Assuntos
Anafilaxia , Alérgenos , Anafilaxia/diagnóstico , Anafilaxia/etiologia , Animais , Peixes , HumanosRESUMO
Type IV hypersensitivity eye reactions have been described after the administration of the sympathomimetic agent phenylephrine. We report the case of an atopic woman who developed nasal congestion and discharge, dysphagia, and dyspnea 1 hour after the administration of Stopcold pills and Disneumon Pernasal nasal spray for otitis. The same symptoms reappeared after the accidental administration of Rinobanedif ointment in the nasal mucosa. Skin patch tests were performed with a standard True Test panel, preservatives, Disneumon Pernasal, pseudoephedrine, eyedrops (tropicamide, cyclopentolate, and phenylephrine), and other sympathomimetic agents. The patient also underwent oral, ocular, and nasal controlled challenges with the same drugs. Finally, patch tests were performed in 11 controls with phenylephrine and ethylephrine. Our patient had a positive outcome in patch testing with nickel sulphate, fragrance mix, phenylephrine, and ethylephrine. To our knowledge, this is the first report of a type IV reaction to nasally administered phenylephrine with cross-reactivity with ethylephrine detected by patch testing.
Assuntos
Hipersensibilidade a Drogas/etiologia , Hipersensibilidade Tardia/etiologia , Fenilefrina/efeitos adversos , Simpatomiméticos/efeitos adversos , Administração Intranasal , Reações Cruzadas , Diagnóstico Diferencial , Hipersensibilidade a Drogas/diagnóstico , Etilefrina/administração & dosagem , Etilefrina/efeitos adversos , Etilefrina/uso terapêutico , Feminino , Humanos , Hipersensibilidade Tardia/diagnóstico , Pessoa de Meia-Idade , Testes do Emplastro , Fenilefrina/administração & dosagem , Fenilefrina/uso terapêutico , Simpatomiméticos/administração & dosagem , Simpatomiméticos/uso terapêuticoAssuntos
Antineoplásicos/uso terapêutico , Autoanticorpos/sangue , Cetuximab/uso terapêutico , Dessensibilização Imunológica/métodos , Imunoglobulina E/sangue , alfa-Galactosidase/imunologia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/imunologia , Carcinoma de Células Escamosas/secundário , Esquema de Medicação , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Neoplasias Faríngeas/tratamento farmacológico , Neoplasias Faríngeas/imunologia , Neoplasias Faríngeas/patologia , Seio Piriforme/efeitos dos fármacos , Seio Piriforme/imunologia , Seio Piriforme/patologia , Testes Cutâneos , alfa-Galactosidase/sangueAssuntos
Anormalidades Múltiplas/diagnóstico , Anafilaxia/diagnóstico , Capsicum/imunologia , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade ao Látex/diagnóstico , Anormalidades Múltiplas/imunologia , Adulto , Alérgenos/imunologia , Anafilaxia/imunologia , Antígenos de Plantas/imunologia , Reações Cruzadas , Feminino , Hipersensibilidade Alimentar/imunologia , Frutas/efeitos adversos , Humanos , Immunoblotting , Imunoglobulina E/imunologia , Hipersensibilidade ao Látex/imunologia , SíndromeRESUMO
Nabumetone is a nonsteroidal antiinflammatory (NSAID) prodrug that inhibits cyclooxygenase-2. It has been recommended as a safe alternative in most patients with hypersensitivity reactions to NSAIDs. Systemic reactions caused by nabumetone are not frequent. We report 2 cases of immediate systemic reactions due to nabumetone. The first case involved a 68-year-old woman who developed immediate generalized pruritus, erythema, morbilliform eruption, swollen tongue sensation, diarrhea, and hypotension after the ingestion of a single dose of nabumetone. In the second case, a 77-year-old woman developed generalized pruritus, palm erythema, colic abdominal pain, diarrhea, dizziness, tightness of the chest, dyspnea, and hypotension immediately after oral intake of nabumetone. Both patients had previously tolerated this drug. Since these episodes, they have avoided nabumetone. Skin prick tests with nabumetone (10 and 100 mg/mL) were negative. Oral challenge tests with other NSAIDs, even of the same group as nabumetone, were negative in both patients. The mechanisms responsible for the reaction were not established.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Butanonas/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Idoso , Anti-Inflamatórios não Esteroides/imunologia , Butanonas/imunologia , Hipersensibilidade a Drogas/diagnóstico , Feminino , Humanos , Nabumetona , Testes CutâneosAssuntos
Anemia Aplástica/imunologia , Soro Antilinfocitário/imunologia , Dessensibilização Imunológica , Hipersensibilidade a Drogas/terapia , Adolescente , Anemia Aplástica/complicações , Animais , Soro Antilinfocitário/administração & dosagem , Soro Antilinfocitário/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/imunologia , Feminino , Humanos , Coelhos , Testes Cutâneos , Trombocitopenia/etiologiaRESUMO
A 26-year-old male suffering from acute rhinitis took the first dose of Zolistan (mizolastine, 10 mg), orally, and 15 minutes later he developed intense generalized pruritus, cutaneous rash, oropharyngeal pruritus, edema on his face, difficulty in swallowing, and mild dyspnea. He was treated with methylprednisolone and epinephrine and improved within 30 minutes. The patient had not taken mizolastine before and he has avoided it since the reaction. Cutaneous tests with Zolistan and its excipients proved negative. Simple-blind oral challenge tests with the excipients and then with Zolistan were positive only with Zolistan. In order to confirm the absence of cross-reactivity between mizolastine and other benzimidazoles, we tested omeprazole, domperidone and mebendazole, all of which yielded negative results. To our knowledge, this is the second case of immediate hypersensitivity to mizolastine documented to date. In our case, the clinical history, physical examination and provocation tests allow us to establish the diagnosis of hypersensitivity to mizolastine and exclude the cross reactivity with other benzimidazole derivatives.