ABSTRACT
Goji berry (wolfberry), a member of the Solanacea family, has been recently introduced in Western countries and its consumption has increased rapidly. The objectives of the study were to describe the cases of 2 patients who experienced allergic symptoms after Goji berry consumption, to identify the protein profile of the extract, to analyze the allergenic profile of individuals, and to determine cross-reactivity with other members of the Solanaceae family (tomato). We describe 2 cases of allergic reaction, 1 of which was an anaphylactic reaction, after Goji berry ingestion. A Goji berry extract was manufactured and immunochemically characterized. The patients were skin prick tested with a battery of common aeroallergens including mites, epithelia, and molds. Individuals were also skin prick tested with food allergens, including Goji berries. A positive skin prick test and specific immunoglobulin (Ig) E to Goji berry was detected in both cases. Serum samples recognized a 9-kDa band, probably related to lipid transfer proteins (LTPs). Cross-reactivity with tomato was analyzed by inhibition studies, which showed that the 9-kDa band was totally inhibited by the tomato extract. This study describes the first 2 cases of allergic reaction following Goji berry ingestion. LTPs seem to be involved in allergic sensitization to Goji berries, as evidenced by cross-reactivity with tomato.
Subject(s)
Anaphylaxis/etiology , Food Hypersensitivity/etiology , Lycium/immunology , Adolescent , Adult , Carrier Proteins/immunology , Cross Reactions , Female , HumansABSTRACT
Several studies have demonstrated different cross-reactivity patterns between proton pump inhibitors (PPIs). The aim of this study was to investigate cross-reactivity between commercially available PPIs and establish a procedure for performing cutaneous tests for verifying PPI allergy. We performed skin prick and intradermal tests with all commercially available PPIs in 5 patients with clinical allergy to omeprazole and observed positive results in all patients. We report 5 cases of immunoglobulin (Ig) E-mediated allergy to omeprazole and document cross-reactivity by skin testing between all the PPIs studied. We also found that the probability of confirming an IgE-mediated mechanism with skin tests decreases with time. Finally, we propose a hypothesis that could explain the different PPI cross-reactivity patterns reported.
Subject(s)
Drug Hypersensitivity/immunology , Hypersensitivity, Immediate/immunology , Omeprazole/immunology , Proton Pump Inhibitors/immunology , Adult , Angioedema , Cross Reactions , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Drug Hypersensitivity/physiopathology , Female , Humans , Hypersensitivity, Immediate/chemically induced , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/physiopathology , Male , Middle Aged , Models, Immunological , Omeprazole/adverse effects , Omeprazole/chemistry , Proton Pump Inhibitors/adverse effects , Proton Pump Inhibitors/chemistry , Skin Tests , UrticariaABSTRACT
Methotrexate (MTX) is a folic acid antagonist that inhibits cellular reproduction. MTX has been shown to be an effective anti-inflammatory agent. Acute interstitial pneumonitis is the main pulmonary side effect during MTX treatment. We report a case of MTX pneumonitis in a 56-year old woman with autoimmune thrombocytopenia who presented with subacute nonproductive cough, dyspnea at rest, fever, and malaise. Chest roentgenogram demonstrated bilateral diffuse interstitial and alveolar infiltration. Infectious diseases were ruled out and methotrexate-induced pneumonitis was suspected. MTX was discontinued and methylprednisolone was prescribed. Patient improved progressively. After eight weeks, radiologic abnormalities and symptoms had disappeared.
Subject(s)
Immunosuppressive Agents/adverse effects , Lung Diseases, Interstitial/chemically induced , Methotrexate/adverse effects , Adrenal Cortex Hormones/therapeutic use , Azathioprine/therapeutic use , Diagnosis, Differential , Female , Humans , Immunosuppressive Agents/therapeutic use , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/drug therapy , Methotrexate/therapeutic use , Methylprednisolone/therapeutic use , Middle Aged , Purpura, Thrombocytopenic, Idiopathic/complications , Purpura, Thrombocytopenic, Idiopathic/drug therapy , RadiographyABSTRACT
BACKGROUND: Troponin I, a specific cardiac muscle protein, has proven to be very helpful in detecting myocardial damage in ischemic heart disease. In order to assess if this laboratory test may also characterize some hypertensive subjects with proven cardiac damage, we compared troponin I serum concentrations of a group of patients affected by systemic hypertension and left ventricular hypertrophy (LVH) with troponin I serum concentrations of hypertensive patients without LVH and with normal controls. METHODS: Of 100 hypertensive patients consecutively enrolled in the study, 27 had an increased left ventricular mass by M-mode/two-dimensional echocardiographic examination. Of these, 4 were excluded for significant Holter ST-segment modification. Troponin I was measured in the remaining 23, in 23 age- and sex-matched hypertensive patients with normal left ventricular mass and in 23 normal controls. RESULTS: Troponin I serum concentration was higher than the upper limit of the normal values (0.5 ng/mi) in 12 of the 23 hypertensives with LVH. On the contrary, all hypertensives without LVH and all normal controls had troponin I serum concentration below the upper limit of the normal values. Consequently, the mean troponin I serum value was significantly higher in the group of hypertensive patients with LVH than in the group of patients without LVH (0.88 +/- 0.93 vs 0.27 +/- 0.08 ng/ml, p = 0.002) and in normal controls (0.88 +/- 0.93 vs 0.22 +/- 0.04 ng/ml, p = 0.0001). CONCLUSIONS: Our data indicate that a significant proportion of patients affected by essential hypertension with LVH have slightly elevated troponin I serum concentrations. This test seems to identify two subgroups of hypertensive subjects with LVH, and, considering that troponin I is a marker of myocardial damage, higher serum values probably indicate a more important cardiac involvement in the setting of a hypertensive disease.
