[Cannabis and crossed allergy with food]. / Cannabis et allergie croisée alimentaire.

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.

Angio-oedema induced by oestrogen contraceptives is mediated by bradykinin and is frequently associated with urticaria.

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.

[Foetomaternal erythrocyte incompatibilities: from immunohaematologic surveillance of pregnant women to haemolytic disease of the newborn]. / Incompatibilités foetomaternelles érythrocytaires (IFME): de la surveillance immunohématologique des femmes enceintes à la maladie hémolytique du nouveau-né (MHNN).

Despite the generalization of prevention measures against foetomaternal alloimmunization with anti-D immunoprophylaxis since 1970s, retrospectively 30 years later, its complications (new-born child's severe haemolytic disease, foetal death by anemia or nuclear icterus by bilirubin encephalopathy) have not disappeared. At the same time, alloimmunizations against antigens other than D increase with no possible prevention. As part of the set up in France of regional files analysing and making an inventory of serious foetomaternal incompatibilities requiring in utero or neonatal transfusion, we felt the need to synthesize current data, biological profiles (early screening of erythrocytic alloimmunization and its follow up during pregnancy, father's immunohaematologic status, evaluation of in utero immune haemolysis and impact of new non invasive techniques of diagnosis-RH1 foetal genotypage from ADN foetal of RH1--mothers' maternal plasma), clinical and paraclinical data (evaluation of foetal haemolysis by echography, recording of foetal movements and foetal cardiac rhythm), therapeutic indicators (in utero foetal transfusions or exsanguinotransfusions, neo and postnatal transfusions or exsanguinotransfusions, induced premature labour, newborn's intensive continue phototherapy and Rhesus immunoprophylaxis) in order to enable medical and paramedical professionals to carry out the specific supervision of pregnancies with foetomaternal incompatibility, the in utero, neo- and postnatal treatment of child and the efficient therapeutic prevention of anti-D alloimmunization, in a cooperative way.

[Delayed hypersensitivity to heparins and heparinoids]. / Hypersensibilité retardée aux héparines et heparinoïdes.

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.

[Fatal anaphylaxis after eating wild boar meat in a patient with pork-cat syndrome]. / Anaphylaxie mortelle après ingestion de sanglier chez un patient porteur du syndrome porc-chat.

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.

[The platelet/leukocyte ratio in red blood cell concentrates is an essential indicator of leukocyte removal filter efficiency which limits their use]. / Le rapport plaquettes/globules blancs dans les concentrés de globules rouges est un élément essentiel de l'efficacité des filtres à déleucocyter qui limite leur utilisation.

Performances of filter systems for leucocyte removal (Pall BPF4 and Sepacell RZ 200 B) have been studied following the preparation of red blood cell concentrates (RBCCs) obtained either by a soft-spin centrifugation at 2967xg (n = 438) or by a hard-spin centrifugation at 5275xg (n = 187). After deleucocytation, 43, i.e., 9.8% of RBCCs obtained following a soft-spin centrifugation contained a number of residual leucocytes higher than 1 x 10(6) leucocytes/RBCC which represents the legal upper limit in France, whereas RBCCs obtained following a hard-spin centrifugation always contained a number of residual leucocytes lower than this limit. Our results strongly suggest that the quality of deleucocytation depends on an adequate ratio of platelets to leucocytes, which favours the capture of leucocytes by filters. In fact, this ratio was higher in RBCCs obtained following a hard-spin centrifugation. Our results demonstrate that the use of these filters does not allow the removal of leucocytes complying with the legal limit of leucodepletion for all preparations of RBCCs.

[Anti-histamines]. / Les anti-histaminiques.

The use of anti-histamines remains the therapy of choice for the ensemble of allergic pathologies with a reaginic mechanism. Knowledge of the metabolism of histamine gives an understanding of a number of allergic symptoms and also clarifies the mechanism of action of the anti-histamines. Many molecules are appearing on the market, each with a more precise action on the specific H1 receptors and also carrying other pharmacological specificities of better and better study. Observance of contra-indications, in particular cardio-vascular, allows their use without reserve, whilst knowing that there are always problems of specific tolerance, that are variable from one individual to another, specially on drowsiness. The importance of stopping anti-histamines must be remembered, every time that this is possible, before making an allergic diagnosis by skin tests.

[Chronic urticaria caused by cow's milk allergy: immediate or delayed allergy? (apropos of a case)]. / Urticaire chronique par allergie au lait de vache: allergie immediate ou retardee? (a propos d'un cas).

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.

[Food allergens]. / Les allergènes alimentaires.

Perhaps more than any other kind of allergen, search for a food allergen seems to be difficult. There should be no bias about the usual allergens found in our food, that are a source of pathology that is less spectacular than shocks or giant urticaria that are provoked by easily recognised causes. Crossed allergies must be recognised in their overall features. This may give decisive aid in the etiological approach by facilitating understanding of the symptoms and the discovery of potential triggering allergens which are systematically sought.

[Food allergens]. / Les allergènes alimentaires.

Perhaps more than any other kind of allergen, search for a food allergen seems to be difficult. There should be no bias about the usual allergens found in our food, that are a source of pathology that is less spectacular than shocks or giant urticaria that are provoked by easily recognised causes. Crossed allergies must be recognised in their overall features. This may give decisive aid in the etiological approach by facilitating understanding of the symptoms and the discovery of potential triggering allergens which are systematically sought.

