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1.
Pediatr Rev ; 41(6): 283-292, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32482691

RESUMO

Urticaria and, to a lesser extent, angioedema are common occurrences in the pediatric population. There are multiple causes of acute and chronic urticaria and angioedema. Most causes are benign, although they can be worrisome for patients and their parents. An allergist should evaluate acute urticaria and/or angioedema if there are concerns of an external cause, such as foods or medications. Chronic urticaria and angioedema can severely affect quality of life and should be managed aggressively with antihistamines and immunomodulators if poorly controlled. Chronic symptoms are unlikely to be due to an external cause. Anaphylaxis is a more serious allergic condition characterized by a systemic reaction involving at least 2 organ systems. Anaphylaxis should be initially managed with intramuscular epinephrine. Patients who experience anaphylaxis should be evaluated by an allergist for possible causes; if found, avoidance of the inciting antigen is the best management. All patients should also be given an epinephrine autoinjector and an action plan. Foods are a common cause of anaphylaxis in the pediatric population. New evidence suggests that the introduction of highly allergic foods is safe in infancy and should not be delayed. In addition, the early introduction of foods such as peanuts may help prevent the development of food allergies.


Assuntos
Anafilaxia/etiologia , Angioedema/etiologia , Antialérgicos/uso terapêutico , Epinefrina/uso terapêutico , Hipersensibilidade Alimentar/diagnóstico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Urticária/etiologia , Adolescente , Anafilaxia/tratamento farmacológico , Angioedema/tratamento farmacológico , Criança , Feminino , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Imunoterapia , Masculino , Omalizumab/uso terapêutico , Urticária/tratamento farmacológico
2.
Braz J Med Biol Res ; 53(3): e8853, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130289

RESUMO

Anaphylactic shock can be defined as an acute syndrome, and it is the most severe clinical manifestation of allergic diseases. Anaphylactoid reactions are similar to anaphylactic events but differ in the pathophysiological mechanism. Nitric oxide (NO) inhibitors during anaphylaxis suggest that NO might decrease the signs and symptoms of anaphylaxis but exacerbate associated vasodilation. Therefore, blocking the effects of NO on vascular smooth muscle by inhibiting the guanylate cyclase (GC) would be a reasonable strategy. This study aimed to investigate the effects of NO/cGMP pathway inhibitors methylene blue (MB), Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME), and indigo carmine (IC) in shock induced by compound 48/80 (C48/80) in rats. The effect was assessed by invasive blood pressure measurement. Shock was initiated by C48/80 intravenous bolus injection 5 min before (prophylactic) or after (treatment) the administration of the inhibitors MB (3 mg/kg), L-NAME (1 mg/kg), and IC (3 mg/kg). Of the groups that received drugs as prophylaxis for shock, only the IC group did not present the final systolic blood pressure (SBP) better than the C48/80 group. Regarding shock treatment with the drugs tested, all groups had the final SBP similar to the C48/80group. Altogether, our results suggested that inhibition of GC and NO synthase in NO production pathway was not sufficient to revert hypotension or significantly improve survival.


Assuntos
Anafilaxia/tratamento farmacológico , GMP Cíclico/antagonistas & inibidores , Inibidores Enzimáticos/administração & dosagem , Músculo Liso Vascular/efeitos dos fármacos , Óxido Nítrico/antagonistas & inibidores , Animais , Modelos Animais de Doenças , Índigo Carmim/administração & dosagem , Masculino , Azul de Metileno/administração & dosagem , NG-Nitroarginina Metil Éster/administração & dosagem , Ratos , Ratos Wistar
3.
Phytomedicine ; 68: 153149, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32032836

