RESUMO
Cannabis use has increased over the last decade. At the same time, we see cannabis allergies appearing, ranging from simple rhinoconjunctivitis to anaphylactic-type reactions, some of which are severe since fatal cases have been described, but we also see allergic-induced food allergies cross-linked in the family of lipid transfer proteins (LTP). Indeed, cannabis contains an LTP called Can s 3. The LT are very widespread in the vegetable kingdom and are present in many vegetables and fruits. LTPs have a similar chemical structure and therefore cross-allergy is common. Thus, by becoming aware of the LTP of cannabis, it is possible to become allergic by a mechanism of cross-allergy to the other LTPs present in fruits and vegetables. This syndrome is referred to as cannabis-fruit-vegetable syndrome.
Assuntos
Cannabis/imunologia , Hipersensibilidade Alimentar/imunologia , Alérgenos/imunologia , Proteínas de Transporte/imunologia , Reações Cruzadas/imunologia , HumanosRESUMO
BACKGROUND: Hereditary C1-inhibitor (C1-Inh) deficiency is associated with 'bradykinin-mediated angio-oedema' (BK-AO) and is believed not to be associated with urticaria. Acquired AO has been related to oestrogen contraceptives. OBJECTIVE: To demonstrate that AO precipitated by oestrogens and characterized by nonfunctional C1-Inh is mediated by BK and to evaluate the occurrence of urticaria in these patients. METHODS: A retrospective evaluation of patients referred for AO related to oestrogen was undertaken. Circulating C1-Inh, high molecular weight kininogen (HK) and enzymes involved in the metabolism of bradykinin were investigated. RESULTS: Fifteen patients were included. HK cleavage concurrent to oestrogen intake was demonstrated in 10 patients with available plasma. Eight patients reported recurrent or chronic urticaria. Discontinuation of the contraceptive resulted in a return to native C1-Inh and HK in all cases studied and to normal kininogenase activity in all but one. The clinical manifestations completely disappeared in 6 patients and improved in 7 after the withdrawal of oestrogen. CONCLUSION: Patients display extensive cleavage of HK in the plasma, which supports that AO precipitated by oestrogen contraception is BK-mediated. Recurrent urticaria may have been underestimated in this context. The presence of recurrent urticaria should not systematically rule out the diagnosis of BK-AO when the history is suggestive.
Assuntos
Angioedema/induzido quimicamente , Bradicinina/metabolismo , Proteína Inibidora do Complemento C1/metabolismo , Anticoncepcionais Orais Hormonais/efeitos adversos , Estrogênios/efeitos adversos , Cininogênio de Alto Peso Molecular/sangue , Urticária/induzido quimicamente , Angioedema/sangue , Diagnóstico Diferencial , Feminino , Humanos , Estudos Retrospectivos , Urticária/sangueRESUMO
Delayed hypersensitivity to heparins and heparinoïd is a problem for prophylaxis of thrombo embolic diseases. The hirudins did not seem to have any cross-reactivity with the two others groups of anticoagulants. We present two clinical cases of delayed type reactions to heparins and heparinoïd and we reviewed the literature about adverse reactions to low molecular weight heparins and the alternative possibilities.
Assuntos
Hipersensibilidade a Drogas/etiologia , Heparina de Baixo Peso Molecular/efeitos adversos , Heparina/efeitos adversos , Hirudinas/análogos & derivados , Hipersensibilidade Tardia/induzido quimicamente , Idoso , Anticoagulantes/efeitos adversos , Anticoagulantes/imunologia , Sulfatos de Condroitina/efeitos adversos , Sulfatos de Condroitina/imunologia , Reações Cruzadas , Dalteparina/efeitos adversos , Dalteparina/imunologia , Dermatan Sulfato/efeitos adversos , Dermatan Sulfato/imunologia , Combinação de Medicamentos , Enoxaparina/efeitos adversos , Enoxaparina/imunologia , Feminino , Heparina/imunologia , Heparina de Baixo Peso Molecular/imunologia , Heparitina Sulfato/efeitos adversos , Heparitina Sulfato/imunologia , Terapia com Hirudina , Humanos , Nadroparina/efeitos adversos , Nadroparina/imunologia , Proteínas Recombinantes/uso terapêutico , Testes CutâneosRESUMO
Crossed allergy between pork and cat epithelia was described by us in 1994. It is due to serum albumin. Nowadays, other bio-chemical observations allow "completion" of the syndrome by extension of the crossed reactivity between other mammal meats and other epithelia of dog and horse. The authors report an observation of the pork-cat syndrome (developing in the form of anaphylaxis, and then ending in the death of the patient), following consumption of wild boar meat. Co-factors, such as effort, taking alcohol or hormonal condition may complicate the picture to make diagnosis more difficult.
