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1.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(8): 650-654, oct. 2020.
Artigo em Espanhol | IBECS | ID: ibc-190839

RESUMO

Con el progresivo control de la pandemia por SARS-CoV-2, los miembros del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC) realizan una propuesta sobre cuáles van a ser los requisitos, las limitaciones y los condicionantes para reanudar el servicio en las unidades de dermatitis de contacto en un escenario en el que se presume la persistencia del virus, con episodios ocasionales o estacionales de exacerbación. Se aconseja ajustar el número de pruebas epicutáneas (PE) a las posibilidades de cada centro y la revisión de los casos en lista de espera para priorizar a los pacientes en función de la gravedad y la urgencia. Se ofrecerán, si es factible, métodos telemáticos para los documentos relativos a las PE (información, pautas, documentos de consentimiento informado). De estar disponible, puede ofrecerse la opción de realizar una primera visita telemática. Igualmente, en pacientes seleccionados puede llevarse a cabo una televisita en las visitas de lectura a través de imágenes realizadas por el paciente o mediante una videovisita que permita visualizar el resultado de la exploración. Estas acciones permitirán reducir el número de visitas presenciales, aunque no el tiempo dedicado y asignado al facultativo para los actos médicos. Todas estas recomendaciones son sugerencias y se adaptarán a los requisitos y a las posibilidades de cada centro sanitario


As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus 2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias , Dermatite Alérgica de Contato/diagnóstico , Testes Cutâneos/normas , Dermatologia/normas , Teledermatologia , Espanha
2.
Artigo em Inglês | MEDLINE | ID: mdl-33027391

RESUMO

Asymptomatic VL is a concern, considering the risk of transmission in highly endemic areas due to human-to-human transmission. The aim of this study was to report the sero-epidemiological prevalence in Bihar, India, a highly endemic area of VL, using the leishmanin skin test (LST) and the direct agglutination test (DAT). This was a cross-sectional study performed in Muzaffarpur, Bihar, India. Relatives of patients with VL were tested by LST and DAT. Other epidemiological data were evaluated and correlated with tests results. Forty individuals (either previous or current patients), and 109 household contacts were studied. There were 36% of male visceral leishmaniasis family members versus 17.57% of females visceral leishmaniasis family members, thus showing more males with symptomatic disease than females (p< 0.01). All visceral leishmaniasis cases had positive DAT tests, but only 37% of past cases were positive on the skin testing. Amongst healthy household contacts, 34% were DAT-positive, whilst 21% were LST-positive. The overall positivity for both assays combined was 44.8% and 23.8% were DAT-positive alone. The finding of high infection prevalence amongst asymptomatic individuals, and the estimation of those at greater risk for overt disease (DAT-positive alone) are important in the development of future disease control policies.


Assuntos
Leishmania/classificação , Leishmania/isolamento & purificação , Leishmaniose Visceral/diagnóstico , Testes Cutâneos/métodos , Teste de Coombs , Estudos Transversais , Feminino , Humanos , Índia , Leishmania/imunologia , Leishmaniose Visceral/imunologia , Masculino
3.
S Afr Med J ; 110(7): 686-690, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32880348

RESUMO

BACKGROUND: Allergy is a common health problem in South Africa (SA), and a rational approach to allergy testing is essential to ensure cost-effective as well as optimal patient diagnosis and management. OBJECTIVES: To review allergy testing data with respect to current national testing recommendations, and to explore the regional variations in sensitisation. METHODS: Retrospective data review on allergy testing from a private pathology provider in SA over a 2-year period. Data on skin-prick testing (SPT) and allergen-specific IgE testing originating from all the provinces of SA were collected and analysed with regards to allergen positivity rate and regional sensitisation patterns. RESULTS: Among the patients (N=45 0320) tested for a suspected inhalant allergy, 46% tested positive. Only 45% of these received additional testing for the nine recommended inhalant allergens included in the current national testing protocol. Among the patients (N=6 775) who received SPT for a suspected inhalant allergy, 59% yielded one or more positive results. The most frequent sensitising allergens were house dust mite (Dermatophagoides pteronyssinus) and grass pollen. The house dust mite, Blomia tropicalis, was a significant sensitiser in coastal regions. SPT identified two other important regional allergens which are not included in the current recommendations for inhalant allergen-specific IgE testing. CONCLUSIONS: The current diagnostic recommendations include allergens that demonstrate significant sensitisation in all regions of SA. Two additional allergens that show significant regional sensitisation in the South African population were identified. These findings may aid the recommendations for the most appropriate and cost-effective approach to allergy testing of symptomatic patients in SA.


