Assuntos
Alérgenos/uso terapêutico , Dessensibilização Imunológica/métodos , Hipersensibilidade ao Látex/terapia , Borracha/uso terapêutico , Administração Sublingual , Alérgenos/imunologia , Criança , Seguimentos , Humanos , Imunoglobulina E/sangue , Hipersensibilidade ao Látex/sangue , Hipersensibilidade ao Látex/imunologia , Masculino , Testes Cutâneos , Resultado do TratamentoAssuntos
Adenocarcinoma Bronquioloalveolar/complicações , Anticoagulantes/efeitos adversos , Neoplasias da Mama/complicações , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade Tardia/diagnóstico , Neoplasias Pulmonares/complicações , Polissacarídeos/efeitos adversos , Veia Cava Superior , Trombose Venosa/tratamento farmacológico , Corticosteroides/uso terapêutico , Anticoagulantes/uso terapêutico , Hipersensibilidade a Drogas/tratamento farmacológico , Hipersensibilidade a Drogas/etiologia , Enoxaparina/efeitos adversos , Enoxaparina/uso terapêutico , Feminino , Fondaparinux , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Hipersensibilidade Tardia/tratamento farmacológico , Hipersensibilidade Tardia/etiologia , Pessoa de Meia-Idade , Nadroparina/efeitos adversos , Nadroparina/uso terapêutico , Testes do Emplastro , Polissacarídeos/uso terapêutico , Resultado do Tratamento , Trombose Venosa/etiologiaRESUMO
The multiple drug intolerance syndrome is a clinical entity characterized by adverse drug reactions to at least three drugs, chemically, pharmacologically and immunogenically unrelated, manifested upon three different occasions, and with negative allergy testing. Symptoms referred by the patients are often subjective, of neurovegetative origin. The aim of the study is to characterize patients suffering from the multiple drug intolerance syndrome from a psychological point of view, and to compare them to healthy subjects. We studied 30 women suffering from the multiple drug intolerance syndrome. All subjects underwent the following psychodiagnostic tests: (1) the State Trait Anxiety Inventory-Form Y, (2) the Zung Self-rating Anxiety Scale, (3) the Zung Self-rating Depression Scale, (4) the Quality of life enjoyment and satisfaction questionnaire, (5) the Minnesota Multiphasic Inventory-2, (6) the Toronto Alexithymia Scale. The study group was compared to 30 healthy women. When compared with the control group, our patients showed: a higher anxiety, a higher grade of depression, this difference was statistically significant (p < 0.01); a high difference (p < 0.01) between the two groups as regards somatic symptoms; a higher grade of alexithymia (p < 0.01); and a worse quality of life, in all the analyzed ambits. These findings clearly demonstrate the importance of psychological symptoms in patients with the multiple drug intolerance syndrome, and show that a complex allergy and psychological work-up is mandatory in the management of these patients.
Assuntos
Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/psicologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Estudos de Casos e Controles , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Hipersensibilidade a Drogas/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Análise Multivariada , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Psicologia , Valores de Referência , Medição de Risco , Síndrome , Adulto JovemRESUMO
OBJECTIVE: We present the case of a woman with 'empty sella syndrome' who experienced generalized urticaria after the administration of sodium succinate hydrocortisone in two episodes. METHODS: The patient underwent an allergological evaluation (prick, intradermal, and patch tests) with hydrocortisone sodium succinate, hydrocortisone acetate, hydrocortisone, hydrocortisone sodium phosphate, methylprednisolone hemisuccinate, methylprednisolone, and preservatives held in the formulation of sodium succinate hydrocortisone (sodium phosphate and methyl-p-oxybenzoate). The basophil activation test (BAT) was also performed with hydrocortisone. The single-blind i.m. challenge test was performed with hydrocortisone sodium phosphate in 4 days. RESULTS: Skin test with hydrocortisone sodium succinate and methylprednisolone hemisuccinate was positive. On the contrary, allergological tests performed with other formulations of the same steroids and preservatives were negative. These results showed an immediate-type allergy to succinate ester. BAT was not helpful to improve our diagnostic work-up because our patient was a 'nonresponder.' Therefore, the patient underwent successfully to a challenge test with hydrocortisone sodium phosphate. CONCLUSIONS: Patients with succinate ester allergy can tolerate alternative corticosteroids without ester.
Assuntos
Toxidermias/diagnóstico , Síndrome da Sela Vazia/tratamento farmacológico , Hidrocortisona/análogos & derivados , Hipersensibilidade Imediata/diagnóstico , Urticária/induzido quimicamente , Antialérgicos/uso terapêutico , Betametasona/uso terapêutico , Toxidermias/complicações , Toxidermias/tratamento farmacológico , Tratamento de Emergência/métodos , Síndrome da Sela Vazia/complicações , Feminino , Humanos , Hidrocortisona/administração & dosagem , Hidrocortisona/efeitos adversos , Hidrocortisona/imunologia , Hipersensibilidade Imediata/induzido quimicamente , Hipersensibilidade Imediata/complicações , Hipersensibilidade Imediata/tratamento farmacológico , Infusões Intravenosas , Pessoa de Meia-Idade , Testes Cutâneos , Urticária/tratamento farmacológicoAssuntos
Antibacterianos/efeitos adversos , Carbapenêmicos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Adulto , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/patologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/patologia , Eczema/induzido quimicamente , Eczema/diagnóstico , Eczema/patologia , Feminino , Humanos , Enfermeiras e Enfermeiros , Exposição OcupacionalRESUMO
Food allergy is a matter of concern because it affects about 0.5-3.8% of the paediatric population and 0.1-1% of adults, and as well may cause life-threatening reactions. Skin prick testing with food extracts and with fresh foods, the measurement of food-specific IgE, elimination diets and a double-blind, placebo-controlled food challenge are the main diagnostic procedures; many non-validated procedures are available, creating confusion among patients and physicians. The treatment of food allergy is still a matter of debate. Antihistamines, corticosteroids and, if necessary (in case of anaphylaxis), epinephrine, are the drugs of choice for the treatment of symptoms of food allergy. Sodium cromolyn may be used prophylactically even though there are no controlled studies certifying its efficacy. The only etiologic treatment of food allergy is specific desensitization. Sublingual-oral-specific desensitization has been used by our group for the treatment of food-allergic patients with a high percentage of success.