Assuntos
Anafilaxia/etiologia , Hipersensibilidade Alimentar/etiologia , Carne/efeitos adversos , Suínos/imunologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Angioedema/etiologia , Animais , Animais Domésticos , Asma Induzida por Exercício/complicações , Gatos , Reações Cruzadas , Dança , Evolução Fatal , Humanos , Imunoglobulina E/imunologia , Masculino , Cooperação do PacienteRESUMO
8 cases of allergic contact dermatitis from hydrangea seen in Angers, France, during the last 15 years are reported and compared to other cases found in the literature. In this review, allergic contact dermatitis from hydrangeas appears to be an occupational dermatosis among nursery workers, presenting as an eczema involving the hands and especially the first 3 fingers, with chronic features of fissuring and scaling and with a chronic course. Differential diagnosis from irritant contact dermatitis may be difficult. Patch tests with the stem as well as the leaf of hydrangeas gave strong positive reactions in all patients, and hydrangenol, the allergen of hydrangea, when tested, always also gave a positive reaction. Sensitization seems to occur after close and prolonged contact with the plant, which could explain the relative frequency in Angers because it provides almost 90% of hydrangea seedling production in France.
Assuntos
Benzopiranos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Dermatoses da Mão/etiologia , Rosales/efeitos adversos , Adulto , Agricultura , Alérgenos/efeitos adversos , Doença Crônica , Cumarínicos/efeitos adversos , Dermatite Irritante/diagnóstico , Diagnóstico Diferencial , Eczema/etiologia , Feminino , França , Humanos , Isocumarinas , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Folhas de Planta/efeitos adversos , Caules de Planta/efeitos adversosAssuntos
Rinite Alérgica Perene , Rinite Alérgica Sazonal , Adolescente , Corticosteroides/uso terapêutico , Adulto , Testes de Provocação Brônquica , Criança , Pré-Escolar , Antagonistas Colinérgicos/uso terapêutico , Cromolina Sódica/uso terapêutico , Dessensibilização Imunológica , Diagnóstico Diferencial , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/terapia , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/terapia , Testes Cutâneos , Tomografia Computadorizada por Raios XRESUMO
Within the purview of a formation day in Allergy for General Practitioners, this presentation on prevention recalls recent data obtained by the expedient of epidemiological studies, the aim of which was to aquaint the treating physicians with the growth in prevalence of the diseases of allergy and to alert them to the need of present advice on the elementary preventative measures for their patients at risk. These elementary measures are a healthy interior environment that is low in pneumoallergens, with especially a fight against passive tobacco smoking, and a differential and progressive introduction of solid foods to infants.
Assuntos
Hipersensibilidade/prevenção & controle , Adulto , Alérgenos/efeitos adversos , Animais , Animais Domésticos , Criança , Pré-Escolar , Exposição Ambiental , Poluição Ambiental/efeitos adversos , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/prevenção & controle , Habitação , Humanos , Hipersensibilidade/epidemiologia , Lactente , Alimentos Infantis , Hipersensibilidade Respiratória/prevenção & controle , Fatores de Risco , Poluição por Fumaça de Tabaco/efeitos adversosRESUMO
Chronic urticaria has multiple etiologies, amongst them food allergy, which is not the most frequent. We report a clinical case of chronic urticaria due to cow milk, where paradoxically the responsibility of the food was shown by an epidermo test when the prick test was negative. Development confirmed the responsibility of cow milk. We discuss the mechanisms that relate chronic urticaria to delayed hypersensitivity.
Assuntos
Hipersensibilidade Tardia/imunologia , Hipersensibilidade Imediata/imunologia , Hipersensibilidade a Leite/imunologia , Urticária/etiologia , Adulto , Animais , Bovinos , Diagnóstico Diferencial , Humanos , Hipersensibilidade Tardia/diagnóstico , Hipersensibilidade Imediata/diagnóstico , Imunoglobulina E/sangue , Masculino , Hipersensibilidade a Leite/diagnóstico , Testes do Emplastro , Testes Cutâneos , Urticária/imunologiaRESUMO
Immunobiological diagnosis of allergy by measurement of total and specific IgE (by the technique of the CAP System on UNICAP) remains very valuable, especially if it is possible to repeat the measurements to follow the development of the patient. Concerning an observation of one patient who presented a rhinotracheitis that developed over 10 years and was linked clinically to guinea pig hair, the measurement of total and specific IgE confirmed the diagnosis and favourable clinical development was corroborated by the significant parallel diminution of total and specific IgE.
