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1.
J Investig Allergol Clin Immunol ; 30(4): 229-253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31932268

RESUMO

BACKGROUND AND OBJECTIVE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a complex multisystemic severe drug hypersensitivity reaction whose diagnosis and management are troublesome. DRESS syndrome requires management by various specialists. The correct identification of the culprit drug is essential to ensure safe future therapeutic options for the patient. There are no previous Spanish guidelines or consensus statements on DRESS syndrome. Objective: To draft a review and guidelines on the clinical diagnosis, allergy work-up, management, treatment, and prevention of DRESS syndrome in light of currently available scientific evidence and the experience of experts from multiple disciplines. METHODS: These guidelines were drafted by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC), together with other medical specialists involved in the management of DRESS syndrome and researchers from the PIELenRed consortium. A review was conducted of scientific papers on DRESS syndrome, and the expert panel evaluated the quality of the evidence of the literature and provided grades of recommendation. Whenever evidence was lacking, a consensus was reached among the experts. RESULTS: The first Spanish guidelines on DRESS syndrome are now being published. Important aspects have been addressed, including practical recommendations about clinical diagnosis, identification of the culprit drug through the Spanish pharmacovigilance system algorithm, and the allergy work-up. Recommendations are provided on management, treatment, and prevention. Algorithms for the management of DRESS in the acute and recovery phases have been drawn up. Expert consensus-based stepwise guidelines for the management and treatment of DRESS syndrome are provided.


Assuntos
Síndrome de Hipersensibilidade a Medicamentos/diagnóstico , Fígado/metabolismo , Pele/patologia , Algoritmos , Alopurinol/efeitos adversos , Antibacterianos/efeitos adversos , Anticonvulsivantes/efeitos adversos , Comorbidade , Consenso , Síndrome de Hipersensibilidade a Medicamentos/tratamento farmacológico , Síndrome de Hipersensibilidade a Medicamentos/epidemiologia , Eosinofilia , Prova Pericial , Humanos , Leucocitose , Fígado/patologia , Fatores de Risco , Espanha/epidemiologia
2.
Clin Exp Allergy ; 28(10): 1286-91, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9824396

RESUMO

BACKGROUND: Cereal flours are used in the wood industry to improve the quality of the glues necessary to produce veneer panels. However, up to now, no cases of sensitization to cereal flour in this kind of industry have been reported. Cereal alpha-amylase inhibitors have been previously described as important occupational allergens responsible for baker's asthma. OBJECTIVE: To determine whether cereal allergens were responsible for occupational sensitization in three wood industry workers. METHODS: The diagnosis was made by clinical questionnaire, physical examination, skin-prick tests to cereals, CAP and immunoblotting. RESULTS: The three patients had positive skin prick tests and CAP to cereal flours. An IgE-immunoblotting revealed that only low molecular weight proteins (under 20 kDa) were detected by the three sera. These main IgE-binding proteins were members of the alpha-amylase inhibitor family which have been described as one of the group of main allergenic proteins in rye, barley and wheat. The three patients changed their workplace and remain asymptomatic in spite of the fact that they are still in contact with different woods and exposed to high concentrations of wood dust and other chemicals such as formaldehyde. CONCLUSION: Proteins from cereal flours are important occupational allergens in some wood industries.


Assuntos
Grão Comestível/imunologia , Inibidores Enzimáticos/imunologia , Hipersensibilidade Imediata/imunologia , Indústrias , Exposição Ocupacional , alfa-Amilases/antagonistas & inibidores , Adesivos , Adulto , Alérgenos/efeitos adversos , Alérgenos/imunologia , Eletroforese em Gel de Poliacrilamida , Farinha , Humanos , Immunoblotting , Imunoglobulina E/sangue , Masculino , Testes Cutâneos , Madeira
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