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1.
Arch. argent. pediatr ; 119(1): e41-e44, feb. 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1147256

ABSTRACT

La terapia de reemplazo enzimático disminuye la morbilidad y mejora la calidad de vida de los pacientes con mucopolisacaridosisii. Se han descrito reacciones de hipersensibilidad inmediata a este fármaco. La desensibilización es un tratamiento que induce la tolerancia temporaria a una droga y permite al paciente alérgico recibir la medicación.Se presenta el caso de un niño de 7 años con diagnóstico de síndrome de Hunter que, luego de 4 años de tratamiento con idursulfase, tuvo dos episodios de anafilaxia durante la infusión del fármaco. Se detectó inmunoglubulina E específica mediante pruebas cutáneas, y fue positiva la intradermorreacción con dilución 1/10 (0,2 mg/ml). Se realizó un protocolo de desensibilización de 12 pasos, sin presentar eventos adversos. La evaluación alergológica y la posibilidad de desensibilización constituyeron herramientas útiles en el manejo de nuestro paciente


Enzyme replacement therapy with idursulfase decreases morbidity and improves quality of life of patients with mucopolysaccharidosis ii. Immediate hypersensitivity reactions to this drug have been described. Desensitization is a treatment that induces temporary tolerance to a culprit drug, allowing the allergic patient to receive the medication.We present the case of a 7-year-old patient diagnosed with Hunter syndrome who presented, after 4 years of treatment, two episodes of anaphylaxis during the infusion of idursulfase. Detection of specific immunoglobulin E was carried out using skin tests, with intradermal reaction at a 1/10 dilution (0.2 mg/ml) being positive. A 12-step desensitization protocol was performed without presenting adverse events.The allergological evaluation and the possibility of desensitization were useful tools in the management of our patient.


Subject(s)
Humans , Male , Child , Desensitization, Immunologic/methods , Enzyme Replacement Therapy , Mucopolysaccharidosis II/drug therapy , Hypersensitivity, Immediate , Metabolism, Inborn Errors
2.
Arq. Asma, Alerg. Imunol ; 4(4): 435-440, out.dez.2020. ilus
Article in Portuguese | LILACS | ID: biblio-1382042

ABSTRACT

O primeiro relato de reação alérgica à Cannabis sativa foi publicado em 1971, com a descrição de uma mulher de 29 anos que após fumar maconha pela primeira vez apresentou sintomas compatíveis com uma reação anafilática. A alergia à maconha pode manifestar-se por sintomas diversos, inclusive graves e generalizados, com reações cruzadas, principalmente, mas não exclusivamente, com frutas e vegetais. Portanto, é de suma importância familiarizar-se com os sinais e sintomas da alergia à Cannabis, conhecer as opções disponíveis para o diagnóstico, as perspectivas de tratamento e como orientar o paciente. Esta revisão tem por objetivo destacar a diversidade de rotas de sensibilização e reações à planta, enfatizando a heterogeneidade de apresentações da alergia à Cannabis.


The first report of an allergic reaction to Cannabis sativa was published in 1971, with the description of a case of a 29-yearold woman who had symptoms consistent with an anaphylactic reaction after smoking marijuana for the first time. A marijuana allergy can manifest by various symptoms, including severe and disseminated symptoms with cross-reactions mainly, but not exclusively, with fruits and vegetables. Therefore, it is extremely important to become familiar with the signs and symptoms of a cannabis allergy and to know the options available for diagnosis, treatment perspectives, as well as how to guide the patient. This review aims to highlight the diversity of sensitization routes and reactions to the plant, emphasizing the heterogeneity of presentations of a cannabis allergy.


Subject(s)
Humans , Cannabis , Cannabis/adverse effects , Anaphylaxis , Patients , Therapeutics , Marijuana Smoking , Allergens , Cross Reactions , Diagnosis , Allergy and Immunology , Hypersensitivity, Immediate
3.
Asia Pacific Allergy ; (4): 4-2020.
Article in English | WPRIM | ID: wpr-785461