RESUMO

BACKGROUND: Mast cells (MCs) are crucial effectors in allergic disorders by secreting inflammatory mediators. The Mas-related G-protein-coupled receptor X2 (Mrgprx2) was shown to have a key role in IgE-independent allergic reactions. Therefore, potential drug candidates that directly target Mrgprx2 could be used to treat pseudo-allergic diseases. Shikonin, an active ingredient derived from Lithospermum erythrorhizon Sieb. et Zucc has been used for its anti-inflammatory properties since ancient China. PURPOSE: To investigate the inhibitory effects of Shikonin on IgE-independent allergy both in vitro and in vivo, as well as the mechanism underlying its effects. METHODS/STUDY DESIGNS: The anti-anaphylactoid activity of Shikonin was evaluated in PCA and systemic anaphylaxis models, Calcium imaging was used to assess intracellular Ca2+ mobilization. The release of cytokines and chemokines was measured using enzyme immunoassay kits. Western blot analysis was conducted to investigate the molecules of PLCγ-PKC-IP3 signaling pathway. The analytical method of surface plasmon resonance was employed to study the interaction between Shikonin and potential target protein Mrgprx2. RESULTS: Shikonin can suppress compound 48/80 (C48/80)-induced PCA, active systemic anaphylaxis, and MCs degranulation in mice in a dose-dependent manner. In addition, Shikonin reduced C48/80-induced calcium flux and suppressed LAD2 cell degranulation via PLCγ-PKC-IP3 signaling pathway. Moreover, Shikonin was found to inhibit C48/80-induced Mrgprx2 expression in HEK cells, displaying specific interactions with the Mrgprx2 protein. CONCLUSION: Shikonin could be a potential antagonist of Mrgprx2, thereby inhibiting pseudo-allergic reactions through Ca2+ mobilization.


Assuntos
Anafilaxia/tratamento farmacológico , Hipersensibilidade/tratamento farmacológico , Naftoquinonas/farmacologia , Proteínas do Tecido Nervoso/imunologia , Receptores Acoplados a Proteínas-G/imunologia , Receptores de Neuropeptídeos/imunologia , Anafilaxia/induzido quimicamente , Animais , Cálcio/metabolismo , Degranulação Celular/efeitos dos fármacos , Linhagem Celular , Quimiocinas/metabolismo , Citocinas/metabolismo , Humanos , Hipersensibilidade/imunologia , Masculino , Mastócitos/efeitos dos fármacos , Mastócitos/metabolismo , Camundongos Endogâmicos C57BL , Naftoquinonas/química , Proteínas do Tecido Nervoso/antagonistas & inibidores , Proteínas do Tecido Nervoso/química , Proteínas do Tecido Nervoso/metabolismo , Fosfolipase C gama/metabolismo , Receptores Acoplados a Proteínas-G/antagonistas & inibidores , Receptores Acoplados a Proteínas-G/química , Receptores Acoplados a Proteínas-G/metabolismo , Receptores de Neuropeptídeos/antagonistas & inibidores , Receptores de Neuropeptídeos/química , Receptores de Neuropeptídeos/metabolismo , Secretagogos/toxicidade , p-Metoxi-N-metilfenetilamina/toxicidade
4.
Allergol. immunopatol ; 48(1): 3-7, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-186585

RESUMO

Background: Anaphylaxis is a sudden, severe, and potentially life-threatening allergic reaction, affecting a portion of allergic patients. Adrenaline is the first-line medication for anaphylaxis and available in many parts of the world as adrenaline autoinjectors (AAIs). Objective: Aim of this study was to determine attitudes and knowledge levels of patients/parents regarding the use of AAIs, frequency, and rate of appropriate AAI use and to give a standardized and better education by improving on mistakes during administration. Method: 190 patients aged 1-18 years who were prescribed AAIs for any reason between 2012 and 2017 in Hacettepe University Pediatric Allergy Unit. Demographic data were collected during face-to-face interview or by telephone. Parents completed a mini-survey regarding use, carriage, and storage of AAI. Results: Some 190 patients (64.7% male) aged 7.83 (4.99-12.08) years, median (inter-quartile), were included in the study. The indications for AAI prescription were food allergy (78.9%); venom allergy (14.2%); idiopathic anaphylaxis (3.7%); mastocytosis (2.1%); and drug allergy (1.0%). One-fourth of AAI-prescribed patients experienced anaphylaxis requiring the use of AAI within the past five years. However, only 30% of the patients dared to use AAI; only three-quarters of whom had managed to use it correctly. Conclusion: After prescription of AAI and initial training, patients and parents' concerns and fears should be taken into consideration and necessary support should be provided. At every opportunity and each clinical visit, not only should training sessions be repeated but also the patients and parents should be psychologically supported


