Manual of Pediatric Allergy
Manual of Pediatric Allergy
Second Edition
Editor-in-Chief
Major K Nagaraju
MD DCH DAP DAA FAGE FIAP FAIMS FICMCH FICAAI FACI EAACI Certificate in Pediatric Allergy and Clinical Immunology
Pediatric Allergist and Immunologist Professor Department of Pediatrics Division of Allergy and Clinical Immunology Director, Fellowship Program in Allergy and Clinical Immunology Saveetha Medical College and Hospital, Chennai Senior Consultant in Pediatric Allergy Apollo Children's Hospital, Chennai Director, VN Allergy and Asthma Research Center Chennai, Tamil Nadu, India Founder Honorary Secretary and Immediate Past President Pediatric Allergy Association of India
Foreword
A Parthasarathy
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Manual of Pediatric Allergy
First Edition : 2015
Second Edition: 2021
9789389587449
Printed at:
- Amrutha D Holla MBBS DAA
- Senior Allergist
- Allergy Asthma and Chest Center
- Mysuru, Karnataka, India
- Cansin Sackesen MD
- Pediatric Allergy and Asthma Unit
- Hacettepe University School of Medicine
- Ankara, Turkey
- D Vijayasekaran MD (Ped) DCH PhD FIAP
- Consultant and Pediatric Pulmonologist
- Kanchi Kamakoti CHILDS Trust Hospital and Apollo Children's Hospital
- Former Professor
- Department of Pediatrics and Respiratory Diseases
- Madras Medical College
- Chennai, Tamil Nadu, India
- Esra Birben PhD (Molecular Genetics)
- Associate Professor
- Molecular Biology Section
- Department of Biology
- Hacettepe University
- Beytepe Campus, Ankara, Turkey
- George V Guibas MD PhD
- Chair, Greater Manchester
- Central Research Ethics Committee
- Health Research Authority
- Allergist
- Clinical Research Fellow
- University of Manchester
- Manchester, UK
- H Paramesh
- MD FAAP (USA) FIAP FIAMS FICAAI FIAA FPAI
- Professor
- Divecha Center for Climate Change, IISc
- Lakeside Center for Health Promotion/Lakeside Education Trust
- Bengaluru, Karnataka, India
- Kavitha Mohanasundaram
- MD DNB DM (Rheumatology)
- Associate Professor
- Department of Rheumatology
- Saveetha Medical College and Hospital
- Chennai, Tamil Nadu, India
- Mahesh PA DNB (Pulmonary Medicine)
- Professor and Head
- Department of Respiratory Medicine
- JSS Medical College
- JSS Academy of Higher Education
- and Research
- Mysuru, Karnataka, India
- Major K Nagaraju
- MD DCH DAP DAA FAGE FIAP FAIMS FICMCH FICAAI FACI EAACI Certificate in Pediatric Allergy and Clinical Immunology
- Pediatric Allergist and Immunologist
- Professor
- Department of Pediatrics
- Division of Allergy and Clinical Immunology
- Director, Fellowship Program in Allergy and Clinical Immunology
- Saveetha Medical College and Hospital Chennai
- Senior Consultant in Pediatric Allergy
- Apollo Children's Hospital, Chennai
- Director, VN Allergy and Asthma Research Center
- Chennai, Tamil Nadu, India
- Founder Honorary Secretary and Immediate Past President
- Pediatric Allergy Association of India
- N Karthik
- MD (Pulm Med) DNB (Pulm Med) IDCCM FACI
- EAACI Certificate in Allergy and
- Clinical Immunology
- Pulmonologist and Allergist
- Hindu Mission Hospital
- Consultant Allergist
- VN Allergy and Asthma Research Center
- Chennai, Tamil Nadu, India
- N Satya Srivatsav MBBS MD PG (Pediatrics)
- Junior Resident
- Department of Pediatrics
- Kasturba Medical College
- Manipal University
- Mangaluru, Karnataka, India
- NC Gowrishankar
- MD (Pediatrics) DCH
- Diplomate in Pediatrics FIAP
- Head (Pediatrics—Clinical Operation and Quality) and Pediatric Pulmonologist
- Mehta Multispecialty
- Hospital India Pvt Ltd
- Chennai, Tamil Nadu, India
- Nikolaos G Papadopoulos
- MD PhD FAAAAI FRCP
- Professor in Allergology—Pediatric Allergology
- Head, Department of Allergy
- 2nd Pediatric Clinic
- University of Athens, Greece
- Professor
- Department of Allergy
- and Pediatric Allergy
- Division of Infection
- Immunity and Respiratory Medicine
- University of Manchester, UK