ABSTRACT

BACKGROUND: Banana fruit has been recognized as an important food allergen source. Nowadays banana hypersensitivity had been reported more frequently with various presentations from oral allergy syndrome to anaphylaxis.OBJECTIVE: This study aims to describe the pattern of banana hypersensitivity and the sensitivity of diagnostic test.METHODS: Six patients who experienced banana hypersensitivity were recruited from adult allergy clinic, Ramathibodi Hospital, Mahidol University between 2015–2018. Demographic data, pattern of banana allergy consisted of the onset of reaction, symptoms, severity, cross-reactivity to kiwi, avocado, latex including type and amount of banana were collected. Skin test, serum specific IgE to banana and open-label food challenge test had been applied.RESULTS: All patients experienced multiple episodes of banana anaphylaxis. Regarding the diagnostic investigation, prick-to-prick skin test had higher sensitivity (sensitivity, 100%; 95% confidence interval [CI], 54.07%–100%) than the commercial banana extract (sensitivity, 83.33%; 95% CI, 35.88%–99.58%) and serum specific IgE to banana (sensitivity, 50%; 95% CI, 11.81%–88.19%). The discordance between skin prick test using commercial banana extract and skin test was reported. The cross-reactivity between the species of banana, kiwi, the avocado was documented in all patients. Latex skin prick test and application test were applied with negative results. From the oral food challenge test, a case of banana anaphylaxis patient can tolerate heated banana.CONCLUSION: The various phenotypes of banana hypersensitivity were identified. The prick-to-prick test showed the highest sensitivity for diagnosis of banana allergy. However, component resolved diagnostics might be needed for conclusive diagnosis.


Subject(s)
Adult , Anaphylaxis , Diagnosis , Diagnostic Tests, Routine , Food Hypersensitivity , Fruit , Hot Temperature , Humans , Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulin E , Latex , Musa , Persea , Phenotype , Skin , Skin Tests , Thailand
4.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 38: e2018398, 2020. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136738

ABSTRACT

ABSTRACT Objective: To evaluate the impact of pediatric asthma on patients of a specialized outpatient clinic in Southern Brazil. Methods: The study included children aged 8 to 17 years old with asthma diagnosis (mild, moderate and severe) under treatment at the asthma clinic of Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil. Measurements of spirometry, quality of life, disease control and atopy tests were applied. Results: A total of 66 children were included in the study and divided into groups, according to the severity of the disease: mild, moderate or severe asthma. The results showed similarities in both the treatment and the impact of asthma between groups, except for adherence to treatment: the group with mild asthma showed least adherence to treatment, and the group with severe asthma, greater adherence (p=0.011). As to school absenteeism, the group with severe asthma showed higher frequency (p=0.012), with over 10 days per year (p=0.043). Spirometry showed lower volume/capacity for the group with moderate asthma, followed by the groups with severe and mild asthma. All groups had a high prevalence of allergic asthma, with mites as the main allergens. For quality of life (QOL), and health-related quality of life (HRQOL) levels, there were no differences between groups. In addition, the values were close to the acceptable levels for the total score and for each one of the six domains. The same occurred for the HRQOL-asthma module. Conclusions: QOL and HRQOL present acceptable levels regardless of the severity of the disease.


RESUMO Objetivo: Avaliar o impacto da asma pediátrica de pacientes em acompanhamento ambulatorial em um centro de referência em pneumopediatria do Sul do Brasil. Métodos: Participaram do estudo crianças com idade entre oito e 17 anos, com diagnóstico de asma (leve, moderada e grave), em acompanhamento no ambulatório de asma do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Foram verificadas medidas de espirometria, avaliação dos níveis de qualidade de vida, controle da doença e teste de atopia. Resultados: Sessenta e seis crianças participaram do estudo, divididas em três grupos (asma leve, moderada e grave). Evidenciaram-se semelhanças tanto no tratamento quanto no impacto da asma, exceto para a adesão ao tratamento (p=0,011), em que o grupo de asma leve é o que menos adere e o grupo de asma grave o que mais adere ao tratamento. Em relação ao absenteísmo escolar, o grupo de asma grave apresentou o maior valor (p=0,012), com mais de dez dias/ano (p=0,043). As espirometrias demonstram menor volume/capacidade para o grupo de asma moderada, seguido do grupo de asma grave e asma leve. Os grupos possuem alta prevalência de asma alérgica, tendo os ácaros como os principais alérgenos. Quanto à qualidade de vida (QV) e à qualidade de vida relacionada à saúde (QVRS), não houve diferença entre os grupos. Além disso, os valores apresentados estão próximos aos níveis aceitáveis, tanto para o escore total quanto para os seis domínios analisados. O mesmo ocorre para o módulo QVRS-asma. Conclusões: Os níveis de QV e de QVRS demonstram-se aceitáveis, independentemente da gravidade da doença.


