To the Editor, Asthma is one of the most common non-communicable chronic respiratory diseases worldwide and still causes a significant public health burden despite recent advancements in asthma treatment. 1,2 Hence, there is an urgent need to establish a cost-effective strategy to reduce the overall disease burden of asthma, including preventive strategies. 3 Obesity may serve as the target of preventive strategies because it is a well-established risk factor for asthma. 4 Although previous studies showed that obesity is associated with a high prevalence of asthma, 4 the association of change in body mass index (BMI) with incident asthma is unclear. Considering obesity is potentially a modifiable risk factor for asthma in adults, it is crucial to elucidate whether weight loss could prevent asthma development. Thus, we aimed to investigate the impact of weight gain or loss on asthma development using nationally representative cohort data.

RATIONALE: Drug hypersensitivity (DH) is a common healthcare concern, but incidence of DH is low in children, resulting in few epidemiological data, especially in Japan. The aim of this study was to elucidate clinical features of DH in Japanese children. METHODS: Study design is a retrospective chart survey based on the data extracted from electrical chart of patients who visited the allergy units of our hospital with referral of DH suspicion from April, 2005 to March, 2016. RESULTS: The number of all patients extracted from electric database was 160 and their median age was 6.9 years old. Fifty five (34.4%) reacted to any drug within 1 hour after intake and 86 (53.8%) did within 2 hours. Fifty four patients (33.8%) were diagnosed as having DH, 52 (32.5%) as suspected DH and 46 (28.8%) as without DH. Drug provocation tests were performed in 35 children, and only 3 had positive reaction. Among 53 confirmed DH patients, the most common incriminated drug was antibiotics (29 ones and beta lactams was 77.4% of them), followed by, nonsteroidal anti-inflammatory drugs (NSAIDs) (7), vaccine (4), muscle relaxant (4), steroids (2), and anesthetic (1). The symptoms caused by antibiotics emerged within 1 hour in 18 patients (62.1%) and 11 (37.9%) showed anaphylaxis. Incidence of non-immediate type exanthema was higher in antibiotics DH (96.6%) than in NSAID DH (71.4%) (p<0.05). CONCLUSIONS: Beta-lactam was the most common cause of childhood DH in Japan. Both of immediate and non-immediate reactions were commonly seen in most DH.

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