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Epinefrina/uso terapêutico , Autoadministração/métodos , Anafilaxia/tratamento farmacológico , Hipersensibilidade Alimentar/tratamento farmacológico , Asma , Rinite , Dermatite Atópica
5.
Curr Allergy Asthma Rep ; 20(1): 4, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31993777

RESUMO

PURPOSE OF REVIEW: Progestogen hypersensitivity (PH) is a condition which typically occurs in women in childbearing years with a spectrum of symptoms ranging from urticaria with or without angioedema, dermatitis to systemic anaphylaxis. Herein, a clinical case of PH is presented followed by a discussion on the evaluation, diagnosis, and management of PH. RECENT FINDINGS: Progestogen hypersensitivity (a.k.a. "autoimmune progesterone dermatitis") symptoms are associated with exogenous progestin exposure (e.g., contraceptive medicines, in vitro fertilization therapy) or endogenous progesterone from progesterone surges during the luteal phase of the menstrual cycle and pregnancy. This condition can be difficult to recognize due to its heterogeneous clinical presentation. The mechanism of PH is believed to be primarily IgE-mediated; however, less commonly other immune responses may be involved. There is now a useful progesterone specific IgE immunoassay to assist in diagnosis and well-defined treatment algorithms that can be used to successfully manage PH. The epidemiology of PH is still poorly elucidated but is likely to be encountered by clinicians and especially allergists given the extensive use of oral contraceptives and increased use of supra-physiologic doses of progesterone required to support pregnancy in IVF. Including PH in the differential diagnosis of women presenting with cyclic hypersensitivity will accelerate diagnosis and successful management of this condition.


Assuntos
Anafilaxia/induzido quimicamente , Doenças Autoimunes/induzido quimicamente , Dispositivos Intrauterinos Medicados/efeitos adversos , Progesterona/efeitos adversos , Progestinas/efeitos adversos , Urticária/induzido quimicamente , Anafilaxia/diagnóstico , Anafilaxia/tratamento farmacológico , Antialérgicos/uso terapêutico , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/tratamento farmacológico , Dermatite/diagnóstico , Dermatite/tratamento farmacológico , Dessensibilização Imunológica , Remoção de Dispositivo , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina E/sangue , Omalizumab/uso terapêutico , Urticária/diagnóstico , Urticária/tratamento farmacológico , Adulto Jovem
7.
Int Arch Allergy Immunol ; 181(2): 136-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31794965

RESUMO

BACKGROUND: Accurate use of adrenaline auto-injectors (AAIs) for anaphylaxis is critical to decrease mortality and morbidity. OBJECTIVE: In this study, we aimed to assess user knowledge of AAIs and evaluate the factors that affect their correct use. METHODS: The study involved caregivers of pediatric patients diagnosed with anaphylaxis who were trained with trainer injectors up to 24 months ago. The demographics of the caregivers, anaphylaxis history of the patients, usage of AAIs in the case of anaphylaxis, and the reasons for not using AAIs in anaphylaxis were evaluated. Users were asked to demonstrate the use of Penepin® with a trainer injector. RESULTS: Fifty-nine caregivers were enrolled in the study. Forty-seven (79.7%) users stated that they always carry AAIs with them. Forty-one (69.5%) of the users demonstrated all steps of the use of AAIs. The time from the last AAI training was the most significant parameter affecting the ability to use AAIs correctly (OR 0.678, 95% CI 0.546-0.841, p < 0.0001). AAI training every 6 months results in the proper usage of AAIs, with 96% probability. Thirty (50.8%) caregivers stated that anaphylactic reactions occurred in their children after the last AAI training. Of these, 16 (53.3%) users stated that they did not use an AAI for the anaphylactic reaction. The most common reason (50%) was not carrying an AAI on their person. CONCLUSION: Training users at least every 6 months is associated with the proper application of AAIs. Although regular training increases the frequency of AAI use in anaphylaxis, awareness of carrying AAIs is the most important factor for usage of AAI in anaphylaxis.


Assuntos
Anafilaxia/tratamento farmacológico , Epinefrina/administração & dosagem , Criança , Pré-Escolar , Feminino , Humanos , Injeções/métodos , Masculino , Autoadministração/métodos
9.
Med Clin North Am ; 104(1): 129-143, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757231

RESUMO

Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped after 5 years in most cases.