Assuntos
Hipersensibilidade/epidemiologia , Alérgenos/imunologia , Animais , Humanos , Imunoglobulina E/sangue , Pólen/imunologia , Pyroglyphidae/imunologia , Estudos Retrospectivos , Testes Cutâneos , África do Sul/epidemiologia
4.
Artigo em Chinês | MEDLINE | ID: mdl-32842222

RESUMO

Objective:To investigate the distribution of allergens in patients with allergic rhinitis(AR) in Rikaze. Method:A retrospective analysis was performed in patients with AR diagnosed by skin prick test (SPT) between June 2017 and June 2018 from Rikaze People's Hospital. Result:One hundred and thirty-one patients were diagnosed with AR using SPT. The most common inhalant allergens were pollen, including Artemisia sieversiana willd(64.8%), Artemisia annua L. (64.1%) and Humulus Scandens(45.8%), while soybean(17.6%), mango(15.3%) and carp(12.2%) were the most common food allergens. Conclusion:The most common inhalant allergens in patients with AR is the pollen in Rikaze area.


Assuntos
Alérgenos , Rinite Alérgica , Humanos , Pólen/imunologia , Estudos Retrospectivos , Testes Cutâneos
5.
PLoS Negl Trop Dis ; 14(8): e0008550, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32841284

RESUMO

BACKGROUND: Leishmanin Skin Test (LST) is considered as a useful indicator of past infection by Leishmania parasites. However, the temporal dynamics of a positive LST under different epidemiologic scenarios and whether it relates to the protection against the recurrence of an overt disease are not fully documented. METHODOLOGY/PRINCIPAL FINDINGS: We report here on a population based prospective study conducted on 2686 individuals living in two foci located in Central Tunisia, to assess over a one-year epidemiologic season, the incidence of Leishmania (L.) major infection and disease and changes in LST reactivity. The two foci were both endemic for Cutaneous Leishmaniasis (CL) due to L. major, but contrasted in their history for this disease (ie: an old focus versus a recent focus). We found that most infections occurred in the new focus (290/1000; 95% CI: 265-315 person-years) with an incidence rate of CL lesions 2.4 times higher than in the old focus. Likewise, the rates of LST reactivity reversion and loss, in the new focus, were 99/1000[38-116] person-years and 14/1000[8-21] person-years, respectively. Loss of LST reactivity was not noticed in the old focus. Interestingly, the incidence rates of symptomatic infection did not differ significantly according to the LST status at enrolment (negative versus positive) between the combined foci and the new one. CONCLUSIONS/SIGNIFICANCE: Our findings confirm LST as a good tool for assessing L. major cryptic infection. However, the instability of the LST positivity in new foci should be considered as an important confounder of the outcome of this infection when developing a research protocol for vaccine trial.


Assuntos
Leishmania major/imunologia , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/imunologia , Testes Cutâneos/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tunísia/epidemiologia , Adulto Jovem
6.
Georgian Med News ; (302): 76-81, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32672694