Subject(s)
Hypertension/diagnosis , Hypertrophy, Left Ventricular/diagnosis , Troponin I/blood , Adult , Aged , Biomarkers , Female , Humans , Hypertension/complications , Hypertrophy, Left Ventricular/complications , Hypertrophy, Left Ventricular/physiopathology , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Echinococcosis/complications , Echinococcosis/epidemiology , Primary Health Care/methods , Early DiagnosisABSTRACT
Anaphylaxis is a generalized reaction produced by the massive release of mediators from mast cells, is rapid in onset and may cause death. The diagnosis is clinical, and the initial symptoms often overlap with those of many other disorders such as, vasovagal reactions, anxiety or asthma, and is often underdiagnosed. A high index of suspicion is necessary for the diagnosis. We report the case of a young woman who presented with syncope in a Primary Care Centre. In spite of the absence of skin lesions, we suspected an anaphylaxis because of the refractory low blood pressure. Thus treatment was started she was transferred to the Hospital. In the Emergency Department, the elevated serum tryptase levels supported our diagnosis. The absence of a clear exposure to a known allergen lead us to suspect a hydatid cysts rupture. The abdominal ultrasound and CT scan confirmed this.
Subject(s)
Anaphylaxis/parasitology , Echinococcosis, Hepatic/complications , Syncope/parasitology , Adult , Female , Humans , Rupture, SpontaneousABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Urticaria/therapy , Urticaria , Exanthema/complications , Exanthema/diagnosis , Abdominal Pain/etiology , Pruritus/etiology , Gastroscopy/methods , Gastric Mucosa/parasitology , Gastric Mucosa , Eosinophilia/complications , Eosinophilia/diagnosis , Albendazole/therapeutic useABSTRACT
OBJECTIVES: To analyse in patients with persistent bronchial asthma the prevalence of tobacco dependency and its degree; and to assess measures of prevention. DESIGN: Cross-sectional, descriptive study. SETTING: Allergy Service of the Lozano Blesa University Hospital, Zaragoza, Spain. PARTICIPANTS: A total of 121 patients, from systematic selection of asthmatics attending for consultation. MAIN MEASUREMENTS: Questionnaire filled out in the consulting room, recording social, demographic and clinical variables. RESULTS: A sample of 121 patients was obtained, 62.7% women and 37.3% men. They had 5.87 +/- 4.99 years mean evolution of asthma. 21.5% were daily smokers, 4.1% occasional smokers, 27.3% ex-smokers, and 47.1% non-smokers. The ages of starting to smoke were < 10 years old, 1.7%; 10-15, 30%; 15-20, 56.7%; 20-25, 6.7%, and > 25, 5% (P > .05). There were significant differences between gender and tobacco dependency and between age and tobacco dependency (P < .01 and P < .014, respectively). 96.8% of smokers thought that tobacco was harmful to their health. This figure was 100% in daily smokers and 80% in occasional smokers (P < .02). 83.9% of smokers had the intention of giving up. Counselling to give up was received from the specialist (41.9%), the primary care doctor (12.9%), and both (9.7% of cases). 35.5% received no counselling. CONCLUSIONS: The prevalence of tobacco dependency in patients with persistent asthma is lower than in the population as a whole; over a third receive no counselling about giving up. Interventions must be conducted in still healthy smokers and chronically ill patients in both primary and specialist care.
