Background: Allergen molecule-based diagnosis has been suggested to facilitate the identification of disease-causing allergen sources and the prescription of allergen-specific immunotherapy (AIT). The aim of the current study was to compare allergen molecule-based IgE serology with allergen extract-based skin testing for the identification of the disease-causing allergen sources. The study was conducted in an area where patients are exposed to pollen from multiple sources (trees, grasses, and weeds) at the same time to compare the diagnostic efficiency of the 2 forms of diagnosis. Methods: Patients from Astana, Kazakhstan, who suffered from pollen-induced allergy (n = 95) were subjected to skin prick testing (SPT) with a local panel of tree pollen, grass pollen, and weed pollen allergen extracts and IgE antibodies specific for marker allergen molecules (nArt v 1, nArt v 3, rAmb a 1, rPhl p 1, rPhl p 5, rBet v 1) were measured by ImmunoCAP. Direct and indirect costs for diagnosis based on SPT and marker allergen-based IgE serology as well as direct costs for immunotherapy depending on SPT and serological test results were calculated. Results: The costs for SPT-based diagnosis per patient were lower than the costs for allergen molecule-based IgE serology. However, allergen molecule-based serology was more precise in detecting the disease-causing allergen sources. A lower number of immunotherapy treatments (n = 119) was needed according to molecular diagnosis as compared to extract-based diagnosis (n = 275), which considerably reduced the total costs for diagnosis and for a 3-year treatment from EUR 1,112.30 to 521.77 per patient. Conclusions: The results from this real-life study show that SPT is less expensive than allergen molecule-based diagnostic testing, but molecular diagnosis allowed more precise prescription of immunotherapy which substantially reduced treatment costs and combined costs for diagnosis and treatment.

BACKGROUND Even though coronavirus 2019 disease (COVID-19) clinical course in children is much milder than in adults, pneumonia can occur in the pediatric population as well. Here, we reported a single-center pediatric case series of COVID-19 from Kazakhstan during the first wave of pandemic. AIM To analyze the main clinical and laboratory aspects in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive and negative children diagnosed with pneumonia. METHODS This is a retrospective analysis of 54 children, who were medically assessed as close contacts of COVID-19 adults in their family setting, between June and September 2020. These children were all hospitalized: We compared the clinical and laboratory characteristics of children affected with pneumonia in the presence (group 1) or absence (group 2) of SARS-CoV-2 infection. RESULTS Overall, the main clinical manifestations at the admission were fever, cough, loss of appetite, fatigue/weakness, nasal congestion and/or rhinorrhea, and dyspnea. Based on the SARS-CoV-2 polymerase chain reaction (PCR) test, 24 positive children with pneumonia (group 1) and 20 negative children with pneumonia (group 2) were identified; 10 positive children did not show any radiological findings of pneumonia. No significant differences were found between the two pneumonia study groups for any clinical and laboratory parameters, except for C-reactive protein (CRP). Of course, both pneumonia groups showed increased CRP values; however, the COVID-19 pneumonia group 1 showed a significantly higher increase of CRP compared to group 2. CONCLUSION In our case series of children assessed for SARS-CoV-2 infection based on contact tracing, the acute inflammatory response and, in detail, CRP increase resulted to be more pronounced in COVID-19 children with pneumonia than in children with SARS-CoV-2-unrelated pneumonia. However, because of multiple limitations of this study, larger, controlled and more complete clinical studies are needed to verify this finding.

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Многопрофильная городская детская больница №1 (Астана) 3 Городской центр инфекционных болезней (Астана)

By definition, primary immunodeficiencies are genetically determined diseases, which are fundamental molecular or organic defects associated with impaired immune responses, in this case there is the clinic of infectious and autoimmune diseases, with an increased risk of developing malignancies. Primary immunodeficiency diseases more frequent than previously thought. The lack of clear algorithms and the use of outdated technologies considerably delay diagnosis process, which leads to delays expensive no specific treatment instead of Immunotropic effective therapy. The first episodes of primary immunodeficiencies (PID) are manifested at an early age, but also the primary PID can also occur in adults, the first episode of the disease observed in the 20-30 years of age.Key words: primary immunodeficiencies -common variable -immunodeficiency. ТұжырымдамаАнықтау бойынша, біріншілікті иммунодефициттер генетикалық детерминаттарылған аурурлар, негізінде молекулярлық неме-се органикалық дефектілер жатады, иммундық реакциялардың бұзылысы мен қоса, инфекциондық және аутоиммундық ауруларының клиникалық көрінісі мен қоса қатерлі ісікті ауруларының пайда болуымын көрінеді. Бұрын ойлағаннан біріншілікті иммунодефициттер жиі кездесетін ауру болып табылады.Зерттеу просессін нақты алгоритміндерінің жоқтығы және ескереген технологияларының қолдануы кешіктігеді, ол иммунотропты терапия өткізу орнына қымбат бейспецификалық емінің ұзақ созылуына себеп болып келеді. Біріншілікті иммунодефициттердің БИД алғашқы эпизодтары ерете жастағы балаларда көрінеді, бірақ БИД ересек адамдардада кездеседі, алғашқы клиникалық көріністері 20-30 жас аралығында байқалады.Маңызды сөздер: біріншілікті иммунодефициттер -жалпы вариабельді иммунодефицит. РезюмеСогласно определению, первичные иммунодефициты являются генетически детерминированными заболеваниями, основопола-гающими которых являются молекулярные либо органические дефекты, сопровождающиеся нарушениями иммунных реакций, при этом наблюдается клиника инфекционных и аутоиммунных заболеваний, при этом наблюдается повышенный риск развития злокачественных новообразований. Первичные иммунодефициты более частые заболевания, чем это предполагалось ранее. Отсутствие четких алгорит-мов и использование устаревших технологий значительно затягивают процесс диагностики, что ведет к затягиванию дорогостоящего не специфического лечения вместо проведения эффективной иммунотропной терапии. Первые эпизоды первичных иммунодефицитов (ПИД) проявляются в раннем детстве, но также первичные ПИД могут встречаться и среди взрослого населения, первые эпизоды заболевания наблюдаются в 20-30 летнем возрасте.Ключевые слова: первичные иммунодефициты, общий вариабельный иммунодефицит.