RESUMO

Objective was to study and compare the parameters of the specificity and sensitivity of skin testing and serologic determination of specific cat and dog IgE. 88 patients with allergic rhinitis and / or asthma were examined by three different methods of specific allergic diagnosis (in vivo and in vitro) in accordance with the guidelines of the ethics committee of the National Pirogov memorial medical university, all were beyond the acute period. The inclusion criteria were allergic rhinitis diagnosis (both intermittent and persistent) and \ or asthma. Skin prick test was carried out according to the classical testing procedure in accordance with regulatory documents with commercial extracts of allergens. Western blot testing for specific IgE levels was performed using RIDA qLine test systems (R-Biopharm AG, Darmstadt, Germany) and Euroline (Euroimmun). The sIgE concentration was converted to a nominal scale (grades) according to the following rules: < 0.35 IU mL-1-level 0 (negative), (0.36-0.69) IU mL-1-level 1 (boundary levels ), (0.7- 3.49) IU mL-1-level 2 (slightly elevated), (3.50-17.4) IU mL-1-level 3 (moderately elevated), (17.5-49 , 9) IU mL-1-level 4 (high levels), (50-100) IU mL-1-level 5 (very high levels) and > 100 IU mL-1-level 6 (extremely high levels). Thus, the results of the two systems for the determination of specific IgE for dog allergen by the Rida AllergyScreen and Euroline methods do not agree very well due to the systematic divergence of indicators; the results of the two systems for the determination of specific IgE for cat allergen by the Rida AllergyScreen and Euroline methods agree very well. There is excellent agreement between the skin test with cat allergen and the detection of specific IgE by the Rida AllergyScreen test, between the skin test with cat allergen and the detection of specific IgE by the Euroline method. There is good agreement between the skin test with dog wool allergens and the detection of specific IgE by the Rida AllergyScreen test, between the skin test with dog hair allergen and the detection of specific IgE by the Euroline method there is satisfactory agreement. The systematic error of the measurement results between two in vitro tests for cat allergen was 0.1 ku/l, which indicates the presence of a small systematic difference, the systematic error of the measurement results between two in vitro tests for dog allergen was 0,26 ku/l, which indicates the presence of a moderate systematic difference.


Assuntos
Asma , Rinite Alérgica , Alérgenos , Animais , Ensaio de Imunoadsorção Enzimática , Alemanha , Humanos , Imunoglobulina E , Testes Cutâneos
7.
Lancet Child Adolesc Health ; 4(10): 728-739, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32702315

RESUMO

BACKGROUND: Peanut allergy is the leading cause of food-related anaphylaxis. Current management options can negatively affect food allergy-related quality of life. We aimed to investigate the efficacy of an investigational oral biologic drug (AR101). METHODS: The AR101 Trial in Europe Measuring Oral Immunotherapy Success in peanut-allergic children (ARTEMIS) trial was a multicentre, double-blind, randomised, placebo-controlled phase 3 trial done at 18 hospitals in Ireland, France, Germany, Italy, Spain, Sweden, and the UK. Children and adolescents with peanut allergy, aged 4-17 years, who developed dose-limiting symptoms to 300 mg or less peanut protein (equivalent to approximately one peanut kernel) during a double-blind placebo-controlled food challenge test at study entry were enrolled. Participants were randomly assigned (3:1) to receive daily doses of either AR101 oral immunotherapy (AR101 group) or a taste-masked placebo (placebo group). All participants, investigators, and care providers were masked to treatment allocation until the study was completed. Doses were increased every 2 weeks over 6 months until a dose of 300 mg was reached and maintained for 3 months. The primary endpoint was the proportion of participants in the intention-to-treat or safety population (defined as those participants who had been randomly assigned and had received at least one dose of the assigned drug) who could consume a single dose of 1000 mg (cumulative dose 2043 mg) peanut protein without developing dose-limiting allergic symptoms at an exit double-blind placebo-controlled food challenge after 9 months of treatment. Additional endpoints included safety (ie, the frequency and severity of adverse events) and changes in food allergy-related quality of life, assessed by use of age-appropriate Food Allergy Quality of Life Questionnaires (FAQLQs) and the Food Allergy Independent Measure (FAIM). The study is registered with ClinicalTrials.gov, NCT03201003, and is completed. FINDINGS: Between June 12, 2017, and Feb 15, 2018, 227 patients were screened, of whom 175 were randomly assigned to the AR101 group (n=132) and the placebo group (n=43). All primary and secondary endpoints were met. 77 (58%) of 132 participants in the AR101 group tolerated 1000 mg peanut protein at the exit food challenge versus one (2%) of 43 participants in the placebo group (AR101-placebo treatment difference 56·0% [95% CI 44·1-65·2], p<0·0001). Adverse events were reported by almost all participants. The maximum severity of adverse events reported was mild or moderate for most participants who received AR101 (mild, 66 [50%] of 132 participants; moderate, 63 [48%]; and severe, one [1%]) or placebo (mild, 24 [56%] of 43 participants; moderate, 18 [42%]; severe, none). Participants aged 8-12 years in the AR101 group reported improvements that exceeded the minimum clinically important difference between the two groups across all FAQLQ domains. Additionally, participants in the AR101 group and their caregivers reported improvements that exceeded the minimum clinically important difference in FAIM domains related to the perceived likelihood and outcomes of a severe allergic reaction. INTERPRETATION: AR101 oral immunotherapy treatment led to rapid desensitisation to peanut protein, with a predictable safety profile that improved with treatment, and an associated improvement in self-reported and caregiver-reported food allergy-related quality of life. These patient-oriented outcomes provide invaluable data to help physicians, patients, and caregivers make informed, shared decisions on the management of peanut allergy. FUNDING: Aimmune Therapeutics.