Subject(s)
Asthma/epidemiology , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/prevention & control , Adolescent , Adult , Age of Onset , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Sex Factors , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
Type III glycogen storage disease (GSD III) is an autosomal recessive disorder characterized by the accumulation of abnormal glycogen in the liver and, in most patients, in the muscle. Although liver fibrosis is a well-known consequence of GSD III, until now only eight cases of liver cirrhosis and two cases of hepatocellular carcinoma have been described in patients affected by this disease. In this case report, the authors describe the clinical history of a patient affected by GSD III who developed severe liver disease during her adult life, progressing from fibrosis to cirrhosis and finally to hepatocellular carcinoma. Until now, the hepatic involvement in GSD III has been considered by most authors as mild and almost always self-limiting. This report, together with the previously published cases, clearly indicates that severe and progressive liver disease may complicate this metabolic disorder. These observations advise a careful hepatologic follow-up of patients affected by GSD III.
Subject(s)
Carcinoma, Hepatocellular/complications , Glycogen Storage Disease Type III/complications , Liver Cirrhosis/etiology , Liver Neoplasms/complications , Carcinoma, Hepatocellular/enzymology , Carcinoma, Hepatocellular/pathology , Fatal Outcome , Female , Glycogen Storage Disease Type III/enzymology , Glycogen Storage Disease Type III/pathology , Humans , Liver/pathology , Liver Cirrhosis/complications , Liver Cirrhosis/enzymology , Liver Neoplasms/enzymology , Liver Neoplasms/pathology , Middle Aged , Muscle, Skeletal/enzymologyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Occupational Health/statistics & numerical data , Occupational Health/standards , Occupational Health/trends , Conjunctivitis/complications , Conjunctivitis/epidemiology , Allergy and Immunology/trends , Hypersensitivity/drug therapy , Hypersensitivity/epidemiology , Eye Diseases/epidemiology , Eye Diseases/prevention & control , Occupational Health Services/methods , Occupational Health Services/organization & administration , Occupational Health Services/trends , Occupational Diseases/epidemiology , Occupational Diseases/prevention & controlABSTRACT
La anafilaxia es una reacción generalizada debida a la liberación masiva de mediadores de mastocitos y otras células inflamatorias que se instaura rápidamente y puede causar la muerte. Su diagnóstico es clínico y en ocasiones los síntomas con que se presenta pueden simular enfermedades más leves como cuadros vasovagales, ansiedad o asma, por lo que a menudo resulta infradiagnosticada. Es necesario un alto índice de sospecha para su diagnóstico. Presentamos el caso de una mujer joven que acude por síncope al centro de atención primaria. A pesar de la ausencia de lesiones cutáneas, la hipotensión mantenida nos hizo sospechar una anafilaxia, permitiendo la administración precoz de tratamiento y derivación urgente al hospital. en urgencias, nuestra hipótesis se vio reforzada al hallar niveles elevados de triptasa en sangre. La ausencia de exposición a alérgenos comunes nos hizo pensar en una hidatidosis hepática complicada como causa del cuadro, lo que se confirmó mediante ecografía y tomografía computarizada (TC) (AU)
Anaphylaxis is a generalized reaction produced by the massive release of mediators from mast cells, is rapid in onset and may cause death. The diagnosis is clinical, and the initial symptoms often overlap with those of many other disorders such as, vasovagal reactions, anxiety or asthma, and is often underdiagnosed. A high index of suspicion is necessary for the diagnosis. We report the case of a young woman who presented with syncope in a Primary Care Centre. In spite of the absence of skin lesions, we suspected an anaphylaxis because of the refractory low blood pressure. Thus treatment was started she was transferred to the Hospital. In the Emergency Department, the elevated serum tryptase levels supported our diagnosis. The absence of a clear exposure to a known allergen lead us to suspect a hydatid cysts rupture. The abdominal ultrasound and CT scan confirmed this (AU)
Subject(s)
Humans , Female , Adult , Syncope/etiology , Syncope/mortality , Anaphylaxis/complications , Anaphylaxis/mortality , Echinococcosis/complications , Echinococcosis/diagnosis , /methods , Early Diagnosis , Echinococcosis/mortality , Primary Health Care/methods , EchinococcosisABSTRACT
El metotrexate (MTX) es un antagonista del ácido fólico que inhibe la reproducción celular. El MTX es actualmente utilizado como antiinflamatorio en diferentes procesos. La neumonitis intersticial aguda es el principal efecto secundario pulmonar que ocurre en pacientes tratados con MTX. Describimos el caso de una neumonitis asociada a MTX en una mujer de 56 años con trombopenia autoinmune, que presentó de forma subaguda tos no productiva, disnea de reposo, fiebre y afectación del estado general. En la radiografía de tórax se observaba una afectación intersticial bilateral difusa e infiltración alveolar. Se descartó una causa infecciosa del cuadro y ante la sospecha de neumonitis asociada a MTX, se procedió a su retirada. Se administró metilprednisolona, observándose una mejoría progresiva. Tras ocho semanas las alteraciones clínicas y radiológicas habían desaparecido
