title: Pediatric allergy and immunology in Brazil.
abstract: The subspecialty of pediatric allergy and immunology in Brazil is in its early years and progressing steadily. This review highlights the research developed in the past years aiming to show the characteristics of allergic and immunologic diseases in this vast country. Epidemiologic studies demonstrated the high prevalence of asthma in infants, children, and adolescents. Mortality rates and average annual variation of asthma hospitalization have reduced in all pediatric age groups. Indoor aeroallergen exposure is excessively high and contributes to the high rates of allergy sensitization. Prevalence of food allergy has increased to epidemic levels. Foods (35%), insect stings (30%), and drugs (23%) are the main etiological agents of anaphylaxis in children and adolescents. Molecular diagnosis of primary immunodeficiencies (PID) showed a high incidence of fungal infections including paracoccidioidomycosis in X-linked hyper-IgM syndrome, and the occurrence of BCG adverse reactions or other mycobacterial infections in patients with chronic granulomatous disease. Education in pediatric allergy and immunology is deficient for medical students, but residency programs are effective in training internists and pediatricians for the practice of allergy. The field of PID requires further training. Last, this review is a tribute to Prof. Dr. Charles Naspitz, one of the pioneers of our specialty in Brazil.
authors.affiliation: Department of Pediatrics, Federal University of Parana, Curitiba, PR, Brazil. nelson.rosario@ufpr.br
authors.forename: Nelson A
authors.initials: NA
authors.lastname: Rosario-Filho
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Jacob
authors.forename: Dirceu
authors.initials: D
authors.lastname: Sole
authors.forename: Antonio
authors.initials: A
authors.lastname: Condino-Neto
authors.forename: Luisa K
authors.initials: LK
authors.lastname: Arruda
authors.forename: Beatriz
authors.initials: B
authors.lastname: Costa-Carvalho
authors.forename: Renata R
authors.initials: RR
authors.lastname: Cocco
authors.forename: Inês
authors.initials: I
authors.lastname: Camelo-Nunes
authors.forename: Herberto J
authors.initials: HJ
authors.lastname: Chong-Neto
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Wandalsen
authors.forename: Ana P M
authors.initials: AP
authors.lastname: Castro
authors.forename: Ariana C
authors.initials: AC
authors.lastname: Yang
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Pastorino
authors.forename: Emanuel S
authors.initials: ES
authors.lastname: Sarinho
mesh_terms: D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D000486:Allergy and Immunology / Q000193:education / Q000639:trends*; D001249:Asthma / Q000150:complications / Q000453:epidemiology*; D001938:Brazil; D002648:Child; D004503:Education, Medical, Graduate / Q000639:trends; D005512:Food Hypersensitivity / Q000150:complications / Q000453:epidemiology*; D006105:Granulomatous Disease, Chronic / Q000453:epidemiology; D006801:Humans; D053307:Hyper-IgM Immunodeficiency Syndrome, Type 1 / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D015995:Prevalence
chemical_list: D000485:Allergens