Assuntos
Alérgenos/administração & dosagem , Produtos Biológicos/administração & dosagem , Dessensibilização Imunológica/métodos , Hipersensibilidade a Amendoim/terapia , Administração Oral , Adolescente , Criança , Pré-Escolar , Relação Dose-Resposta Imunológica , Método Duplo-Cego , Europa (Continente) , Feminino , Humanos , Masculino , Hipersensibilidade a Amendoim/imunologia , Testes Cutâneos , Resultado do Tratamento
8.
PLoS One ; 15(7): e0234633, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649729

RESUMO

BACKGROUND: Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America. OBJECTIVE: To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca. METHODS: A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression. RESULTS: Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67). CONCLUSIONS: A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children.


Assuntos
Asma/epidemiologia , Eczema/epidemiologia , Rinite/epidemiologia , Alérgenos , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Prevalência , Fatores de Risco , Testes Cutâneos , Inquéritos e Questionários
9.
Lancet Child Adolesc Health ; 4(7): 526-535, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32562634

RESUMO

Peanut allergy is an important public health concern and causes substantial psychosocial comorbidity. Although fatal anaphylaxis is rare (occurring at 0·03-0·3 per million person-years in the general population), peanuts are one of the most frequent causes of food allergy mortality. The Learning Early About Peanut study transformed prevention of peanut allergy by showing that early introduction of peanut into the diet of children at high risk (ie, those with an egg allergy or severe eczema) reduced the relative risk of peanut allergy at age 5 years by 81%. Following publication of this study, the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, convened an expert panel, which recommended that, for infants with severe eczema or egg allergy, health professionals should strongly consider evaluation with peanut-specific serological IgE or skin prick test (or both) and, if necessary, an oral food challenge before peanut introduction. In the USA, depending on test results, peanut-containing foods are recommended to be introduced from age 4-6 months in infants with severe eczema or egg allergy. Early introduction to peanuts is also advocated for children with either mild to moderate or no eczema, and in children who are not allergic to egg, but without screening before peanut introduction. However, the NIAID addendum guidelines contrast with other international approaches that do not advocate for allergy screening at a population level before introducing peanuts into infants' diets. In this Review, we evaluate the advantages and disadvantages of a pre-emptive screening approach before the early introduction of peanuts in infants at high risk of peanut allergy.


Assuntos
Hipersensibilidade a Amendoim/diagnóstico , Alérgenos/administração & dosagem , Alérgenos/imunologia , Dessensibilização Imunológica/métodos , Eczema/complicações , Hipersensibilidade a Ovo/complicações , Humanos , Imunoglobulina E/sangue , Lactente , Hipersensibilidade a Amendoim/prevenção & controle , Guias de Prática Clínica como Assunto , Testes Cutâneos , Desmame
10.
PLoS One ; 15(6): e0233707, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484810

RESUMO

Royal jelly (RJ), a creamy substance secreted by honeybees, is the exclusive diet for queen bee differentiation and life maintenance. RJ has been used in cosmetics, beverages, medicines, and supplements worldwide. However, allergy is a concerning issue for RJ, especially in atopic dermatitis (AD) and asthma patients. In some cases, allergic reactions are seen after the first intake of RJ, suggesting the existence of allergens cross-reactive with RJ. Information about the cross-reactive allergens is very important for the safe application of RJ; however, study of this cross-reactivity is quite limited. In this study, we attempted to identify allergens cross-reactive with RJ by using serum samples from 30 AD patients who had never been exposed to RJ. In an enzyme-linked immunosorbent assay (ELISA) experiment, RJ-binding IgE antibodies were detected in the serum of 10 out of 30 patients, and their antibody titers ranged from 4- to 2,048-fold dilution ratios. Additionally, 3 AD patients were determined to be positive in a skin-prick test (SPT) with an RJ solution. Significant correlations were observed between the anti-RJ antibody titer and nonspecific IgE and between the anti-RJ antibody titer and the Eczema Area and Severity Index score. We further examined the cross-reactivity between RJ and 14 typical allergens by using an ELISA-inhibition assay and demonstrated that the following 6 allergens showed cross-reactivity with RJ: the European house dust mite (HDM) (Dermatophagoides pteronyssinus), American HDM (Dermatophagoides farinae), snow crab (Chionocetes spp.), edible crab (Cancer pagurus), German cockroach (Blatella germanica), and honeybee venom (Apis mellifera). In conclusion, people with a history of allergic diseases, including AD, asthma, and allergic rhinitis, should be cautioned against consuming RJ products because of the potential for cross-reactive responses to ensure the safe and successful use of RJ supplements.