Assuntos
Anafilaxia/tratamento farmacológico , Epinefrina/uso terapêutico , Hipersensibilidade/tratamento farmacológico , Mordeduras e Picadas de Insetos/complicações , Anafilaxia/etiologia , Animais , Humanos , Hipersensibilidade/etiologia , Imunoterapia/métodos , Peçonhas/uso terapêutico
10.
Ann Allergy Asthma Immunol ; 124(1): 16-27, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31513910

RESUMO

Anaphylaxis is considered idiopathic when there is no known trigger. The signs and symptoms of idiopathic anaphylaxis (IA) are identical to those of anaphylaxis because of a known cause and can include cutaneous, circulatory, respiratory, gastrointestinal, and neurologic symptoms. Idiopathic anaphylaxis can be a frustrating disease for patients and health care providers. Episodes are unpredictable, and differential diagnosis is challenging. Current anaphylaxis guidelines have little specific guidance regarding differential diagnosis and long-term management of IA. Therefore, the objective of the Idiopathic Anaphylaxis Yardstick is to use published data and the authors' combined clinical experience to provide practical recommendations for the diagnosis and management of patients with IA.


Assuntos
Anafilaxia/diagnóstico , Anafilaxia/tratamento farmacológico , Epinefrina/uso terapêutico , Corticosteroides/uso terapêutico , Diagnóstico Diferencial , Humanos , Mastocitose/diagnóstico , Mastocitose/imunologia
14.
Int J Mol Sci ; 20(19)2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31597362

RESUMO

Anaphylaxis is an acute and life-threatening systemic reaction. Food, drug, aero-allergen and insect sting are known to induce anaphylaxis. Mast cells and basophils are known to mediate Immunoglobulin E (IgE)-dependent anaphylaxis, while macrophages, neutrophils and basophils mediate non IgE-dependent anaphylaxis. Histone deacetylases (HDACs) play various roles in biological processes by deacetylating histones and non-histones proteins. HDAC inhibitors can increase the acetylation of target proteins and affect various inflammatory diseases such as cancers and allergic diseases. HDAC3, a class I HDAC, is known to act as epigenetic and transcriptional regulators. It has been shown that HDAC3 can interact with the high-affinity Immunoglobulin E receptor (FcεRI), to mediate passive anaphylaxis and cellular interactions during passive anaphylaxis. Effects of HDAC3 on anaphylaxis, cellular interactions involving mast cells and macrophages during anaphylaxis, and any tumorigenic potential of cancer cells enhanced by mast cells will be discussed in this review. Roles of microRNAs that form negative feedback loops with hallmarks of anaphylaxis such as HDAC3 in anaphylaxis and cellular interactions will also be discussed. The roles of MCP1 regulated by HDAC3 in cellular interactions during anaphylaxis are discussed. Roles of exosomes in cellular interactions mediated by HDAC3 during anaphylaxis are also discussed. Thus, review might provide clues for development of drugs targeting passive anaphylaxis.


Assuntos
Anafilaxia/etiologia , Anafilaxia/metabolismo , Comunicação Celular , Quimiocina CCL2/metabolismo , Histona Desacetilases/metabolismo , Receptores de IgE/metabolismo , Transdução de Sinais , Anafilaxia/tratamento farmacológico , Animais , Suscetibilidade a Doenças , Inibidores de Histona Desacetilases/farmacologia , Inibidores de Histona Desacetilases/uso terapêutico , Humanos , Imunoglobulina E/imunologia , Imunoglobulina G/imunologia , MicroRNAs/genética
15.
Food Funct ; 10(10): 6767-6778, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31576893