Subject(s)
Humans , Animals , Male , Female , Child , Adolescent , Outpatients/statistics & numerical data , Asthma/drug therapy , Treatment Adherence and Compliance/statistics & numerical data , Quality of Life , Asthma/immunology , Asthma/psychology , Asthma/epidemiology , Spirometry/methods , Severity of Illness Index , Brazil/epidemiology , Allergens/adverse effects , Prevalence , Cross-Sectional Studies , Sickness Impact Profile , Absenteeism , Hypersensitivity, Immediate/immunology , Mites/immunology
7.
Asia Pacific Allergy ; (4): e14-2019.
Article in English | WPRIM | ID: wpr-750179

ABSTRACT

Hypersensitivity to cholecalciferol (vitamin D3) or its active metabolite, calcitriol, is an exceedingly rare clinical phenomenon, with only 2 previously reported cases of suspected immediate hypersensitivity. Diagnosis of delayed drug hypersensitivity reactions is inherently difficult due to the lack of any robust in vitro diagnostic assay, particularly in those patients for whom provocation testing confers an unacceptable risk. In these situations, diagnosis relies on reproducible clinical manifestations following administration of the culprit agent, resolution upon its withdrawal and exclusion of other potential differential diagnoses. Based on these criteria, we propose the first reported case of delayed hypersensitivity to cholecalciferol successfully managed with a desensitisation protocol to pure cholecalciferol.


Subject(s)
Calcitriol , Cholecalciferol , Diagnosis , Diagnosis, Differential , Drug Hypersensitivity , Humans , Hypersensitivity , Hypersensitivity, Delayed , Hypersensitivity, Immediate , In Vitro Techniques
8.
Article in Korean | WPRIM | ID: wpr-762198

ABSTRACT

Anaphylaxis is a sudden-onset life-threatening systemic hypersensitivity reaction. Allergens, such as foods, stinging insect venoms, and drugs, are the globally important causative factors for anaphylaxis. Para-phenylenediamine (PPD), an aromatic amine, is a well-known hair dye component that can act as a skin irritant and/or a skin sensitizer. As an allergen, PPD can induce various reactions; the most common being contact dermatitis, a delayed-type hypersensitivity reaction. Anaphylaxis or other immediate hypersensitivity reactions by hair dye contact is extremely rare, with only a few cases reported worldwide. Here, we report a case of a 63-year-old female who presented to the Emergency Department with dyspnea, rash, vomiting, and diarrhea within minutes after using a hair dye product containing PPD. Her past medical history includes urticaria of unknown cause. Her total IgE antibody level was increased to 630 kU/L. Skin prick and patch tests with the hair dye she applied at the time of anaphylaxis demonstrated an immediate reaction. An additional patch test with 25 common contact allergens showed positive reaction to PPD. This is the first case report of hair dye-induced contact anaphylaxis presenting sensitization to PPD in Korea.


Subject(s)
Allergens , Anaphylaxis , Bites and Stings , Dermatitis, Contact , Diarrhea , Dyspnea , Emergency Service, Hospital , Exanthema , Female , Hair Dyes , Hair , Humans , Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulin E , Insecta , Korea , Middle Aged , Patch Tests , Skin , Urticaria , Venoms , Vomiting
9.
Article in Korean | WPRIM | ID: wpr-739511

ABSTRACT

Nizatidine is a histamine H₂ receptor antagonist that inhibits stomach acid production and is commonly used in the treatment of peptic ulcer and gastroesophageal reflux. H₂ receptor antagonists are typically well tolerated, and hypersensitivity reactions are rare. A 19-year-old woman developed urticaria 30 minutes after taking a drug containing nizatidine. Allergic reactions to nizatidine were confirmed via skin prick test, which also revealed cross-reactions to ranitidine. We believe that this is the first case report on immediate hypersensitivity to nizatidine in Korea.


Subject(s)
Female , Gastroesophageal Reflux , Histamine , Humans , Hypersensitivity , Hypersensitivity, Immediate , Korea , Nizatidine , Peptic Ulcer , Ranitidine , Skin , Stomach , Urticaria , Young Adult
10.
Article in Korean | WPRIM | ID: wpr-739510

ABSTRACT

Rituximab is a monoclonal antibody used for the treatment of B-cell malignancies, including diffuse large B-cell lymphoma. Infusion-related hypersensitivity reactions to rituximab is well known, and delayed hypersensitivity reactions to rituximab are also reported. Desensitization is commonly used to prevent immediate hypersensitivity reactions, but recently there have been cases of successful desensitization therapy for delayed hypersensitivity reactions. A 66-year-old patient who underwent rituximab treatment for diffuse large B-cell lymphoma showed repeated rituximab-induced delayed hypersensitivity reactions with whole body rashes. Intravenous rapid desensitization was performed by using a 1-bottle, 11-step protocol for 6 cycles and thereafter hypersensitivity reaction did not recur. We herein reported a case of delayed hypersensitivity reaction caused by rituximab, which was successfully desensitized using our 11-step protocol.


