Dried fruit hypersensitivity and its correlation with pollen allergy.

A group of 102 patients (children and adults) with hypersensitivity to dried fruits and dermo-respiratory pathology underwent "in vivo" tests (skin tests) and "in vitro" tests (histamine release test, specific IgE) using a battery of foods and neumoallergens. We assessed immunoglobulin (IgG, IgA, IgM, IgE) levels as well as the complement (CH50), its components (C3, C4) and the possible presence of circulating immune complexes. Of the dried fruits the almond was the most sensitizing (89%, 87% and 68% of correlation between the clinical history and "in vivo" tests--skin tests--and "in vitro" tests--histamine release test and RAST--, respectively). As regards the other sensitizations, a hypersensitivity to peach was detected in 47% of the cases. As for the association between food allergy and pollen hypersensitivity, the highest percentages were for tree pollen (51%) followed by weeds (27%) and grasses (25%). The complement values did not show significant differences when they were compared with the control population. The statistical study correlating the clinical history with the results of the diagnostic methods--agreements between two or three tests--was positive (p greater than 0.05) for almond and peanut whereas it was negative (p less than 0.005) for hazelnut.

Angioedema, rhinitis and asthma provoked by fishing bait (Eisenia foetida).

The Eisenia foetida is an earthworm that is used as fishing bait in river fishing. We report a case of facial angioedema, rhinitis and asthma in an amateur fisherman who used this worm (Eisenia foetida) as fishing bait when fishing in rivers. However, the manifestations of dermo-respiratory hypersensitivity did not arise when he used other fishing bait (Tenibrio molitor and Marphysa sanguinea) in open-sea fishing. "In vivo" and "in vitro" tests using a battery of the usual neumoallergens and food (fish) were negative. Consequently, extracts of Eisenia foetida, Tenibrio molitor and Marphysa sanguinea were prepared. Skin tests, nasal challenge, histamine release curve and levels of specific IgE were positive when using an extract of Eisenia foetida. These parameters, however, were negative for beetle larvae (Tenibrio molitor) and marine worm (Marphysa sanguinea). The allergo-immunological study was also negative for the group of healthy and atopic controls when using these three extracts of fishing bait. The rarity of the allergen responsible for this dermo-respiratory picture stresses the need to include, on occasions, not only insects but also worms in the battery of the usual neumoallergens.

"In vivo" and "in vitro" evaluation of four antihistamines (astemizole, azatadine, mequitazine, terfenadine).

A group of 32 patients with perennial allergic rhinitis sensitized exclusively to house dust and mites were evaluated for "in vivo" modifications (skin tests for histamine, house dust and mites) and "in vitro" alterations (seric IgE, specific IgE, histamine release curve to different concentrations of Dermatophagoides pteronyssinus and histamine release curve to this pneumoallergen after incubation with H1 receptor antagonists) to four antihistamines (astemizole, azatadine, mequitazine and terfenadine). The patients were divided into 4 groups of 8 and the "in vivo" and "in vitro" tests were performed on days -1, +15 and +30 of administration of these drugs. The reduction in the size of the wheal (prick test) for histamine when comparing days -1 and +15 and -1 and +30 was 69% and 79% (astemizole), 64% and 71% (azatadine), 69% and 64% (mequitazine) and 61% and 64% (terfenadine), respectively. The difference in the mean size of the wheal in mm2 for house dust, Dermatophagoides pteronyssinus and farinae was statistically significant (p less than 0.001) except when comparing the results obtained for mequitazine on days -1 and +15. This was also the case on days -1 and +30 for terfenadine. The values of the serum IgE and specific IgE did not attain statistical significance (p greater than 0.05) in the various tests carried out. After incubation with H1 receptor antagonists an inhibition curve of the histamine release in the presence of Dermatophagoides pteronyssinus was obtained. The inhibition of this curve on day -1 was higher for terfenadine and mequitazine than for azatadine and astemizole.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypersensitivity to wheat flour in bakers.

Eleven bakers and 4 pastry cooks with hypersensitivity to wheat flour underwent skin tests to flours (wheat, barley, rye, oats), pollens (wheat, barley, rye, oats, grasses), mites (dermatophagoides pteronyssinus, dermatophagoides farinae), molds (alternaria, aspergillus) and weeds (parietaria judaica). The levels of serum immunoglobulins (IgG, IgA, IgM and IgE) were studied and the values of specific IgE (RAST) in the presence of wheat flour and the histamine release test for wheat flour, grass pollens, mites, molds and weeds were assessed. All the patients underwent a nasal challenge test to wheat flour. The results demonstrated the existence of cross reactions between the extracts of barley and rye flour with wheat flour (15/15) as well as between the pollens of cereals and cereal flours. The levels of specific IgE (PRU greater than .35) and the percentages of histamine release (greater than 10%) were positive in 14/15 cases. The nasal challenge test was positive for all the 15 patients under study. Of the patients studied, 11 received immunotherapy for periods ranging from 12 to 18 months. Of these patients, 9/11 continued working in the same occupation whereas the 2 who left their jobs in the industry corresponded to the cases of severe asthma which were polysensitized (flour, mites, molds).