RESUMO

Coumarin is an important organic heterocyclic compound with a wide range of sources in nature. It plays an important role in the drug discovery process due to its existence in diverse biologically active compounds and its broad bioactivity. In this study, the anti-allergic activity of coumarin was evaluated using an ovalbumin (OVA)-induced mouse food allergy model and an immunoglobulin (Ig)E mediated mouse bone marrow-derived mast cell (BMMC) model. Coumarin could alleviate the OVA-induced allergic symptoms, decrease the diarrhea rates, and promote the rectal temperature rise in allergic mice. Moreover, coumarin had the ability to reduce the levels of histamine and mouse mast cell proteinases, inhibit OVA-specific IgE, and significantly decrease the population of mast cells in the spleen and mesenteric lymph nodes. Coumarin could also significantly suppress mast cell-dependent passive cutaneous anaphylaxis. Additionally, the number of mature BMMCs was decreased as coumarin caused the suppression of c-KIT receptors. Furthermore, coumarin up-regulated the apoptosis of OVA-activated BMMCs in a concentration-dependent manner. In conclusion, coumarin displayed effective anti-food allergy activity via the regulation of mast cell function and numbers. Coumarin and its derivatives provide a new direction for the development of anti-food allergic drug components.


Assuntos
Anafilaxia/tratamento farmacológico , Antialérgicos/farmacologia , Cumarínicos/farmacologia , Hipersensibilidade Alimentar/tratamento farmacológico , Mastócitos/efeitos dos fármacos , Ovalbumina/efeitos adversos , Animais , Linhagem Celular , Modelos Animais de Doenças , Feminino , Histamina , Imunoglobulina E , Camundongos , Camundongos Endogâmicos BALB C , Anafilaxia Cutânea Passiva , Baço
16.
J Agric Food Chem ; 67(43): 11911-11921, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31475818

RESUMO

Red algae sulfated polysaccharides (RASP) were extracted from Porphyra haitanensis and Gracilaria lemaneiformis. RASP were applied to effervescent tablets to develop a type of functional food, termed red algae sulfated polysaccharide effervescent tablets (RASPET), based on the antiallergic activities of RASP. The antiallergic activities and the mechanisms of RASPET were investigated in an ovalbumin (OVA)-induced mouse model of food allergy. The results revealed that RASPET alleviated intestinal villi injury by scanning electron microscopy and anaphylactic symptoms; reduced OVA-specific immunoglobulin E, histamine, and mast cell protease-1 levels in the serum; reduced the level of serum interleukin-4; increased serum interferon-γ level; and decreased B cell and mast cell populations. Remarkably, RASPET increased the levels of serum interleukin-10, transforming growth factor-ß, and upregulated splenic CD4+foxp3+ T cell populations (15.28, 16.82, and 17.58%, respectively) compared to the OVA group (13.17%). In conclusion, RASPET attenuated OVA-induced anaphylaxis via the upregulation of regulatory T cells.


Assuntos
Anafilaxia/tratamento farmacológico , Antialérgicos/administração & dosagem , Ovalbumina/efeitos adversos , Polissacarídeos/administração & dosagem , Rodófitas/química , Linfócitos T Reguladores/imunologia , Anafilaxia/etiologia , Anafilaxia/imunologia , Animais , Antialérgicos/química , Modelos Animais de Doenças , Feminino , Histamina/imunologia , Humanos , Imunoglobulina E/imunologia , Interferon gama/imunologia , Interleucina-4/imunologia , Mastócitos/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Polissacarídeos/química , Comprimidos/administração & dosagem , Comprimidos/química
17.
Orv Hetil ; 160(38): 1514-1518, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31537093

RESUMO

Immunglobulin E (IgE)-based, irregularly recurring, severe anaphylactic reactions occurred in a 50-year-old European white male patient suffering also from Crohn's disease. On the base of immunologic laboratory tests concerning the mechanism of the phenomenon, the idea arose whether molecules derived for certain microbial derivatives could enter the blood circulation via the damaged bowel walls in the patient with Crohn's disease and they might act as allergens. The microbial analysis diagnosed atypical Staphylococcus in the stool. The serum level of IgE was very high. The concomitant use of targeted antibiotics and anti-allergy and immunosuppressive agents resulted in a complete remission during a couple of months. Not only Crohn's disease has improved, but also the total serum IgE level has decreased significantly, and the unpredictable anaphylactic attacks have been completely eliminated. In Crohn's disease, the anaphylactic complications induced by atypical microbial allergens (e.g., derivatives of Staphylococcus) can be effectively treated after the recognition of this pathological mechanism. This is the first description of such a pathologic state. Orv Hetil. 2019; 160(38): 1514-1518.