Subject(s)
Aged , B-Lymphocytes , Desensitization, Immunologic , Exanthema , Humans , Hypersensitivity , Hypersensitivity, Delayed , Hypersensitivity, Immediate , Lymphoma, B-Cell , Rituximab
11.
Article in English | WPRIM | ID: wpr-739398

ABSTRACT

PURPOSE: Eperisone is an oral muscle relaxant used in musculoskeletal disorders causing muscle spasm and pain. For more effective pain control, eperisone is usually prescribed together with nonsteroidal anti-inflammatory drugs (NSAIDs). As such, eperisone may have been overlooked as the cause of anaphylaxis compared with NSAIDs. This study aimed to analyze the adverse drug reaction (ADR) reported in Korea and suggest an appropriate diagnostic approach for eperisone-induced anaphylaxis. METHODS: We reviewed eperisone-related pharmacovigilance data (Korea Institute of Drug Safety-Korea Adverse Event Reporting System [KIDS-KAERS]) reported in Korea from 2010 to 2015. ADRs with causal relationship were selected. Clinical manifestations, severity, outcomes, and re-exposure information were analyzed. For further investigation, 7-year ADR data reported in a single center were also reviewed. Oral provocation test (OPT), skin prick test (SPT) and basophil activation test (BAT) were performed in this center. RESULTS: During the study period, 207 patients had adverse reactions to eperisone. The most common ADRs were cutaneous hypersensitive reactions (30.4%) such as urticaria, itchiness or angioedema. Fifth common reported ADR was anaphylaxis. There were 35 patients with anaphylaxis, comprising 16.9% of the eperisone-related ADRs. In the single center study, there were 11 patients with eperisone-induced anaphylaxis. All the patients underwent OPT and all the provoked patients showed a positive reaction. Four of the 11 patients with anaphylaxis also underwent SPT and BAT, which were all negative. CONCLUSIONS: Incidence of eperisone-induced anaphylaxis calculated from the KIDS-KAERS database was 0.001%. Eperisone can cause hypersensitive reactions, including anaphylaxis, possibly by inducing non-immunoglobulin E-mediated immediate hypersensitivity.


Subject(s)
Anaphylaxis , Angioedema , Anti-Inflammatory Agents, Non-Steroidal , Basophils , Drug-Related Side Effects and Adverse Reactions , Humans , Hypersensitivity , Hypersensitivity, Immediate , Incidence , Korea , Pharmacovigilance , Skin , Spasm , Urticaria
12.
Arq. Asma, Alerg. Imunol ; 2(2): 283-287, abr.jun.2018. ilus
Article in Portuguese | LILACS | ID: biblio-1380878

ABSTRACT

A investigação diagnóstica de reações anafiláticas durante a anestesia é difícil, uma vez que vários medicamentos são administrados. O diagnóstico é necessário para evitar uma reexposição ao medicamento potencialmente ofensivo. Os opioides raramente causam anafilaxia. A incidência total de reação de hipersensibilidade imediata aos opiáceos é desconhecida, e as incidências diferenciais de reações alérgicas e não alérgicas aos opiáceos também. Os dados sobre a sensibilidade cruzada entre as classes de medicamentos são limitados pela ocorrência rara destas alergias, e qualquer uso de opioide em um paciente com alergia relatada deve ser feito com cautela. O valor dos testes cutâneos de leitura imediata nos indivíduos sensíveis aos opiáceos é incerto, por poderem causar desgranulação direta dos mastócitos, e o teste de IgE sérico para opiáceos não está disponível comercialmente. O objetivo dos autores é relatar um caso de anafilaxia perioperatória, tendo como agente causal um opioide e discorrer sobre a investigação e implicações decorrentes do uso destes medicamentos. Estudos bem desenhados e adequadamente controlados sobre o assunto ainda são necessários para melhor entendimento das reações e maior segurança para o uso destes medicamentos.


Diagnostic investigation of anaphylactic reactions during anesthesia is difficult, since several drugs are administered simultaneously. However, diagnosis is necessary to avoid reexposure to potentially harmful drugs. Opioids rarely cause anaphylaxis. The overall incidence of immediate hypersensitivity reactions to opiates is unknown, as are the differential incidences of allergic and non-allergic reactions. Data on cross-sensitivity between different classes of drugs are limited by the rare occurrence of these allergies, and any use of opioids in a patient with a reported history of allergy should be made with caution. The value of immediate-reading skin tests in opiate-sensitive individuals is uncertain, as they may cause direct degranulation of mast cells; serum-specific IgE testing for opiates, in turn, is not commercially available. The objective of this study was to report a case of perioperative anaphylaxis to opioid and to discuss the diagnostic investigation and implications of the use of these drugs. Well-designed and adequately controlled studies are needed to improve our understanding of reactions to these drugs and to make their use safer.


