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J Cardiovasc Med (Hagerstown) ; 17 Suppl 2: e109-e111, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26556445


: Necrotizing eosinophilic myocarditis (NEM) is a life-threatening condition that needs rapid diagnosis by endomyocardial biopsy and hemodynamic support usually by mechanical circulatory systems. We present the case of a 25-year-old Caucasian man who developed a refractory cardiogenic shock due to a NEM that was supported with a peripheral veno-arterial extracorporeal membrane oxygenation associated with intravenous steroids and recovered after 2 weeks. Further instrumental investigations lead to the final diagnosis of NEM as first presentation of eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), remarking the importance of identifying the systemic disorder that usually triggers the eosinophilic damage of the myocardium.

Síndrome de Churg-Strauss/complicações , Granulomatose com Poliangiite/complicações , Miocardite/etiologia , Choque Cardiogênico/etiologia , Administração Intravenosa , Adulto , Biópsia , Síndrome de Churg-Strauss/diagnóstico , Síndrome de Churg-Strauss/terapia , Oxigenação por Membrana Extracorpórea , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/terapia , Humanos , Imunossupressores/administração & dosagem , Imageamento por Ressonância Magnética , Masculino , Miocardite/diagnóstico , Miocardite/terapia , Miocárdio/patologia , Necrose , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/terapia , Esteroides/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
J Agric Food Chem ; 61(3): 740-6, 2013 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-23210484


Fennel allergy has been rarely reported, and the association with peach allergy has never been described. Our aim was to (i) study the correlation between symptom severity of peach and fennel and (ii) identify fennel allergens and the role of rPru p 3 antibodies in severe reactions to fennel. In 148 patients with peach allergy, we investigated 58 patients with symptoms and IgE antibodies positive to fennel. IgE to rPru p 1, 3, and 4 and rBet v 1, 2, and 4 were measured by immunoblotting, and the N-terminal amino acid sequences and relevant allergens were determined. We found significant association between severe reactions to fennel and peach (p = 0.0009). A major allergen was ~9 kDa lipid-transfer protein (LTP), cross-reactive with Pru p 3, a 15 kDa protein identified as a pathogenesis-related protein 1 of the Bet v 1 family. In conclusion, peach and fennel severe allergic symptoms are significantly related, and LTP is a major fennel allergen. Fennel should be included in the LTP syndrome.

Proteínas de Transporte/imunologia , Foeniculum/química , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/imunologia , Prunus/química , Adolescente , Adulto , Idoso , Alérgenos/imunologia , Antígenos de Plantas/imunologia , Reações Cruzadas , Feminino , Humanos , Immunoblotting , Imunoglobulina E/sangue , Masculino , Pessoa de Meia-Idade , Adulto Jovem
J Allergy Clin Immunol ; 122(5): 951-60, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19000581


BACKGROUND: Recombinant DNA technology has the potential to produce allergen-specific immunotherapy vaccines with defined composition. OBJECTIVE: To evaluate the effectiveness of a new recombinant birch pollen allergen vaccine in patients with birch pollen allergy. METHODS: A multicenter, randomized, double-blind, placebo-controlled trial was undertaken to compare the following 3 vaccines in 134 adults with birch pollen allergy: recombinant birch pollen allergen vaccine (rBet v 1a), licensed birch pollen extract, natural purified birch pollen allergen (nBet v 1), and placebo. Patients received 12 weekly injections followed by monthly injections of the maintenance dose containing 15 microg Bet v 1 for 2 years. RESULTS: Significant reductions (about 50%) in rhinoconjunctivitis symptoms (rBet v 1, P = .0002; nBet v 1, P = .0006; birch extract, P = .0024), rescue medication (rBet v 1, P = .0011; nBet v 1, P = .0025; birch extract, P = .0063), and skin sensitivities (P < .0001) were observed in the 3 actively treated groups compared with placebo during 2 consecutive pollen seasons. Clinical improvement was accompanied by marked increases in Bet v 1-specific IgG levels, which were higher in the rBet v 1-treated group than in the birch and nBet v 1-treated groups. New IgE specificities were induced in 3 of 29 patients treated with birch pollen extract, but in none of the 32 rBet v 1-treated or 29 nBet v 1-treated patients. No severe systemic adverse events were observed in the rBet v 1-treated group. CONCLUSION: The rBet v 1-based vaccine was safe and effective in treating birch pollen allergy, and induced a highly specific immune response.

Alérgenos/imunologia , Betula/imunologia , Conjuntivite Alérgica/terapia , Dessensibilização Imunológica , Pólen/imunologia , Rinite Alérgica Sazonal/terapia , Adulto , Alérgenos/efeitos adversos , Antialérgicos/uso terapêutico , Betula/efeitos adversos , Conjuntivite Alérgica/imunologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólen/efeitos adversos , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/uso terapêutico , Rinite Alérgica Sazonal/imunologia , Vacinas/imunologia , Vacinas/uso terapêutico , Adulto Jovem