Assuntos
Alérgenos/imunologia , Abelhas/imunologia , Dermatite Atópica/imunologia , Ácidos Graxos/imunologia , Adulto , Animais , Antígenos de Dermatophagoides/imunologia , Venenos de Abelha/imunologia , Blattellidae/imunologia , Braquiúros/imunologia , Reações Cruzadas , Dermatite Atópica/sangue , Dermatite Atópica/diagnóstico , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Frutos do Mar , Testes Cutâneos , Adulto Jovem
12.
Vet Res Commun ; 44(3-4): 131-136, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32583301

RESUMO

Post-mortem surveillance in Ireland discloses skin-test negative cattle with presumptive evidence of infection of Mycobacterium bovis (lesions at routine slaughter (LRS)), the causative agent of bovine tuberculosis (bTB). Laboratory confirmation of lesions has impacts on trade restrictions for herds, therefore if laboratory capacity was diminished, how herds are treated would require an informed risk policy. Here we report the proportion of herds with subsequent evidence of within-herd transmission, based on skin-test results. We assess how herd-size, herd-type, and bTB-history affect the probability of additional reactors at follow-up test using univariable and multivariable random-effects models. The study represents a rapid response to developing an evidential base for policy demands during an extraordinary event, the COVID-19 epidemic in Ireland. A dataset from 2005 to 2019 of breakdowns were collated. Overall, 20,116 breakdowns were initiated by LRS cases. During the index tests of these breakdowns, 3931 revealed ≥1 skin-test reactor animals (19.54%; ≥1 standard reactors: 3827; 19.02%). Increasing herd-size was associated with reactor disclosure on follow-up. For small herds (<33 animals), 11.74% of follow-up tests disclosed ≥1 reactor; 24.63% of follow-up tests from very large herds (>137) disclosed ≥1 reactors. Beef (13.87%) and "other" (13%) herd production types had lower proportion of index tests with reactors in comparison with dairy (28.27%) or suckler (20.48%) herds. Historic breakdown size during the previous 3-years was associated reactor disclosure risk on follow-up. Our results are useful for rapid tailored policy development aimed at identifying higher risk herds.


Assuntos
Tuberculose Bovina/epidemiologia , Matadouros , Animais , Bovinos , Irlanda/epidemiologia , Mycobacterium bovis , Vigilância da População , Probabilidade , Testes Cutâneos/veterinária , Tuberculose Bovina/diagnóstico
13.
Allergol. immunopatol ; 48(3): 232-236, mayo-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192024

RESUMO

BACKGROUND: China and Spain are world leaders in the consumption of edible bulbs (garlic and onion), but there are few references to their capacity to cause allergic symptoms. The target was to study allergic sensitization and clinical symptoms associated with garlic and onion consumption in a large sample of allergic patients. METHODS: An observational cross-sectional study was conducted, testing garlic and onion extracts in 8109 patients of all ages seen by our allergy clinic in 2018. Forty-four aeroallergens and foods were tested, including garlic and onion, with prick test and determination of specific IgE. Oral provocation and contact tests were performed if a delayed reaction was suspected. Western Blot was performed in the serum of patients positive to garlic and onion. RESULTS: We conducted 356,798 skin tests and 4254 specific IgE determinations. Of the 8109 patients tested, 2508 (30.92%) presented with symptoms associated with food intake and, in these patients, food hypersensitivity was detected by skin test, positive specific IgE or provocation in 924 patients, and was caused by garlic or onions in 27, indicating a prevalence of 2.92%. Immunodetection showed an association between the symptoms and a specific LTP to these bulbs, without cross-reactivity with other LTPs in the Mediterranean diet (peach, wheat). CONCLUSIONS: Allergic hypersensitivity to garlic and onions should not be underestimated and, given their high consumption, should be included in the diagnostic food allergy battery


