We demonstrated the clinical and immunologic effect of probiotic and vitamin D supplementation on SLIT. Probiotic supplementation showed better clinical and immunologic response in children with allergic rhinitis.

Nutcracker syndrome (NCS) is an unusual cause of haematuria and is defined as compression of the left renal vein between the aorta and superior mesenteric artery, resulting in elevation of left renal vain pressure and collateral vein development. Symptoms of NCS include the following: haematuria, abdominal and left flank pain, pelvic congestion syndrome, and orthostatic proteinuria, although, clinically, gross haematuria may be the only disorder. We report a 13-year-old girl who experienced haematuria for two years with chronic back and abdominal pain. Each urinalysis revealed haematuria (20% dysmorphic). In the presented case Doppler ultrasonography revealed left renal vein dilatation up to the angle between the superior mesenteric artery and the aorta with a diameter of 7 mm in the hilar region. NCS can be easily missed by routine tests in children.

Urticaria is a heterogeneous group of disorders, with various clinical manifestations and intensity of symptoms. Urticaria can be induced with a wide variety of environmental stimuli, such as cold, pressure, vibration, sunlight, exercise, temperature changes, heat, and water. In a select group of patients, exercise can induce a spectrum of urticaria symptoms, ranging from cutaneous pruritus and warmth, generalised urticaria, angioedema, and the appearance of such additional manifestations as collapse, upper respiratory distress, and anaphylaxis. Specific provocation tests should be carried out on an individual basis to investigate the suspected cause and proper diagnosis. Modification of activities and behaviour is the mainstay of treatment in patients with physical urticaria. The aim of this study was to emphasise that primary care paediatricians should be able to recognise physical urticaria, supply a patient with rescue medications, and refer him/her to a specialist. In the article, the authors present a 13-year-old girl with typical urticaria lesions and angioedema after exercise. According to the history, physical examination, and provocation test, exercise-induced urticaria and angioedema were diagnosed.