Subject(s)
Humans , Female , Middle Aged , Tramadol , Hypersensitivity, Immediate , Anaphylaxis , Morphine , Patients , Immunoglobulin E , Skin Tests , Sensitivity and Specificity , Diagnosis , Opiate Alkaloids , Heart Arrest , Hypersensitivity , Analgesics, Opioid , Anesthesia
13.
Rev. Soc. Bras. Med. Trop ; 51(2): 207-211, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-1041456

ABSTRACT

Abstract INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1)induces exaggerated Th1 responses, whereas atopy is associated with exacerbated Th2 responses. METHODS: Here, a cross-sectional study compared the prevalence of atopy in HTLV-1 carriers and HAM/TSP patients. It also compared the spontaneous cytokine production in HTLV-1-infected individuals. A retrospective cohort study evaluated the development of neurological manifestations in atopic and non-atopic carriers. RESULTS: Atopic HAM/TSP patients with high IFN-γ production exhibited higher IL-5 levels than non-atopic patients. Allergic rhinitis accelerated the development of Babinski signals and overactive bladders. CONCLUSIONS: Abnormal Th1 and Th2 responses coexist in HTLV-1-infected individuals and allergic diseases may worsen the clinical course of HTLV-1 infections.


Subject(s)
Humans , Male , Female , HTLV-I Infections/complications , Hypersensitivity, Immediate/epidemiology , Nervous System Diseases/virology , HTLV-I Infections/immunology , HTLV-I Infections/pathology , Paraparesis, Tropical Spastic/complications , Paraparesis, Tropical Spastic/immunology , Paraparesis, Tropical Spastic/pathology , Cross-Sectional Studies , Retrospective Studies , Cohort Studies , Cytokines/biosynthesis , Hypersensitivity, Immediate/immunology , Hypersensitivity, Immediate/blood , Middle Aged , Nervous System Diseases/immunology
14.
Medisan ; 22(1)ene. 2018. tab
Article in Spanish | LILACS | ID: biblio-894669

ABSTRACT

Se realizó un estudio epidemiológico analítico, de casos y controles en fase exploratoria, con vistas a determinar si la frecuencia de infecciones respiratorias en niños y adolescentes con asma de la provincia de Pinar del Río superaba la observada en aquellos que no presentaban esa enfermedad, desde julio del 2014 hasta junio del 2015. Para ello se conformaron 2 grupos de 585 integrantes cada uno, o sea un control por cada caso. Luego de procesada la información, se obtuvo un predominio del sexo masculino, en tanto, el catarro común fue la infección que afectó con mayor frecuencia fundamentalmente a los pacientes de 5-9 años de edad. Asimismo, se destacó un incremento del riesgo de padecer -- por orden de frecuencia -- afecciones, tales como catarro común, amigdalitis aguda y neumonía, bronconeumonía, así como neumonía intersticial


An analytic epidemiologic, of cases and controls study in exploratory phase, aimed at determining if the frequency of breathing infections in children and adolescents with asthma from Pinar del Río exceeded the one observed in those that didn't present that disease, was carried out from July, 2014 to June, 2015. Two groups of 585 members each one were conformed for that purpose, that is to say a control for each case. After having processed the information, there was a prevalence of the male sex, while, the common cold was the infection that affected with higher frequency fundamentally those patients aged 5-9. Also, it was emphasized an increment of the risk from suffering -- in order of frequency -- disorders, such as common cold, acute tonsillitis and pneumonia, bronchopneumonia, as well as interstitial pneumonia


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Respiratory Tract Infections/epidemiology , Asthma/epidemiology , Hypersensitivity, Immediate , Primary Health Care , Epidemiologic Studies , Cuba
15.
Article in English | WPRIM | ID: wpr-713713

ABSTRACT

Corticosteroids are potent anti-inflammatory and anti-allergic agents used in the treatment of various inflammatory diseases, including allergic disease. They are frequently considered the therapy-of-choice for many skin diseases. However, allergic reactions caused by corticosteroids have been reported. Among these, delayed reactions to topical steroids are more common, whereas immediate reactions to systemic steroids are rare. Herein, we report the case of a 32-year-old woman with triamcinolone-induced immediate hypersensitivity reaction, in which the patient had a positive prick test result with triamcinolone. She has had atopic dermatitis (AD) for three years. She had used systemic steroid, cyclosporine, and antihistamine with topical steroids for AD. In clinic, approximately 10 minutes after intralesional injection of triamcinolone, she complained of erythematous patches with slight elevation and itching on the face, trunk, and both hands. After intravenous injection of dexamethasone, her symptoms got worse. After treatment with epinephrine, all symptoms resolved within two hours. We performed an open test and skin prick test. She had a positive result only from the prick test with triamcinolone; all other steroids showed negative results from the open tests. Dermatologists should be aware of the possibility of anaphylaxis or other allergic hypersensitivity in response to corticosteroids.