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Hipersensibilidade Alimentar/diagnóstico , Alho/imunologia , Imunoglobulina E/sangue , Cebolas/imunologia , Hipersensibilidade Alimentar/imunologia , Testes Cutâneos , Teste de Radioalergoadsorção , Estudos Transversais , Western Blotting
14.
Allergol. immunopatol ; 48(3): 244-250, mayo-jun. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-192026

RESUMO

INTRODUCTION AND OBJECTIVES: Eosinophilic esophagitis (EoE) is frequently miss-diagnosed or overlooked for several years because of the invasiveness of investigations and the non-specificity of symptoms in childhood. Due to the lack of specific recommendations in children, its management remains very heterogeneous, especially concerning allergy testing. The aim of this study is to analyze our population and practices, in comparison with the literature, with a focus on allergic management, to harmonize and optimize our practice. MATERIAL AND METHODS: We included all children with a diagnosis of EoE at the Hospital Femme Mere Enfant, Bron, France. Data were collected via retrospective chart review. RESULTS: 108 patients were included with an average age of 9.5 years. Average delay before diagnosis was 6.65 years. Symptoms varied with age, with a predominance of vomiting (60% of patients), feeding difficulties (72%) and growth difficulties (24%) in children < 5 years, whereas older children often presented with feeding blockage (64%) and dysphagia (61%). Cough was frequent in our cohort (18.5%), especially in children < 10 years (38.5% between three and five years). The allergic background was frequent (70.3%) and 80% of our patients benefited from allergy testing. Allergy testing was particularly useful to guide therapy as elimination diet represented an effective treatment in 60% of our patients CONCLUSIONS: Allergy testing has to be harmonized to include major allergens (egg, milk, peanut, fish, wheat, and soy), including prick and patch tests. Allergy-testing based diet seemed to be the best compromise between efficiency and constraints, especially in mono-sensitized patients


No disponible


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Esofagite Eosinofílica/imunologia , Esofagite Eosinofílica/diagnóstico , Técnicas Imunológicas , Estudos Retrospectivos , Hipersensibilidade/diagnóstico , Esofagite Eosinofílica/complicações , Hipersensibilidade Alimentar/diagnóstico , Rinite Alérgica/diagnóstico , Dermatite Atópica/diagnóstico , Endoscopia , Imunoglobulina E/análise , Testes Cutâneos
15.
Allergol. immunopatol ; 48(3): 251-258, mayo-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192027

RESUMO

INTRODUCTION AND OBJECTIVES: Allergy to galactose-α-1,3-galactose (alpha-gal) is a peculiar form of food allergy generally manifesting as an anaphylactic reaction hours after mammalian meat consumption, due to the presence of specific IgE against this oligosaccharide. In addition, immediate anaphylaxis may develop after exposure to other sources of alpha-gal, such as monoclonal antibody cetuximab, vaccines, plasma expanders or anti-snake venoms. Sensitization to alpha-gal has also been implicated in the rapid degeneration of biological valve implants, and recognized as a cause of occupational disease in cattle raisers. The implication of tick bites in this type of sensitization has been accepted by all the research groups dedicated to this disease. PATIENTS AND METHOD: The present study describes the clinical and sensitization characteristics of 39 patients diagnosed with alpha-gal allergy in the hospitals of our province (Lugo, Monforte de Lemos and Burela, Spain). RESULTS: Most patients were middle-age males. Of note, is the fact that the series includes the first pediatric patient reported in Spain to date. The predominant clinical manifestations were urticaria or delayed anaphylaxis after consumption of mammalian meat. Seventy-four percent of the patients reported having suffered a previous tick bite, and the clinical presentation of anaphylaxis was significantly more prevalent in those with a persistent local reaction following the bite than in those with no such reaction (p = 0.032). CONCLUSIONS: A review is also made of the disorder which, due to its variable clinical expression, is referred to as alpha-gal syndrome. The study concludes that a diagnosis of alpha-gal allergy should be considered in patients with urticaria-anaphylaxis of uncertain origin or manifesting after the administration of vaccines or products of bovine/porcine origin


