Sensitization to Vitis vinifera Pollen in a Wine Production Area: Identification of the Allergens Involved.

BACKGROUND: Vine cultivation is widely distributed in La Rioja, Spain (37% of all crops) and is associated with exposure of the general population to vine pollen. The aims of this study were to investigate the prevalence of sensitization to Vitis vinifera pollen in persons with respiratory allergy in the general population and to identify the allergens involved. MATERIALS AND METHODS: The study population comprised patients who came to the hospital between September 2019 and January 2020 with suspected respiratory allergy. All patients underwent skin prick testing with a panel of standardized aeroallergens, profilin, lipid transfer protein (LTP), and V vinifera pollen extract and prick-prick testing with fresh grapes. The in vitro study included specific IgE by ImmunoCap and ELISA, allergenic profile by immunoblot with individual sera from patients positive to V vinifera pollen extract, and 2D immunoblot with a pool of sera. The spots recognized by IgE were identified using mass spectrometry. RESULTS: A total of 151 patients were included. Of these, 124 were positive to some of the allergens tested. Thirty-four (27.4%) were positive to vine pollen in the skin prick tests. The serology study revealed positive results in 20 patients. Five vine pollen allergens were identified, and profilin was the most prevalent (30%). The other 4 allergens could be considered specific to this pollen. CONCLUSIONS: Sensitization to vine pollen was frequent in the general population in a vine growing area. The clinical relevance of this finding is unknown owing to sensitization to other pollens in the vine pollen-positive patients. Five new vine pollen allergens were identified.

Study of hypersensitivity reactions and anaphylaxis during anesthesia in Spain.

BACKGROUND: Several studies have identified neuromuscular blocking agents as the most common cause of anaphylaxis during general anesthesia. The reported frequencies vary considerably between countries. There are few reports from Spain, probably due to the low prevalence of reactions. METHODS: For 5 years (1998-2002), all the patients who presented perioperative anaphylactic-type reactions, were studied in 2 Spanish allergy departments (Santiago Apostol, Vitoria-Gasteiz and San Pedro, Logroño). The diagnostic protocol consisted of a case history (age, gender, number of previous interventions, characteristics of the reaction, reaction phase, previously administered drugs), serum tryptase measurements, skin tests, and specific immunoassays (immunoglobulin [Ig] E determination against latex, penicillin, and Echinococcus). RESULTS: Forty-eight patients were studied, with ages ranging from 7 to 86 years. The ratio of women to men was 3:2. An IgE-mediated mechanism was confirmed in 27/48 patients (56%). The etiological agents were antibiotics in 12 cases (44%) (10 betalactams, 1 vancomycin, and 1 ciprofloxacin), muscle relaxants in 10 cases (37%), pyrazolones in 2 cases, latex in 2 cases, and Echinococcus in 1 case. CONCLUSIONS: Fifty-six percent of the perianesthetic reactions studied were IgE-mediated. Antibiotics and neuromuscular blocking agents were the most frequent causal agents, as verified by skin tests, and specific IgE and/or challenge tests. It is important to keep appropriate documentation on any of the drugs used during surgery, since our results show that those drugs involved in the reaction as the etiological agent, such as antibiotics and nonsteroidal anti-inflammatory agents, can be used again outside the context of surgery.

In vivo diagnostic tests in adverse reactions to quinolones.

BACKGROUND AND OBJECTIVE: Contradictory reports of the sensitivity of skin tests in quinolone allergy have been reported. Our objectives were to describe the outcome of quinolone skin and challenge tests in patients consulting because of a history of adverse reaction to quinolone and to compare the outcome of quinolone skin tests and challenge tests in the subsample of patients who had undergone both tests. METHODS: We reviewed skin and challenge test results of all patients who consulted at our allergy service over the last 5 years because of a history of quinolone adverse reaction in the form of urticaria or anaphylaxis within 1 hour of drug intake (group 1), urticaria or maculopapular eruption between 1 and 24 hours after intake (group 2) or after 24 hours had passed (group 3), or atypical symptoms (group 4). RESULTS: A total of 71 cases were identified: 27, 8, 24 and 12 in groups 1 through 4, respectively. Skin tests were performed in all patients, with positive results in 31 patients. In group 1, 62.9 % of these patients showed positive skin tests and 22.2% showed positive challenge tests, whereas in the other 3 groups, about 30% of patients had positive skin tests and a variable percentage (from 0% to 4.1% depending on the group) had positive challenge tests. Quinolone challenge tests were performed in 10 patients with positive skin tests (5 of them with positive results) and in 34 patients with negative skin tests (2 of them with positive results). CONCLUSIONS: A highly suggestive history of quinolone allergy is more frequently associated with positive skin tests and positive challenge tests. Therefore, skin tests help to predict the result of the challenge test.

Anaphylaxis produced by oxaliplatin.

We are discussing two patients, with clinically compatible reactions, who display an immediate hypersensitive mechanism following the administration of oxaliplatin, confirmed by the performance of cutaneous tests.

Rosemary contact dermatitis and cross-reactivity with other labiate plants.

Rosemary, a plant belonging to the labiate family, is frequently used in the making of cosmetics and also for medicinal purposes. There are few reported cases of contact dermatitis due to this plant. Here we present 1 case and asses the existence of cross-reactivity with plants from the same family. 53-year-old man with several episodes of a pruritic and erythematous eruption that resulted in peeling of the skin, after applying rosemary alcohol, on the chest reported. Epicutaneous tests were done with the standard European series (GEIDC), with the commercial plant series (Bial-Aristegui) and with plants from the labiate family. Results were positive for 3 of 4 labiate species tested. we present a case of rosemary contact dermatitis, where we have found cross-reactivity with 3 of 4 species tested from the same family.