- President
- Respiratory Effectiveness Group (REG)
- Board Member
- Global Allergy and Asthma European Network (GA2LEN)
- Respiratory Syncytial Virus Network (ReSViNET)
- Omer Kalayci MD
- Pediatric Allergist
- Pediatric Allergy and Asthma Unit
- Hacettepe University School of Medicine
- Ankara, Turkey
- Saranya Chinnadurai MD DM (Rheumatology)
- Assistant Professor
- Department of Rheumatology
- Sri Ramachandra Institute of Higher Education and Research
- Chennai, Tamil Nadu, India
- Somu Sivabalan
- MBBS MD (Ped) DNB (Ped) MNAMS FCCP (USA)
- FIAP FRCP (Edin)
- Consultant Pediatrician and Pulmonologist
- Kanchi Kamakoti CHILDS Trust Hospital and Sundaram Medical Foundation
- Chennai, Tamil Nadu, India
- Srinath MV MBBS DNB (Ped)
- Senior Resident
- Department of Pediatrics
- Saveetha Medical College
- Chennai, Tamil Nadu, India
- Srinivas K Rao DO DNB FRCS (Ed)
- Ophthalmologist
- Darshan Eye Clinic and Surgical Center
- Chennai, Tamil Nadu, India
- Suresh Anne MD FAAAAI FACAAI FACP
- Associate Professor
- Allergy and Immunology Division
- School of Medicine
- Michigan State University
- Flint, Michigan, USA
- TU Sukumaran MD MPhil PhD
- Professor and Head
- Department of Pediatrics
- Pushpagiri Institute of Medical Sciences
- Thiruvalla, Kerala, India
- VV Kasyapi MS (ENT)
- Otorhinolaryngologist
- VN Allergy and Asthma Research Center
- Chennai, Tamil Nadu, India
Allergy in pediatric and adolescent practice can be encountered in routine office practice and in emergency room in hospitals. A ready reckoner, concise yet comprehensive, for reference and management is a necessity for the busy practitioners. This manual with national and international contributions fulfills this need with practical management guidelines.
Pediatric and adolescent allergy can be due to allergens by contact, inhalation, or food or drug hypersensitivity. Newer topics such as standardization of allergens and contact dermatitis are added upon very thoughtfully in this edition. All aspects of allergies and their management are dealt with in this manual.
I am sure that the undergraduates, postgraduates, faculty, and practitioners will find this manual very useful for their practice. The very fact that the manual is being published as 2nd edition speaks out its popularity.
Realizing this responsibility fully, the contributors have thoroughly revised and updated all topics keeping in mind the practical aspects.
Major K Nagaraju, the Editor, deserves all congratulations for his “eagle eye” crisp editing of the contents in a reader-friendly presentation. I wish the manual serves well the objective of its publication and is received widely by all concerned with Pediatric and Adolescent Practice and goes in for several editions in future with updation of newer concepts and future trends.
I take this opportunity to congratulate M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for bringing out yet another edition matching international standards.
A Parthasarathy
MD DCH DSc (Hon) FIAP
Senior Consultant Pediatrician
AP Child Care, Chennai
Former Distinguished Professor
Department of Pediatrics
The Tamil Nadu Dr MGR Medical University
Retired Senior Clinical Professor
Department of Pediatrics
Madras Medical College, Chennai
Deputy Superintendent
Institute of Child Health and Hospital for Children
Chennai, Tamil Nadu, India
Preface to the Second Edition
Allergic diseases pose a great health challenge in the 21st century and have assumed epidemic proportions in all parts of the world. With the scientific advancement, the menace of environmental pollution also has contributed towards the problem of allergy. Allergic diseases start in the pediatric age group and generally they do not present with typical symptoms. Pediatricians must be aware of the symptoms and signs of different allergic diseases in children and this book aims at building their confidence while handling such children.
