 . The 5th percentile for absolute R rs8 BDR was À3.16 hPa s L À1, whereas the 95th percentile for absolute X rs8 BDR was 2.25 hPa s L À1. These cut-off values corresponded to a change in the Z-score of À1.88 and 2.48, respectively. Conclusions: We have established reference equations for R rs and X rs in healthy Italian preschool children using forced oscillations. We recommend a change in Z-score of À1.88 for R rs8 and 2.48 for X rs8 as cut-off values for a positive BDR.