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Petah Tikva, Israel

Levy Y.,Kipper Institute of Immunology | Levy Y.,Tel Aviv University | Peleg-Weiss L.,Nutrition and Dietary Unit | Goldberg-Stern H.,Epilepsy Center | Goldberg-Stern H.,Tel Aviv University
Nutrition | Year: 2011

The modified Atkins diet is a therapeutic option for children with intractable epilepsy. It is less restrictive than the traditional ketogenic diet, with ∼60% of calories from fat sources. We describe a 6-y-old boy with intractable epilepsy treated with the modified Atkins diet who presented to the emergency department with first-time anaphylactic reaction to egg. Symptoms of urticaria and angioedema, shortness of breath, wheezing, and cyanosis developed several minutes after he ate a hard-boiled egg. His history was remarkable for asthma, but no food allergies were documented. The anaphylactic reaction appeared after 6 mo of treatment with the modified Atkins diet (including 10-15 eggs daily), which ameliorated his seizures, and was preceded by streptococcal pharyngitis. Laboratory workup revealed specific immunoglobulin E antibodies to egg. This is the first report of new-onset egg allergy in a child, probably triggered by the high egg content of the modified Atkins diet. The risk of egg allergy should be kept in mind when treating epileptic children with the modified Atkins diet, especially those with comorbid asthma. © 2011 Elsevier Inc. Source


Shkalim V.,Tel Aviv University | Monselize Y.,Tel Aviv University | Segal N.,Kipper Institute of Immunology | Zan-Bar I.,Tel Aviv University | And 3 more authors.
Journal of Clinical Immunology | Year: 2010

IgA deficiency is the most common human primary immune-deficiency. We evaluated the clinical and immunological characteristics of selective IgA deficiency in children in Israel. The study group included 63 children diagnosed with IgA deficiency from 1987 to 2005. Mean follow-up time per child was 10.6 years. Average age at diagnosis was 10.5 years. In one child, the IgA deficiency was transient. Infectious diseases, mainly recurrent pneumonia and ear infection, were common and occurred in 25 patients (39.7%). Allergic diseases were documented in 20 (31.7%) of our patients. Thirteen children (20.6%) had autoimmune diseases. Malignancies were diagnosed in three children (4.8%), an association that has not been reported in previous series. IgA deficiency appears to be a risk factor for infections, allergic diseases, autoimmune conditions, and malignancy. © 2010 Springer Science+Business Media, LLC. Source


Nachmias N.,Kipper Institute of Immunology | Nachmias N.,Rabin Medical Center Beilinson Campus | Landman Y.,Maayanei Hayeshua Hospital | Danon Y.L.,Kipper Institute of Immunology | And 3 more authors.
Israel Medical Association Journal | Year: 2010

Background: Feeding neonates with humanized milk formula in maternity hospitals may increase the prevalence of milk allergy in infants. However, prospective studies of the possible allergenic effect of very early soy-based formula feeding are lacking. Objectives: To assess the prevalence of soy allergy in infants fed soy-based formula in the first 3 days of life. Methods: The study group included 982 healthy fullterm infants born within a 7 month period at a hospital that routinely uses soy-based formula to supplement breastfeeding. In-hospital feeding was recorded and the parents were interviewed once monthly over the next 6 months regarding feeding practices and clinical symptoms suggesting soy allergy in the infant. Results: Ninety-nine percent of the infants received soybased formula supplement in hospital, and 33%-42% at home. No cases of immediate allergic reaction to soy or soyinduced enterocolitis were reported. Conclusions: The use of soy-based formula in the early neonatal period does not apparently increase the prevalence of soy allergy in infants followed for the next 6 months. Source


Levy Y.,Kipper Institute of Immunology | Levy Y.,Tel Aviv University | Anis E.,Public Health Services | Anis E.,Hebrew University of Jerusalem | And 6 more authors.
Vaccine | Year: 2012

Background: The population at risk of adverse events after smallpox vaccination has increased in recent years. This has important implications for preparedness strategies against bioterrorism with the variola virus. The aim of the study was to estimate the size of this special population in Israel. Methods: The study was conducted in January 2010. Data on patients with contraindications to smallpox vaccination, as delineated by the Israel Ministry of Health for planning post-event strategies, were retrieved from the computerized records of the Department of AIDS and Tuberculosis and the Transplantation Center of the Israel Ministry of Health. In addition, the database of the main Health Maintenance Organization in Israel which insures 60% of the national population was searched using ICD-9 codes and specific medications issued in the last quarter of 2009. Results: Of the 7,563,800 persons residing in Israel in January 2010, 326,318 were at risk of an adverse event after smallpox vaccination. Conclusion: Approximately 4.3% of the Israeli population should not be exposed to the currently used smallpox vaccine. This knowledge is important to ensure the effectiveness of mass vaccination programs in the event of a bioterror attack. © 2012 Elsevier Ltd. Source


Segal N.,Kipper Institute of Immunology | Garty B.-Z.,Kipper Institute of Immunology | Garty B.-Z.,Tel Aviv University | Hoffer V.,Tel Aviv University | And 2 more authors.
Israel Medical Association Journal | Year: 2012

Background: Patients with allergy as well as their parents frequently fail to use the self-administered epinephrine injection (EpiPen®) properly in cases of allergic emergencies. Objectives: To determine the benefit of an instruction session with follow-up instruction. Methods: We evaluated 141 patients aged 1.9-23.4 years (median 5.8 years, 83% with food allergy) or their parents (for those aged < 12 years) who were trained in the use of the EpiPen during the first diagnostic visit to the allergy clinic during 2006-2009. At the next follow-up visit, the patients or their parents were asked to list the indications for epinephrine administration and to demonstrate the five steps involved in using the EpiPen. Each step was scored on a scale of 0-2. Results: Fourteen participants (9.9%) had used self-injectable epinephrine in the past. Only 65 (46%) brought the device with them to the follow-up visit. The mean total score for the whole sample was 4.03 ± 3. Fifty-three participants (38%) failed to remove the cap before trying to apply the device. Only 8 (5.6%) had a maximum score. The patients and their parents were reinstructed in the use of the device: 41 participants were reexamined at a subsequent follow-up visit after 1.02 ± 0.56 years their mean score improved from 4.71 ± 3.04 to 6.73 ± 3.18 (P < 0.001). Conclusions: Patients with severe allergic reactions, as well as their parents, are not sufficiently skilled in the use of the EpiPen after only one instruction session with a specialist. Repeated instruction may improve the results and we therefore recommend that the instructions be repeated at every follow-up visit. Source

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