Saint-André-lez-Lille, France
Saint-André-lez-Lille, France

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Rance F.,TSA 70034 | Deschildre A.,Unite de Pneumologie et Allergologie Pediatriques | Bidat E.,Service de pediatrie | Couderc L.,Unite de Pneumologie et Allergologie | Weiss L.,Service de pediatrie
Revue des Maladies Respiratoires | Year: 2010

Asthma is a disease of the lung epithelial barrier, most often associated with allergy in children. Asthma and allergy are two distinct diseases, but the phenotypic expression of asthma depends on atopic status. A better definition of phenotypes of asthma would result in better targeting of prevention and treatment modalities. Secondary prevention aims to prevent the onset of asthma and the acquisition of new sensitizations in sensitized children. Studies concerning allergen avoidance are insufficient to reach a definitive conclusion and antihistamines have not been shown to be effective. The results for specific immunotherapy suggest a benefit to prevent transition from allergic rhinitis to asthma and the onset of new sensitizations. Tertiary prevention aims to reduce symptoms in children with an existing allergic asthma diagnosis. The avoidance of known respiratory allergens will only be effective in combination with management of the whole environment. Specific immunotherapy has a real place, in combination with background therapy. It should be used according to guidelines in appropriately treated patients. © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.


Flammarion S.,Unite de pneumologie et allergologie pediatriques | Santos C.,Unite de pneumologie et allergologie pediatriques | Guimber D.,Unite de gastroenterologie et nutrition pediatriques | Jouannic L.,Service de dietetique | And 3 more authors.
Pediatric Allergy and Immunology | Year: 2011

The aim of the present study was to assess the food intakes and nutritional status of children with food allergies following an elimination diet. We conducted a cross sectional study including 96 children (mean age 4.7±2.5years) with food allergies and 95 paired controls (mean age 4.7±2.7years) without food allergies. Nutritional status was assessed using measurements of weight and height and Z scores for weight-for-age, height-for-age and weight-for-height. Nutrient intakes assessment was based on a 3-day diet record. Children with food allergies had weight-for-age and height-for-age Z scores lower than controls (0.1 versus 0.6 and 0.2 versus 0.8 respectively). Children with 3 or more food allergies were smaller than those with 2 or less food allergies (p=0.04). A total of 62 children with food allergies and 52 controls completed usable diet records. Energy, protein and calcium intakes were similar in the two groups. Children with food allergies were smaller for their age than controls even when they received similar nutrient intakes. Nutritional evaluation is essential for the follow up of children with food allergies. © 2010 John Wiley & Sons A/S.


Deschildre A.,Unite de pneumologie et allergologie pediatriques | Delvart C.,Unite de pneumologie et allergologie pediatriques | Catteau B.,Unite de dermatologie pediatrique | Thumerelle C.,Unite de pneumologie et allergologie pediatriques | Santos C.,Unite de pneumologie et allergologie pediatriques
Revue Francaise d'Allergologie | Year: 2011

Atopic march describes the progresse; des résultats intéressants sur la survenue d'un asthme. ion of atopic disorders and the link between eczema, allergic rhinitis and asthma. Longitudinal studies as well as physiopathologic data (filagrin mutation for example) support this theory. However, atopic march is observed in certain children. Identifying these children and defining " at risk" phenotype is a matter of debate. Intervention studies for interrupting the atopic march generally have not reported any long-term benefice. Encouraging results on the risk of developing asthma in children with hay fever treated with immunotherapy are reported. © 2011 Elsevier Masson SAS.


Deschildre A.,Unite de pneumologie et allergologie pediatriques | Le Mee A.,Unite de pneumologie et allergologie pediatriques | Mitha S.,Unite de pneumologie et allergologie pediatriques | Leclere D.,Unite de pneumologie et allergologie pediatriques | And 3 more authors.
Revue Francaise d'Allergologie | Year: 2014

Severe asthma in children is now, by consensus, well defined. It means poorly controlled asthma with severe exacerbations and/or persistent airway obstruction in spite of optimal therapy with good compliance. Its phenotypic characteristics have also been well defined: predominantly allergic asthma, polysensitization, concomitant diseases (rhinitis, eczema, and/or food allergy), frequent acute exacerbations, and a tendency to worsening airflow obstruction. It is important to distinguish difficult-to-treat asthma from severe asthma resistant to treatment. Pathophysiological features such as remodeling, inflammatory profile and innate immunity have been described. © 2014.


Deschildre A.,Unite de Pneumologie et Allergologie Pediatriques | Tillie Leblond I.,Service de Pneumologie et Dimmuno allergologie | Mordacq C.,Unite de Pneumologie et Allergologie Pediatriques | De Blic J.,University of Paris Descartes | And 2 more authors.
Revue des Maladies Respiratoires | Year: 2013

According to the Global Initiative for Asthma (GINA) classification, mild asthma includes intermittent and mild persistent asthma. It represents more than 75% of asthmatic children. The symptoms and functional impact are well described. Mild asthma can lead to severe exacerbations. Progression to more severe disease may occur. Consequently, it is important to diagnose mild asthma, to initiate the appropriate treatment early, and to identify the risk factors for aggravation. Nevertheless, mild asthma is under-diagnosed and under-treated. Bronchial inflammation and remodeling are observed in mild asthma. A daily low-dose of inhaled corticosteroids is the reference treatment for mild persistent asthma. Intermittent inhaled corticosteroids cannot be recommended in children with mild persistent asthma. © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

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