Subject(s)
Adrenal Cortex Hormones , Adult , Anaphylaxis , Anti-Allergic Agents , Cyclosporine , Dermatitis, Atopic , Dexamethasone , Epinephrine , Female , Hand , Humans , Hypersensitivity , Hypersensitivity, Immediate , Injections, Intralesional , Injections, Intravenous , Pruritus , Skin , Skin Diseases , Steroids , Triamcinolone
16.
Yonsei Medical Journal ; : 968-974, 2018.
Article in English | WPRIM | ID: wpr-717932

ABSTRACT

PURPOSE: Cefaclor, a second-generation oral cephalosporin, is known to cause IgE-mediated hypersensitivity. Assays of serum-specific IgE (sIgE) to cefaclor are commercially available via the ImmunoCAP system (Thermo Fisher Scientific). While serum levels of sIgE >0.35 kU/L are considered indicative of an allergy, some patients with cefaclor allergy show low serum IgE levels. This study aimed to evaluate the proper cut-off levels of sIgE in the diagnosis of immediate hypersensitivity to cefaclor. MATERIALS AND METHODS: A total of 269 patients with drug allergy history, who underwent assays of sIgE to cefaclor at Ajou University hospital and Dong-A University Hospital, were reviewed retrospectively. Among them, 193 patients exhibited cefaclor-induced immediate hypersensitivity with certain or probable causality of an adverse drug reaction according to the WHO-UMC (the World Health Organization-the Uppsala Monitoring Centre) algorithm, and 76 controls showed delayed hypersensitivity reactions to non-antibiotics. RESULTS: In total, 126 of the 193 patients (65.3%) experienced anaphylaxis; they had higher serum sIgE levels than patients with immediate hypersensitivity who did not experience anaphylaxis (6.36±12.39 kU/L vs. 4.28±13.61 kU/L, p < 0.001). The best cut-off value for cefaclor-induced immediate hypersensitivity was 0.11 kU/L, with sensitivity of 80.2% and specificity of 81.6%. A cut-off value of 0.44 kU/L showed the best sensitivity (75.4%) and specificity (65.7%) for differentiating anaphylaxis from immediate hypersensitivity reactions. CONCLUSION: Patients with cefaclor anaphylaxis exhibit high serum IgE levels. A cut-off value of 0.11 kU/L of sIgE to cefaclor is proper for identifying patients with cefaclor allergy, and 0.44 kU/L may be useful to detect anaphylaxis.


Subject(s)
Anaphylaxis , Cefaclor , Diagnosis , Drug Hypersensitivity , Drug-Related Side Effects and Adverse Reactions , Global Health , Humans , Hypersensitivity , Hypersensitivity, Delayed , Hypersensitivity, Immediate , Immunoglobulin E , Retrospective Studies , Sensitivity and Specificity
17.
Korean Journal of Medicine ; : 306-310, 2018.
Article in Korean | WPRIM | ID: wpr-715340

ABSTRACT

Pyrazinamide (PZA) is an anti-tuberculosis drug and an essential component of the standard four-drug regimen for tuberculosis. Here, we report a case of immediate angioedema secondary to PZA administration intended for pulmonary tuberculosis treatment. A previously healthy 48-year-old woman was diagnosed with pulmonary tuberculosis and tuberculous lymphadenitis. Thirty minutes after taking the first dose of isoniazid, rifampicin, pyrazinamide, and ethambutol, the patient developed facial edema, generalized rash, and dizziness. An oral provocation test was performed on the four drugs, and 1,000 mg pyrazinamide showed a positive result characterized by 50 minutes of urticaria, angioedema, and hypotension. As the prevalence of tuberculosis increases, prescriptions for anti-tuberculosis drugs may increase as well. Clinicians should be aware of the possibility of immediate hypersensitivity as well as delayed hypersensitivity to anti-tuberculosis drugs.