[Assay of IgE specific to dog epithelia by the Pharmacia CAP RAST technique: comparison of the two CAP RAST e2 and e5]. / Dosage des IgE spécifiques aux épithélia de chien par technique CAP Rast Pharmacia: comparaison des deux Cap Rast e2 et e5.

We present a comparative study of measurement of dog-epithelium-specific IgE by two Pharmacia CAP Rast techniques e2 and e5. For both measurements the technique is identical, but the allergen extracts are different: e2 = dachshund extract whilst e5 = a mixture of squames of german shepherd and poodle. We show that the e5-specific IgE seems to be more sensitive than the e2-specific IgE.

[Allergy to diphenylmethane diisocyanate: apropos of a case]. / Allergie au diisocyanate de diphénylméthane: à propos d'une observation.

In this observation, an association is described between contact eczema and asthma, by sensitization with diaminophenylmethane and isocyanates, following a review of the chemistry of polyurethanes and their use.

[Contact allergy to sulfites: contact allergens, sources of exposure, and clinical profile]. / Allergie de contact aux sulfites: allergènes de contact, sources d'exposition et profil clinique.

Contact allergy to sulphites has been discovered recently. This study considers the data necessary to make an accurate clinical profile that gives the possibility of such sensitization. Exposure sources are recalled to suggest avoidance by affected patients.

[Survey of pathologies caused by sulfites in allergology]. / Enquête sur pathologies induites par les sulfites en allergologie.

Increased use of sulphites as a preservative for foods and drugs is partly the origin of increasing prevalence of allergy to this anti-oxidant. All organs that are concerned with allergic problems may be affected, especially skin and the digestive tract. We have noted a frequent association between the pathology to aspirin (ORL, bronchial, skin) and that of sulphites: 30.8%. The history is fundamental and compensates for the lack of effectiveness of skin tests.

[The pork-cat syndrome or crossed allergy between pork meat and cat epithelia (1)]. / Le syndrome porc-chat ou l'allergie croisée entre viande de porc et épithélia de chat (1re partie).

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.

[Conjunctivitis and contact allergy]. / Conjonctivite et allergie de contact.

Allergologic testing is more and more practiced in etiologic research in conjonctivitis, especially patch testing may improve diagnosis. It is possible to draw up a list of frequent allergens and enough, informations about exposure and use of these as mercurial compounds or ammoniums.

Allergy to heparin. Special problems set by pregnant women.

Oral anti-coagulants are always contra-indicated for pregnant women. Only anti-coagulants of the types of heparin or its derivatives may be used. However, some patients have an allergy to heparin. In this article the correct action to make both for diagnosis and prevention is studied. We present 2 observations of heparin-allergic pregnant women with, in the first case an attempted tolerization which failed and in the second case there was success in a second pregnancy with low-molecular weight heparin.

[Allergy to heparin. Particular problems in the pregnant woman]. / Allergie à l'héparine. Problèmes particuliers posés chez la femme enceinte.

Oral anti-coagulants are always contra-indicated for pregnant women. Only anti-coagulants of the types of heparin or its derivatives may be used. However, some patients have an allergy to Heparin. In this article the correct action to take both for diagnosis and prevention is studied. We present 2 observations of heparin-allergic pregnant women with, in the first case a tentative addiction to heparin which created a check and in the second case there was success in a second pregnancy with low-molecular weight heparin.

[Atopic dermatitis. Epidemiology]. / La dermatite atopique. Epidémiologie.

It was in 1923 that Coca and Cooke made a distinctive entity of a group of diseases of allergy, including asthma, and hay fever. They remarked that these affections were frequently associated and/or preceded by eczema localised to certain regions (flexor folds), sometimes generalised, perhaps appearing suddenly, from the third month in infants. In effect, the majority of constitutional eczema is in infants of 6 months, 75% of the cases are in one-year-old children. There is recovery in 5 years following the start of the affection in 90% of cases. Only 5% of cases persist to adulthood.

[Immunological causes of male infertility]. / A propos des causes immunologiques de l'infertilité masculine.

Sperm (spermatozoa and the various secretions of the accessory glands) with its very complex antigenic system is only produced from puberty and thus at a time when the body has already had a for a long time the facility to respond to an antigenic stimulation with an immune reaction. Because of this, the spermatozoa, in contrast to other cells of the organism, are considered as strangers and may behave as auto-antigens. However, the existence of a haemato-testicular barrier, that prevents all contact between the sperm and the immune system must be recognized in man, its rupture has the consequence of formation of anti-spermatozoa antibodies. It is estimated that 5% of cases of sterility are of immunological origin and linked to the presence in man and/or woman of anti-sperm antibodies. The production is greater in man than in women because of the roles, in the first of macrophages and in the second of polynuclear neutrophils in the destruction of the spermatozoa. Anti spermatozoal antibodies play a part in sterility by: Spontaneous agglutination in ejaculation, thus preventing their progression in the female genital tract. Free spermatozoa, charged with antibody are retained at the level of the cervical secretion = SHAKING phenomenon. The anti-spermatozoal antibodies mask some antigens, so preventing penetration of the spermatozoa into the ovule. Contact of spermatozoa with antibody fixed to the uterine tissue is followed by secretion of histamine and this encourages the expulsion of an implanted egg. This is before the existence of: Spontaneous agglutination in ejaculation, Oligospermatosis, Indeterminate cause sterility, Immobilisation of the spermatozoa in the cervical secretion, Failure of repetition.