Assuntos
Anafilaxia/tratamento farmacológico , Antialérgicos/uso terapêutico , Antibacterianos/uso terapêutico , Doença de Crohn/complicações , Imunoglobulina E/sangue , Imunossupressores/uso terapêutico , Staphylococcus , Anafilaxia/diagnóstico , Anafilaxia/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Resultado do Tratamento
18.
J Vet Med Sci ; 81(10): 1522-1526, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31406035

RESUMO

A 10-year-old male castrated Maltese was referred with clinical signs of hematuria, stranguria, and pollakiuria. The dog was diagnosed with sterile hemorrhagic cystitis with urethroliths and cystoliths. To remove the uroliths, the dog underwent retrograde urohydropropulsion followed by a cystotomy. The following day, persistent bleeding in the urinary bladder was identified with large hematoma, hematuria and anemia. In order to reduce bleeding, the dog received 10 mg/kg of tranexamic acid (TXA) intravenously. Immediately after TXA administration, the dog developed anaphylactic shock manifested by hypotension, hypothermia, tachycardia and a dull mentation. Thus, an emergency treatment including bolus injection of crystalloid, administration of dexamethasone and diphenhydramine, and oxygen supplementation was given, after which the dog quickly recovered within a few minutes.


Assuntos
Anafilaxia/veterinária , Cistite/veterinária , Doenças do Cão/tratamento farmacológico , Hematúria/veterinária , Hemorragia/veterinária , Ácido Tranexâmico/efeitos adversos , Urolitíase/veterinária , Anafilaxia/induzido quimicamente , Anafilaxia/tratamento farmacológico , Animais , Cistite/diagnóstico , Cistotomia , Cães , Hematúria/tratamento farmacológico , Hemorragia/tratamento farmacológico , Masculino , Ácido Tranexâmico/uso terapêutico , Urolitíase/diagnóstico , Urolitíase/cirurgia
19.
Pediatr Clin North Am ; 66(5): 995-1005, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31466687

RESUMO

Anaphylaxis is an acute, potentially life-threatening systemic hypersensitivity reaction. Classically, anaphylaxis is an immunoglobulin (Ig) E-mediated reaction; however, IgG or immune complex complement-related immunologic reactions that lead to degranulation of mast cells can also cause anaphylaxis. Food allergy is the most common cause of anaphylaxis, followed by drugs. Patients with anaphylaxis commonly present with symptoms involving skin or mucous membranes, followed by respiratory and gastrointestinal symptoms. Epinephrine is the drug of choice for treating anaphylaxis. Patients and caregivers should be educated on the use of epinephrine autoinjectors with periodic review of symptoms and emergency action plan for anaphylaxis.


Assuntos
Anafilaxia/diagnóstico , Anafilaxia/tratamento farmacológico , Anafilaxia/etiologia , Epinefrina/uso terapêutico , Adolescente , Criança , Hipersensibilidade a Drogas/complicações , Hipersensibilidade Alimentar/complicações , Humanos
20.
Rural Remote Health ; 19(3): 5163, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31421666

RESUMO

Nycticebus spp, commonly known as the slow lorus, is a small nocturnal primate found mainly in Asia. The adult slow loris weighs between 265 g and 1150 g depending on the type of species. It has a characteristic round head with large, forward-facing eyes. Slow lorises are known for their poisonous bite and are the only venomous primates. To date, there have been two published cases of slow loris bite in humans. This case report illustrates a case of anaphylactic shock following a bite of a wild Kayan slow loris (Nycticebus kayan) to a young man at Mulu District, in a remote area of Sarawak, Malaysian Borneo. The patient developed dyspnoea, a feeling of suffocation, swollen lips and cramp-like sensations over both hands. He subsequently developed syncope and hypotension. The patient was clinically stable following intramuscular injection of adrenaline 0.5 mg stat dose.


Assuntos
Anafilaxia/tratamento farmacológico , Anafilaxia/etiologia , Mordeduras e Picadas/complicações , Epinefrina/administração & dosagem , Epinefrina/uso terapêutico , Lorisidae , Adulto , Animais , Bornéu , Humanos , Injeções Intramusculares , Masculino , Resultado do Tratamento , Adulto Jovem
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