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Galactose/imunologia , Hipersensibilidade Alimentar/imunologia , Alérgenos/imunologia , Hipersensibilidade Alimentar/diagnóstico , Galactose/efeitos adversos , Hipersensibilidade Tardia/imunologia , Espanha , Imunoglobulina E/imunologia , Anafilaxia/imunologia , Testes Cutâneos , Anticorpos Monoclonais/imunologia
16.
Allergol. immunopatol ; 48(3): 265-269, mayo-jun. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-192029

RESUMO

INTRODUCTION AND OBJECTIVES: A high rate of cross-reactivity has been reported between the specific proteins of hen's egg with proteins of various avian eggs by quantitative immunoelectrophoretic techniques. The aim of this study was to assess the clinical cross-reactivity of different birds' eggs in children with hen's egg allergy based on skin prick test results. MATERIAL AND METHODS: This cross-sectional study enrolled 52 infants with hen's egg allergy and 52 healthy infants with no history of food allergy from October 2018 to April 2019. Skin prick tests were performed in both patient and control groups with fresh extract of white and yolk related to pigeon, duck, goose, turkey, quail, and partridge. RESULTS: Fifty (96.1%) children with hen's egg allergy showed positive sensitization to at least one of the avian eggs. The most frequent positive skin tests were related to quail's white (36 = 69.2%) followed by duck's white (34 = 65.5%), and sensitization was the least frequent in pigeon's yolk (23 = 44.2%). Skin tests of the control group were negative to all the tested extracts. CONCLUSIÓN: Because of fewer sensitizations to some avian eggs, further research should clarify starting oral immunotherapy with the yolk of goose and pigeon in children with hen's egg allergy


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Proteínas do Ovo/imunologia , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade a Ovo/imunologia , Apresentação Cruzada/imunologia , Alérgenos/análise , Hipersensibilidade a Ovo/diagnóstico , Testes Cutâneos/métodos , Estudos Transversais , Imunoterapia/métodos , Inquéritos e Questionários
17.
Allergol. immunopatol ; 48(3): 281-289, mayo-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192031

RESUMO

INTRODUCTION AND OBJECTIVES: In Africa, few studies of sensitisation profiles have been performed in children or adolescents and, in Angola, there are none. The objectives of the present study were to assess the sensitisation profile of Angolan schoolchildren and to determine the relationship between that pattern, sociodemographic factors, asthma and other allergic diseases. MATERIALS AND METHODS: Cross-sectional, observational study in 5-14-year-old children, performed between September and November 2017, in the Province of Bengo, Angola. Five schools (15%) were randomly selected in the geographical area of the study: three from an urban area, and two from a rural area. Data were collected using the Portuguese versions of the ISAAC questionnaires for children and adolescents, regarding asthma, rhinitis and eczema. Skin prick tests (SPT) were performed with a battery of 12 aeroallergens. Stools were assessed for the presence of helminths. Descriptive statistics were used, as well as univariate calculation of odds ratios. RESULTS: Sensitisation to aeroallergens was low (8%) and most sensitised children were asymptomatic. Most frequent sensitisations involved house dust mites, cockroach or fungi, and a high proportion of children (78.1%) were monosensitised. No relationship was detected between sensitisations and asthma, rhinitis or eczema. Place of residence, gender, age or helminthic infection did not affect the probability of having positive SPTs. CONCLUSIONS: The most frequent sensitisations in children from Bengo Province in Angola involve house dust mites, followed by cockroach and fungi. No relationship was found between atopic sensitisation and asthma or other allergic diseases


No disponible


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Imunização/métodos , Alérgenos/imunologia , Asma/epidemiologia , Hipersensibilidade/epidemiologia , Estudos Transversais , Angola/epidemiologia , Doenças Respiratórias/imunologia , Razão de Chances , Testes Cutâneos , Dermatite Atópica/epidemiologia
18.
JAMA Netw Open ; 3(5): e204199, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32374398