Subject(s)
Angioedema , Dizziness , Drug Hypersensitivity , Edema , Ethambutol , Exanthema , Female , Humans , Hypersensitivity, Delayed , Hypersensitivity, Immediate , Hypotension , Isoniazid , Middle Aged , Prescriptions , Prevalence , Pyrazinamide , Rifampin , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary , Urticaria
18.
Rev. paul. pediatr ; 35(3): 252-257, jul.-set. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-902844

ABSTRACT

RESUMO Objetivo: Avaliar os resultados dos exames utilizados para identificar a sensibilização IgE-mediada ao Aspergillus fumigatus em pacientes com fibrose cística. Métodos: Estudo transversal descritivo com amostra de conveniência de 86 pacientes com fibrose cística, acompanhados em Serviço de Referência de Fibrose Cística de hospital universitário terciário. Realizaram-se exames para avaliar sensibilização ao A. fumigatus em pacientes com fibrose cística: IgE sérica total, contagem de eosinófilos sanguíneos, identificação do fungo por swab de orofaringe ou por cultura de escarro, IgE sérica específica e testes cutâneos de hipersensibilidade imediata. Foram comparados os resultados dos diferentes exames realizados. Resultados: Em 33 (38,4%) pacientes com fibrose cística, com faixa etária de 1 a 33 anos (mediana de 8 anos), os resultados dos exames sobre sensibilização IgE mediada ao A. fumigatus foram: em 16 pacientes, aumento de IgE sérica específica (>0,35 kU/L); em 23, positividade aos testes cutâneos; e seis mostraram sensibilização a partir dos dois exames. Foram observados dois pacientes com eosinofilia (>1.000 eosinófilos/mm3) e sete com aumento de IgE sérica total (>1.000 UI/mL), sem que esses apresentassem positividade aos testes cutâneos ou aumento de IgE específica ao A. fumigatus. Em nenhum paciente foi isolado A. fumigatus no swab de orofaringe e/ou na cultura de escarro. Conclusões: Concluímos que, entre os exames para avaliar a sensibilização ao A. fumigatus na fibrose cística, são necessários os teste cutâneos de hipersensibilidade imediata e a dosagem de IgE sérica específica ao A. fumigatus. A eosinofilia sérica e a cultura de secreções respiratórias não foram essenciais neste estudo.


ABSTRACT Objective: To evaluate the results of the tests used to identify the IgE mediated sensitization to Aspergillus fumigatus in patients with cystic fibrosis. Methods: This is a cross-sectional descriptive study with a convenience sample of 86 patients diagnosed with cystic fibrosis in the Reference Service in Cystic Fibrosis at a tertiary teaching hospital. The following tests were performed to assess the sensitization to A. fumigatus in patients with cystic fibrosis: Total serum IgE, eosinophil count, fungus detection through oropharyngeal swab or sputum culture, serum-specific IgE, and immediate-type hypersensitivity (IgE) skin tests. We compared the results of the different tests performed. Results: In 33 (38.4%) patients with cystic fibrosis, with ages ranging from 1 to 33 years (median of 8 years), the IgE-mediated A. fumigatus sensitization test results were: in 16 patients, there was an increase in serum-specific IgE (>0.35 kU/L); in 23, skin tests were positive; and six had sensitization in both tests. We observed two patients with eosinophilia (>1,000 eosinophils/mm3) and seven with increasing total serum IgE (>1,000 IU/mL), all of whom obtained negative results in skin tests and had no IgE increase specific to A. fumigatus. A. fumigatus was not detected in oropharyngeal swabs and/or sputum culture of any patients. Conclusions: We conclude that, among the tests used to assess sensitization to A. fumigatus in cystic fibrosis patients, both serum-specific IgE and immediate-type hypersensitivity (IgE) skin tests are required. Serum eosinophilia and respiratory secretion culture were not essential in this study.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Aspergillus fumigatus/immunology , Immunoglobulin E , Cystic Fibrosis/immunology , Hypersensitivity, Immediate/diagnosis , Cross-Sectional Studies
19.
Rev. fac. cienc. méd. (Impr.) ; 14(1): 28-43, ene.-jun. 2017. ilus
Article in Spanish | LILACS | ID: biblio-849422