Assuntos
Hipersensibilidade/diagnóstico , Imunoglobulina E/sangue , Adulto , Animais , Cobaias , Cabelo/imunologia , Humanos , Hipersensibilidade/imunologia , Rinite/imunologia , Traqueíte/imunologiaRESUMO
During a meeting between anaesthetists and allergists, skin tests were presented to show their value and the difficulties to which they give rise when they are weak. General principles, techniques and readings are described first. As usual, it is sensitivity, specificity and negative predictive value that are at the centre of attention. Selected clinical cases are given as examples. The high prevalence of cases who show a latent sensitisation to curare indicates an increase in allergological tests to patients who present risk factors.
Assuntos
Alérgenos/efeitos adversos , Anestésicos Gerais/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Testes Cutâneos , Alérgenos/imunologia , Anestésicos Gerais/imunologia , Curare/efeitos adversos , Curare/imunologia , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/etiologia , Humanos , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
The field of systemic contact dermatitis is particularly interesting for an allergist. To think of an allergen with cross-reaction and monosensilization should be the first reflex when an enquiry into a skin problem involves an allergic symptom. The three examples quoted involve Peruvian balm as the sensitizing agent. The causal triggering medicines are all vegetal extracts.
Assuntos
Dermatite Alérgica de Contato , Idoso , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/imunologia , Eczema/etiologia , Eczema/imunologia , Feminino , Humanos , Pessoa de Meia-Idade , Polygonaceae/imunologiaRESUMO
To investigate the clinical signs of food allergy is to open new horizons for the understanding of worrying acute symptoms for the patients and too often only symptomatic treatment. It is also possible to take control in a more logical way of illnesses that are classified as chronic and so incurable. The clinical examination requires great attention and much listening. Urticaria, eczema, rhinitis, asthma, colitis are the most frequent symptoms. More rarely, there may be certain migraines or lipoid nephrosis in children.
Assuntos
Hipersensibilidade Alimentar/diagnóstico , Doença Aguda , Adolescente , Anafilaxia/etiologia , Criança , Doença Crônica , Colite/etiologia , Eczema/etiologia , Feminino , Hipersensibilidade Alimentar/complicações , Conservantes de Alimentos/efeitos adversos , Humanos , Transtornos de Enxaqueca/etiologia , Hipersensibilidade a Leite/complicações , Nefrose Lipoide/etiologia , Hipersensibilidade Respiratória/etiologia , Sulfitos/efeitos adversos , Urticária/etiologiaRESUMO
To investigate the clinical signs of food allergy is to open new horizons for the understanding of worrying acute symptoms for the patients and too often only symptomatic treatment. It is also possible to take control in a more logical way of illnesses that are classified as chronic and so incurable. The clinical examination requires great attention and much listening. Urticaria, eczema, rhinitis, asthma, colitis are the most frequent symptoms. More rarely, there may be certain migranes or lipoid nephrosis in children.
Assuntos
Hipersensibilidade Alimentar/diagnóstico , Doença Aguda , Adulto , Anafilaxia , Criança , Doença Crônica , Eczema/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Urticária/diagnóstico , Urticária/imunologiaRESUMO
Observations are reported of two heparin-allergic patients (in one case, urticaria and in the other urticaria and asthma). These two patients show a curious association of the pork/cat syndrome, previously described (1, 2), that is an association of sensitivity to cat epithelia and pork meat. Since the heparins used nowadays are of porcine origin, the question is raised of a possible causal link that may exist between these 2 allergies. It seems that the possibility of association of these two allergies is much more likely than chance encounter.
Assuntos
Alérgenos/imunologia , Asma/induzido quimicamente , Gatos/imunologia , Dalteparina/efeitos adversos , Hipersensibilidade a Drogas/imunologia , Heparina/efeitos adversos , Suínos/imunologia , Urticária/induzido quimicamente , Adulto , Animais , Asma/imunologia , Western Blotting , Reações Cruzadas , Dalteparina/uso terapêutico , Toxidermias/etiologia , Toxidermias/imunologia , Hipersensibilidade a Drogas/etiologia , Feminino , Heparina/uso terapêutico , Humanos , Hipersensibilidade Imediata , Gravidez , Complicações Hematológicas na Gravidez/tratamento farmacológico , Teste de Radioalergoadsorção , Tromboflebite/tratamento farmacológico , Urticária/imunologiaRESUMO
The aim of this study was to compile a register of all the employees of a University Hospital Centre who complained of dermatosis of the hands due to latex. Recruitment was made by their spontaneous presentation in the service of the Workers Doctor (Médecine de Travail). The prevalence of clinical signs of contact eczema or professional urticaria is 2.3% for all personnel. 2.7% for nurses, 4.4% for care assistants or ancillary staff of the hospital service. In this population, 73% of subjects have shown previous atopy. The positive predictive value of the allergy tests was 51.3%, 2.32% of ASH-ASI, 1.75% of AS, 1.47% of IDE were allergic to latex, about 1.06% of the total personnel. 80% had atopy and 36.66% had a crossed allergy (banana, kiwi, avocat, pollen). Prevalence was zero amongst the administrative officers, but not systematic enquiry was made in the professional category. The orthoergical dermatoses were more frequent amongst the ASH-ASI, though the positive predictive value of tests was less. The considerable exposure to a number of caustic substances, as well as absence of precautions such as rinsing and drying of hands may explain this. All employees with allergy to latex have been declared to have a professional illness a card that mentions this allergy has been given to them.