There was a felt need for publication of an updated Second Edition of this book after a gap of 5 years. This was also prompted by the enthusiastic response to the first edition from the faculty of departments of pediatrics and practicing pediatricians from all over India and neighboring countries. The first edition was also popular among the family physicians.
It has been our endeavor to present allergies in children in a simplified and practical manner to provide adequate knowledge to the pediatricians, so that they can diagnose early and provide optimal treatment.
The main focus of this edition is to help the postgraduates along with practicing pediatricians. We have expanded the topics with the recent advances in the field of allergy, asthma and clinical immunology.
This book represents a substantial revision of all topics in the field of allergy and clinical immunology. The number of chapters are increased from original 28 to 33. We have included few new chapters, especially important from the practitioners’ point of view, e.g. “Standardization of Allergens”, which is the need of the hour in this country. We have also included the upcoming topics like “Probiotics in Allergic Diseases” and “Rheumatology in Allergic Diseases”. The topic of In Vitro Testing has been expanded to a complete chapter, inclusive of the need for component resolved diagnosis. Oscillometry and FENO have been included in the chapter “Devices in Allergy and Asthma”. Though Allergen-specific Immunotherapy has been in discussion for the past 3 decades, practitioners are not utilizing this mode of treatment, may be due to lack of knowledge or lack of faith. In this second edition, we have elaborated more on the “Allergen-specific Immunotherapy” by incorporating the different schedules, inclusion of standardized allergen extracts in the immunotherapy preparation and usage of mono-immunotherapy in polysensitized patients.
The entire contents of this book were formulated to provide appropriate clinical information relevant to our country. The chapters were penned fresh or revised and edited by experts of national and international reputation.
I would like to place on record our appreciation to all the authors, who have taken great pains to contribute the chapters with practical guidelines amidst their busy clinical practice and academic schedules.
I am thankful to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their excellent cooperation in bringing out this edition.
I request the readers to send their valuable suggestions to improve the quality of future editions.
Major K Nagaraju
Preface to the First Edition
Pediatric Allergy is a fascinating subject.
Allergic diseases are increasing alarmingly all over the world. Most of the pediatricians are not trained to handle allergy cases in children, though they see plenty of cases in their practice. This book aims to increase the awareness and build the confidence of the pediatricians while handling the allergy patients.
Many times, the parents are not aware that their child is suffering from allergic disease and once we reveal to the parents, they want to know the cause of allergy. This is how I developed my own interest in the field of pediatric and adolescent allergy. It is my long-time wish to come out with Manual of Pediatric Allergy and its management with my 19 years of experience in the specialty.
When I approached international and national experts on pediatric and adolescent allergy, they willingly contributed the topics of their interest. I filled up the rest of the list. This manual thus contains 28 chapters contributed by luminaries in the field of management of allergy in children and adolescents. The topics range from ‘Approach to Allergic Child’ to ‘Devices in Allergy and Asthma’. The text has been presented in a crisp format with emphasis on management guidelines. This book explains the topics in a lucid way and also gives a simple algorithm to approach the child with allergic problem. We have not dealt much about asthma as several books are available written by our own specialists. This book also contains recent developments in allergy and asthma such as Vitamin D and Allergy, and Genetics of Allergy and Asthma. It is my fervent hope that this Manual will serve as a desktop reference for the practicing pediatricians in their busy office practice. The merits and demerits of various drugs used in the management of pediatric and adolescent allergy should enable the busy practitioners to select the right drug for the right type of allergy and for the right duration. We have chapter on Devices Used in Allergy and Asthma. This chapter will be very useful for practitioners about the usage, cleaning and maintenance of the devices used in allergy and asthma.
The readers are requested to send their valuable inputs. Your valuable suggestions will enable me to enrich the contents of the book in its future editions.
Major K Nagaraju
Acknowledgments
I would like to thank the authors of all the chapters, who have taken the time and effort off from their busy work and family. I am grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director-Content Strategy) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for bringing out this second edition.