Methotrexate (MTX) is a folic acid antagonist that inhibits cellular reproduction. MTX has been shown to be an effective anti-inflammatory agent. Acute interstitial pneumonitis is the main pulmonary side effect during MTX treatment. We report a case of MTX pneumonitis in a 56-year old woman with autoimmune thrombocytopenia who presented with subacute non productive cough, dyspnea at rest, fever, and malaise. Chest roentgenogram demonstrated bilateral diffuse interstitial and alveolar infiltration. Infectious diseases were ruled out and methotrexte-induced pneumonitis was suspected. MTX was discontinuated and methylprednisolone was prescribed. Patient improved progressively. After eight weeks, radiologic abnormalities and symptoms had disappeared
Subject(s)
Humans , Female , Middle Aged , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/therapy , Folic Acid/adverse effects , Methotrexate/adverse effects , Thrombocytopenia/complications , Thrombocytopenia/diagnosis , Methylprednisolone/therapeutic use , Thrombocytopenia/therapy , Radiography, Thoracic , /complications , Lung/pathology , LungABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Hemochromatosis/complications , Hemochromatosis/diagnosis , Hemochromatosis/genetics , Hemochromatosis/mortality , Death, Sudden/etiology , Electrocardiography , Mutation , Early DiagnosisABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Dengue/diagnosis , Brazil , Exanthema , TravelABSTRACT
Objetivo. Analizar en pacientes con asma bronquial persistente la prevalencia de tabaquismo, el grado de éste y valorar las medidas de prevención. Diseño. Estudio descriptivo, transversal. Emplazamiento. Servicio de Alergología del Hospital Clínico Universitario Lozano Blesa de Zaragoza. Participantes. Un total de 121 pacientes, resultado de la selección sistemática de los sujetos asmáticos que acudían a consulta. Mediciones principales. Cuestionario cumplimentado en la consulta, en el que se registraba las variables sociodemográficas y clínicas. Resultados. Se obtuvo una muestra de 121 pacientes, 62,7% mujeres y 37,3% varones, con 5,87 ± 4,99 años de evolución media del asma. El 21,5% fumaba diariamente, el 4,1% era fumador ocasional, el 27,3 era ex fumador y el 47,1% no fumaba. La edad de comienzo del tabaquismo era: 25 años, 5% (p > 0,05). Hay diferencias significativas entre sexo y tabaquismo y entre edad y tabaquismo (p < 0,01 y p < 0,014, respectivamente). El 96,8% de los fumadores cree que el tabaco es perjudicial para su salud, el 100% de los que fuman diariamente y el 80% de los que lo hacen ocasionalmente (p < 0,02). El 83,9% de los que fuma tiene intención de abandonar el tabaco. El 41,9% ha recibido consejo para dejar de fumar del especialista, el 12,9% del médico de atención primaria, el 9,7% de ambos y el 35,5% no ha recibido ningún consejo. Conclusiones. La prevalencia del tabaquismo en pacientes con asma persistente es inferior a la de la población general; más de la tercera parte no recibe consejo para abandonar el tabaco. Es necesario realizar intervenciones en fumadores sanos y en pacientes con enfermedad crónica, tanto en atención primaria como en la consulta especializada
Objectives. To analyse in patients with persistent bronchial asthma the prevalence of tobacco dependency and its degree; and to assess measures of prevention. Design. Cross-sectional, descriptive study. Setting. Allergy Service of the Lozano Blesa University Hospital, Zaragoza, Spain. Participants. A total of 121 patients, from systematic selection of asthmatics attending for consultation. Main measurements. Questionnaire filled out in the consulting room, recording social, demographic and clinical variables. Results. A sample of 121 patients was obtained, 62.7% women and 37.3% men. They had 5.87±4.99 years mean evolution of asthma. 21.5% were daily smokers, 4.1% occasional smokers, 27.3% ex-smokers, and 47.1% non-smokers. The ages of starting to smoke were 25, 5% (P>.05). There were significant differences between gender and tobacco dependency and between age and tobacco dependency (P<.01 and P<.014, respectively). 96.8% of smokers thought that tobacco was harmful to their health. This figure was 100% in daily smokers and 80% in occasional smokers (P<.02). 83.9% of smokers had the intention of giving up. Counselling to give up was received from the specialist (41.9%), the primary care doctor (12.9%), and both (9.7% of cases). 35.5% received no counselling. Conclusions. The prevalence of tobacco dependency in patients with persistent asthma is lower than in the population as a whole; over a third receive no counselling about giving up. Interventions must be conducted in still healthy smokers and chronically ill patients in both primary and specialist care