Self-reported drug allergy in health care workers in conservative and surgical medicine departments.

BACKGROUND: Drug allergy comprises 10% to 30% of all adverse drug reactions, and according to data from the literature, sensitivity to drug allergens is 2 to 3 times more common in health care workers than in the general population. OBJECTIVE: The aims of this study were to estimate the prevalence of self-reported drug allergy in health care workers and compare the data obtained between doctors and nurses from conservative medicine (CM) and surgical medicine (SM) departments. METHODS: This was an analytic questionnaire-based survey conducted using the European Network of Drug Allergy questionnaire adapted to the Lithuanian population. The questionnaires were completed by 346 individuals. RESULTS: Nurses from SM departments reported allergy symptoms more frequently than doctors from the same departments (38.1% vs. 16.7%, P = .01) and nurses from the CM departments (38.1% vs. 18%; P = .02). The most common drugs reported to cause hypersensitivity symptoms were similar in the CM and SM departments: antibiotics (8.8% and 12.7%), local anesthetics (2.9% and 6.9%), and group B vitamins (1.2% and 2.1%). Skin damage was indicated as the most common clinical manifestation. CONCLUSIONS: Based on the data reported by the questionnaire respondents, drug allergy was most prevalent among nurses from the SM departments, and antibiotics and local anesthetics were the most common substances that induced the symptoms.

Localization of Knops system antigens in the long homologous repeats of complement receptor 1.

BACKGROUND: The Sl(a) (Knops system) located on complement receptor 1 (CR1) has been associated with malarial rosetting, a process associated with severe malarial infections. Moreover, the long homologous repeats (LHRs) B and C of CR1 were implicated in rosette formation. As a step toward mapping the location of Knops system antigens, truncated CR1 proteins have been expressed and their ability to inhibit antibodies to the high-incidence Knops system antigens was assessed. STUDY DESIGN AND METHODS: Individual LHRs (A, B, C, and D) of CR1 of the common CR1*1 (F) allotype were expressed as secreted forms in 293T cells. Their abilities to specifically neutralize Knops system antibodies were tested by both hemagglutination and flow cytometry. RESULTS: Three examples of anti-Kn(a) (n = 6) were almost completely inhibited by LHR-C and three by LHR-D. Two examples of anti-McC(a) (n = 2) and seven examples of anti-Sl(a) (n = 8) were inhibited by LHR-D. Both examples of anti-Yk(a) (n = 2) were partially inhibited by LHR-D. CONCLUSION: The high-incidence Knops system antigens reside within LHR-D and to a lesser extent within LHR-C. Because of the role of Sl(a) antigen in malaria rosetting, these results indicate that LHR-D may represent an additional malaria interaction region in CR1.

A homologous naturally occurring mutation in Duffy and CCR5 leading to reduced receptor expression.

Genetic variations in the CC chemokine receptor (CCR5) leading to reduced or absent expression are associated with resistance to human immunodeficiency virus infection and delayed onset of acquired immunodeficiency syndrome. Similarly, lack of the red-cell chemokine receptor Duffy confers protection against malarial infection by Plasmodium vivax. Investigators have previously described a missense mutation (R89C) in the first intracellular loop of Duffy that results in reduced protein expression. The present study shows that the lower Duffy expression is due to loss of the positive charge at this position, resulting in protein instability. Moreover, R60S, a mutation in the first intracellular loop of CCR5 noted in a recent cohort study, likewise results in reduced surface expression and function of CCR5. The presence of a homologous, naturally occurring mutation that may be protective against disease thus defines a novel mechanism accounting for the decreased expression of these receptors in some individuals. (Blood. 2001;97:3651-3654)