RESUMO

Importance: Allergy to ß-lactam antibiotics is one of the most frequently reported drug reactions, but epidemiological data in Chinese populations are lacking. Ethnic- and region-specific sensitization patterns of skin testing for ß-lactam antibiotic allergy are also unknown. Objective: To identify the prevalence, 1-year incidence, and sensitization patterns of ß-lactam antibiotic allergy in patients in Hong Kong. Design, Setting, and Participants: This cross-sectional study obtained territorywide, anonymized electronic patient data from the Clinical Management Systems of the Hospital Authority, the sole publicly funded health care system in Hong Kong with facilities in 7 regions (Hong Kong East, Hong Kong West, Kowloon Central, Kowloon East, Kowloon West, New Territories East, and New Territories West). All referrals to Queen Mary Hospital for ß-lactam antibiotic allergy testing from January 1, 2018, to December 31, 2019, were also analyzed for sensitization patterns. Main Outcomes and Measures: Prevalence and cumulative incidence of ß-lactam antibiotic allergy reported in Hong Kong, and sensitization patterns according to ß-lactam antibiotic allergy skin testing. Results: Complete records of 7 184 271 unique patients were analyzed, with a men to women ratio of 1:1.2 and with a median age of 44 years. The prevalence of physician-reported ß-lactam antibiotic allergy was 2.0%, and the cumulative incidence was 107 per 100 000 population. Of the 34 402 new drug allergies reported in 2018, 8032 (23.3%) were ß-lactam antibiotic allergies. Three hundred fifty-five patients with reactions suggestive of ß-lactam antibiotic allergy underwent skin testing, and only 49 (13.8%; 95% CI, 10.64%-17.90%) of them had positive test results. Of these 49 patients, 14 (28.6%; 95% CI, 18.35%-44.49%) had selective reaction and 35 (71.4%; 95% CI, 59.84%-85.27%) had nonselective reaction. The sensitization rate to either benzylpenicilloyl polylysine or a minor determinant (benzylpenicilloate) was 47.0% (n = 23; 95% CI, 34.85%-63.21%), with 10 patients monosensitized to benzylpenicilloyl polylysine only (20.4%; 95% CI, 11.74%-35.48%) and 5 to benzylpenicilloate only (10.2%; 95% CI, 4.45%-23.42%). Conclusions and Relevance: Results of this study suggest that patients in Hong Kong with ß-lactam antibiotic allergy had much higher rates of monosensitization to benzylpenicilloyl polylysine and benzylpenicilloate, making these reagents essential in ß-lactam antibiotic skin tests. Such a finding warrants future studies into whether this sensitization is specific to ethnicity or region.


Assuntos
Antibacterianos/efeitos adversos , Hipersensibilidade a Drogas/epidemiologia , beta-Lactamas/efeitos adversos , Adulto , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Demografia , Hipersensibilidade a Drogas/etiologia , Feminino , Hong Kong/epidemiologia , Humanos , Incidência , Masculino , Prevalência , Testes Cutâneos
19.
Arerugi ; 69(3): 209-212, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32435022

RESUMO

A 28-year-old man was transferred to our emergency room for dyspnea and wheals on the entire body. He had eaten landlocked ayu fish (Plecoglossus altivelis) the so-called "koayu fish", from Lake Biwa, and had immediately experienced a stomachache. Wheals and dyspnea developed one hour later and were successfully treated with intravenous corticosteroids. The patient was examined for koayu fish and related allergens by skin prick and allergen-specific immunoglobulin E (IgE) (ImmunoCAP®) tests. Positive skin prick results were obtained for Lake Biwa koayu fish (raw and heated) as well as for standard skin test allergens (prepared by Torii pharmaceuticals) including shrimp, crab, and squid. Negative prick test results were observed for regular ayu fish and other fish such as horse mackerel, sardine, salmon, mackerel, codfish, and tuna. Allergen-specific IgE tests (ImmunoCAP ®) showed positivity for shrimp, crab, ticks, moths, and mosquitoes, while ImmunoCAP® tests were negative for the allergen components rGad c 1 (pollackparvalbumin) and rPen a 1 (shrimp tropomyosin). Moreover, enzyme-linked immunosorbent assay (ELISA) tests were negative for mackerel parvalbumin and collagen. We considered this case to be of anaphylaxis caused by koayu fish from Lake Biwa and speculated that a novel koayu-specific antigen might have been the cause of the condition.


Assuntos
Anafilaxia/etiologia , Hipersensibilidade Alimentar/etiologia , Osmeriformes , Adulto , Animais , Humanos , Japão , Lagos , Masculino , Testes Cutâneos
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