Assuntos
Alérgenos , Toxidermias/epidemiologia , Látex/efeitos adversos , Doenças Profissionais/epidemiologia , Recursos Humanos em Hospital , Adulto , Reações Cruzadas , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Toxidermias/diagnóstico , Toxidermias/etiologia , Eczema Disidrótico/epidemiologia , Eczema Disidrótico/etiologia , Feminino , França/epidemiologia , Luvas Cirúrgicas , Administradores Hospitalares , Hospitais Universitários , Humanos , Hipersensibilidade Imediata/epidemiologia , Masculino , Enfermeiras e Enfermeiros , Assistentes de Enfermagem , Doenças Profissionais/induzido quimicamente , Valor Preditivo dos Testes , Prevalência , Urticária/induzido quimicamente , Urticária/epidemiologiaRESUMO
Epicutaneous tests do not permit resolution of all the problems set by drug allergy, but they are an important asset. Their value is sure when the pathology does not correspond precisely with a Gell and Coombes hypersensitisation classification, and especially when there is an interaction between several mechanisms. This presentation of five cases shows the value of these tests.
Assuntos
Toxidermias/diagnóstico , Testes Cutâneos , Administração Cutânea , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Reações Cruzadas , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Eczema/induzido quimicamente , Eczema/diagnóstico , Eritema/induzido quimicamente , Reações Falso-Negativas , Feminino , Flavonoides/efeitos adversos , Géis , Dermatoses da Mão/induzido quimicamente , Humanos , Níquel/efeitos adversos , Fenilenodiaminas/efeitos adversos , Hipersensibilidade Respiratória/induzido quimicamente , Sulfonamidas/efeitos adversos , Urticária/induzido quimicamente , Urticária/diagnósticoRESUMO
This work is a study of the frequency of the association between sensitivity to pork meat and cat epithelia. Comparison with a reference population that was not sensitized to pork meat, shows that this association is highly significant. This suggests therefore the possibility of a crossed allergenicity. If there is a real crossed allergenicity between pork meat and cat epithelia, we suggest that this crossed allergenicity is without doubt much greater and concerns more the meats and epithelia of mammals.
Assuntos
Gatos/imunologia , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade Imediata/imunologia , Carne/efeitos adversos , Suínos/imunologia , Animais , Reações Cruzadas , Cães/imunologia , Epitélio/imunologia , Feminino , Cavalos/imunologia , Humanos , Imunoglobulina E/imunologia , Masculino , Hipersensibilidade a Leite/imunologia , Coelhos/imunologia , Teste de Radioalergoadsorção , Roedores/imunologia , Ruminantes/imunologia , Especificidade da Espécie , SíndromeRESUMO
Fifty-eight patients with well-documented history of seasonal rhinoconjunctivitis caused by grass pollens were allocated randomly on a double-blind basis to receive either sublingual therapy with a solution of purified, standardized allergen preparation (Stallergènes) or a matched placebo for 17 weeks. The assessment of the effect of oral immunotherapy, done with drops of five-grass allergen extract, was on the clinical symptoms and on the medication score of the authorized rescue treatments. The actively treated patients had significantly (P < 0.05 to P < 0.01) fewer symptoms of rhinitis (sneezing and rhinorrhea) and of conjunctivitis (redness and tears) during the pollen season than the placebo group. Consumption of nasal solution of sodium cromoglycate and of betamethasone and dexchlorpheniramine was significantly less in the desensitized group (P < 0.01). Side-effects were negligible. This study concludes that perlingual immunotherapy with grass pollen extract in grass-pollen-sensitive seasonal hay fever and conjunctivitis patients is effective, easy to perform, inexpensive, and safe.