ABSTRACT

El dermografismo, conocido como "escritura sobre la piel", fenómeno que ocurre en forma espontánea o a la provocación física de la misma, es un síntoma, signo o síndrome semiológico, característico de procesos clínicos alérgicos y no alérgicos. Se expresa comúnmente como dermografismo rojo (urticaria dermatográfica, con o sin angioedema acompañante), con eritema y/o roncha muy frecuente en procesos alérgicos, pero también en las urticarias físicas, autoinmunes o tóxicas por aditivos alimentarios, infecciones, medicamentos y otros agentes. El dermografismo blanco, que se evidencia como un área que palidece alrededor de la línea de estimulación física, muy característico de la atopia; y, el que en esta comunicación hemos denominado dermografismo "mixto o bifásico", por su carácter bimodal, en el que se alternan las expresiones de los dermografismos rojo y blanco, en forma casi simultánea o en sucesión de blanco temprano en el primer minuto a rojo tardío a los cinco minutos o más, o al contrario, rojo inmediato y blanco posterior, típico de atopia. El paciente con hiperreactividad atópica en piel es el que exhibe el dermografismo mixto o bifásico, pues muestra el dermografismo blanco como estigma de atopia y el dermografismo rojo de la urticaria sintomática aguda o crónica. Esta última forma de dermografismo no se encuentra en las descripciones clásicas y es el objetivo de esta comunicación, que se acompaña de una amplia discusión sobre la ocurrencia de dermografismo en la práctica clínica. Material y Métodos: Se realizó una extensa revisión bibliográfica, consultando bases de datos como Medline, PubMed, DocChek, Wiley, Amedeo, Cochrane, Scielo, Hinari y Lilacs; se presentan viñetas clínicas de casos de pacientes atópicos. Conclusión: En esta revisión se ha presentado la ocurrencia clínica del dermografismo como un fenómeno frecuente de diferentes orígenes, pero que, muchas veces, es acompañante casi invariable de expresiones atópicas, en donde el dermografismo es un signo de ayuda para la tipificación del paciente alérgico...(AU)


Subject(s)
Humans , Allergy and Immunology , Food Hypersensitivity/complications , Hypersensitivity, Immediate , Mastocytosis/complications , Urticaria/complications
20.
Pesqui. vet. bras ; 37(3): 248-256, Mar. 2017. tab, ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-842065

ABSTRACT

Descrevem-se as características clínicas e histopatológicas da dermatite alérgica diagnosticada em cães da região metropolitana de João Pessoa, Paraíba. Durante o período de setembro de 2014 a setembro de 2015, um total de 90 cães com lesões cutâneas. Desses 24 apresentaram alterações compatíveis com dermatite alérgica, sendo 12 machos e 12 fêmeas. A dermatite atópica (DA) foi a mais frequente, afetando 58,33% (14/24) dos cães, seguido por dermatite por hipersensibilidade alimentar (HA) 25% (6/24), dermatite de contato alérgica (DAC) com 8,33% (2/24) dos casos, dermatite alérgica por picada de pulgas (DAPP) com um caso e a hipersensibilidade a medicamento (farmacodermia) também um caso, que representou 4,17% respectivamente. As lesões macroscópicas incluíram hipotricose, hiperpigmentação, comedões, eritema, alopecia, xerose, erosões, úlceras e exsudato, anatomicamente distribuídas na face, cabeça, pescoço, toracolombar, lombossacra, flanco, membros e abdome. As lesões microscópicas mais frequentes foram hiperceratose, acantose, espongiose e exocitose de linfócitos na epiderme. Na derme superficial foi observada perivasculite, perianexite e em alguns casos de incontinência pigmentar, edema, dilatação de vasos sanguíneos, linfáticos e glândulas sudoríparas. O exame histopatológico associado com a história clínica, exame clínico e pele são ferramentas importantes para o diagnóstico de dermatite alérgica em cães, bem como medidas terapêuticas associadas.(AU)


This paper describes the clinical and histopathological features of allergic dermatitis in dogs diagnosed the metropolitan region of João Pessoa, Paraíba. From September 2014 to September 2015 a total of 90 dogs with skin lesions was studied. Twenty-four cases showed changes consistent with allergic dermatitis, in 12 males and 12 females. The age of dogs ranged from 3 months to 15 years. Atopic dermatitis was the most common, affecting 58.33% (14/24) of the dogs, followed by food hypersensitivity dermatitis at 25% (6/24), allergic contact dermatitis at 8.33% (2/24), a case of allergic dermatitis flea and one case of drug hypersensitivity, which represented 4.17% respectively. Gross lesions included hypotrichosis, hyperpigmentation, comedones, erythema, alopecia, xerosis, erosions, ulcers, and exudates. Anatomically distributed was on face, head, neck, thoracolumbar, lumbosacral, flank, limbs and abdomen. The most common microscopic lesions were hyperkeratosis, acanthosis, spongiosis and exocytosis of lymphocytes in the epidermis. In the superficial dermis was observed perivasculitis, perianexite and in some cases pigmentary incontinence, edema, dilated lymphatic vessels and sweat glands. Histopathological examination associated with medical history, clinical examination and skin examen are important tools for the diagnosis of allergic dermatitis in dogs, as well as for associated therapeutic measures.(AU)


Subject(s)
Animals , Dogs , Dermatitis/etiology , Hypersensitivity, Immediate/veterinary , Dermatitis, Allergic Contact/etiology , Skin Diseases/veterinary
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