Anti-neutrophil cytoplasmic antibody (ANCA)- associated vasculitides are characterized by necrotizing inflammation of small blood vessels and primarily affect the kidneys, the lungs, and the upper respiratory tract. These conditions mainly include granulomatosis with polyangiitis and microscopic polyangiitis. Diagnosis relies on serological detection of ANCA directed against myeloperoxidase or proteinase-3, and on biopsy of an affected organ, most commonly the kidney. Management is provided by specialized centers with expertise in ANCA-associated vasculitides. Induction therapy for ANCA-associated vasculitis with kidney involvement or life-threatening manifestations consists of a combination of glucocorticoids and either rituximab or cyclophosphamide. Rituximab is preferred for relapsing cases. A rapid tapering of glucocorticoids, following the PEXIVAS trial regimen, is currently recommended to significantly reduce the risk of severe infections without compromising efficacy. For remission maintenance, fixed and repeated doses of rituximab administered over 18-48 months are preferred over azathioprine. The recent identification of the role of the complement system in the pathogenesis of ANCA-associated vasculitides has led to the development of avacopan, an oral C5a receptor antagonist. Administering avacopan alongside rituximab or cyclophosphamide for one year has demonstrated superior efficacy in achieving remission and kidney recovery, with lower toxicity compared to glucocorticoids, thus representing a promising therapeutic alternative.

Each pediatric pneumo-allergology consultation begins with a thorough medical history, followed by a complete clinical examination. After these preliminary steps, additional investigations may be requested. Records of 993 patients who attended the pediatric pneumo-allergology consultation at the UCL Namur university hospital (Godinne site) during the first semester of 2023 were reviewed and analyzed. Based on the medical history and symptoms, skin prick tests were performed for aeroallergens using the prick test method. Skin prick tests were conducted in 204 children between 7 months and 17 years and 3 months of age. Among them, 102 showed positive results. The distribution of sensitizations revealed a clear predominance of sensitization to house dust mites (58.8%), followed by cat dander (37.3%) and grass pollen (33.3%). Polysensitization was observed in over 60% of sensitized patients. In the management of pediatric respiratory allergies, allergen avoidance is the primary step, with a particular emphasis on environmental management. In the case of a positive test for an animal, avoidance remains challenging, even if a correlation between symptoms and the test result has been well-established and recognized by the family. Avoidance could not be achieved in the immediate environment in 68.4% of cases for cats and 66.6% of cases for dogs.

The social and human sciences, including health anthropology and ethnomedicine, offer valuable tools for understanding patients, their therapeutic journeys, and the complex dynamics influencing health. Integrating these perspectives into healthcare education and the healthcare system allows us to provide care that is better suited to patients’ realities and promote greater equity in access to healthcare. The future of health requires continuous dialogue between biomedicine and traditional knowledge to build a truly inclusive healthcare system that respects cultural diversity.