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Sample records for anaphylaxis

  1. Anaphylaxis

    Science.gov (United States)

    ... Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice ... with others. Join us on Facebook and Twitter . Test your knowledge about anaphylaxis . » Anaphylaxis Symptoms & Diagnosis Symptoms ...

  2. Anaphylaxis

    Science.gov (United States)

    ... life-threatening. How do you know if a person is having an anaphylactic reaction? Anaphylaxis is likely ... in anaphylaxis; identify molecular events that cause and characterize anaphylactic reactions to understand their triggers; and discover ...

  3. Anaphylaxis

    DEFF Research Database (Denmark)

    Muraro, A; Roberts, G; Worm, M;

    2014-01-01

    evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis. While the primary audience is allergists, these guidelines are also relevant to all other healthcare professionals. The...... adrenaline. Discharge arrangements should involve an assessment of the risk of further reactions, a management plan with an anaphylaxis emergency action plan, and, where appropriate, prescribing an adrenaline auto-injector. If an adrenaline auto-injector is prescribed, education on when and how to use the...... device should be provided. Specialist follow-up is essential to investigate possible triggers, to perform a comprehensive risk assessment, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy. Training for the...

  4. Idiopathic anaphylaxis.

    Science.gov (United States)

    Greenberger, Paul A

    2007-05-01

    Idiopathic anaphylaxis is a prednisone-responsive condition without external cause, but it can coexist with food-, medication-, or exercise-induced anaphylaxis. Mast cell activation may occur at night or after foods that have been eaten with impunity many times previously. Idiopathic anaphylaxis can be classified into frequent (if there are six or more episodes per year or two episodes in the last 2 months) or infrequent (if episodes occur less often). Idiopathic anaphylaxis-generalized consists of urticaria or angioedema associated with severe respiratory distress, syncope or hypotension, and gastrointestinal symptoms. Idiopathic anaphylaxis-angioedema consists of massive tongue enlargement or severe pharyngeal or laryngeal swelling with urticaria or peripheral angioedema. The differential diagnosis of idiopathic anaphylaxis is reviewed, and treatment approaches are presented. PMID:17493503

  5. Perioperative anaphylaxis.

    LENUS (Irish Health Repository)

    Mertes, P M

    2010-07-01

    The incidence of immune-mediated anaphylaxis during anesthesia ranges from 1 in 10,000 to 1 in 20,000. Neuromuscular blocking agents are most frequently incriminated, followed by latex and antibiotics, although any drug or substance used may be a culprit. Diagnosis relies on tryptase measurements at the time of the reaction and skin tests, specific immunoglobulin E, or basophil activation assays. Treatment consists of rapid volume expansion and epinephrine administration titrated to symptom severity.

  6. Anaphylaxis-Like Reactions

    Science.gov (United States)

    ... be "primed" by previous exposure to cause anaphylaxis, anaphylactoid reactions can occur with no previous exposure at all. ... an X-ray. Although the mechanism of an anaphylactoid reaction is different, the treatment is the same as ...

  7. Management of anaphylaxis

    DEFF Research Database (Denmark)

    Dhami, S; Panesar, S S; Roberts, G;

    2014-01-01

    To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted...... time series and - only in relation to adrenaline - case series investigating the effectiveness of interventions in managing anaphylaxis. Fifty-five studies satisfied the inclusion criteria. We found no robust studies investigating the effectiveness of adrenaline (epinephrine), H1-antihistamines......, systemic glucocorticosteroids or methylxanthines to manage anaphylaxis. There was evidence regarding the optimum route, site and dose of administration of adrenaline from trials studying people with a history of anaphylaxis. This suggested that administration of intramuscular adrenaline into the middle...

  8. Anaphylaxis: diagnosis and management.

    Science.gov (United States)

    Brown, Simon G A; Mullins, Raymond J; Gold, Michael S

    2006-09-01

    Anaphylaxis is a serious, rapid-onset, allergic reaction that may cause death. Severe anaphylaxis is characterised by life-threatening upper airway obstruction, bronchospasm and/or hypotension. Anaphylaxis in children is most often caused by food. Bronchospasm is a common symptom, and there is usually a background of atopy and asthma. Venom- and drug-induced anaphylaxis are more common in adults, in whom hypotension is more likely to occur. Diagnosis can be difficult, with skin features being absent in up to 20% of people. Anaphylaxis must be considered as a differential diagnosis for any acute-onset respiratory distress, bronchospasm, hypotension or cardiac arrest. The cornerstones of initial management are putting the patient in the supine position, administering intramuscular adrenaline into the lateral thigh, resuscitation with intravenous fluid, support of the airway and ventilation, and giving supplementary oxygen. If the response to initial management is inadequate, intravenous infusion of adrenaline should be commenced. Use of vasopressors should be considered if hypotension persists. The patient should be observed for at least 4 hours after symptom resolution and referred to an allergist to assist with diagnosis, allergen avoidance measures, risk assessment, preparation of an action plan and education on the use of self-injectable adrenaline. Provision of a MedicAlert bracelet should also be arranged. PMID:16948628

  9. Marking nut anaphylaxis.

    Science.gov (United States)

    Fok, Jie Shen; Kral, Anita Christine; Hayball, John; Smith, William B

    2016-07-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  10. Autoimmune Progesterone Anaphylaxis

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Bemanian

    2007-06-01

    Full Text Available Progesterone induced dermatitis is a rare disorder. It typically occurs in females due to anautoimmune phenomenon to endogenous progesterone production, but can also be caused byexogenous intake of a synthetic progestin. Here in, we present a case of autoimmune progesterone anaphylaxis (AIPA observed in an adolescent female.The patient is an 18-year-old Caucasian female with no significant past medical history and noprior exogenous hormone use, who presented to her primary care physician complaining of cyclic skin eruptions with dyspnea, cough and respiratory distress. She noted that her symptoms occurred monthly, just prior to her menses. An intradermal skin test using 0.1 cml of progesterone was performed. The patient developed a 15mm wheal after 15 minutes, confirming the diagnosis of AIPA.The patient was started on a continuous regimen of an oral conjugated estrogen (0.625mg. The skin eruptions and respiratory symptoms have not returned since the initiation of this therapy.Autoimmune progesterone dermatitis manifests via the occurrence of cyclic skin eruptions.Women with the disorder commonly present with dermatologic lesions in the luteal phase of themenstrual cycle, if there are any other organ involvement in addition to skin (e.g. lung, GI thereaction should be called as autoimmune progesterone anaphylaxis. Diagnosis of AIPA is confirmed by performing a skin allergen test using progesterone.

  11. A pharmacologic review of anaphylaxis.

    Science.gov (United States)

    Yunker, Nancy S; Wagner, Bradley J

    2014-01-01

    Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning. Secondary prevention measures should be instituted to prevent future occurrences. All health care professionals should have an understanding of the clinical presentation and medical management of anaphylaxis to improve patient outcomes. PMID:25461639

  12. Navigating the Updated Anaphylaxis Parameters

    Directory of Open Access Journals (Sweden)

    Kemp Stephen F

    2007-06-01

    Full Text Available Anaphylaxis, an acute and potentially lethal multi-system clinical syndrome resulting from the sudden, systemic degranulation of mast cells and basophils, occurs in a variety of clinical scenarios and is almost unavoidable inmedical practice. Healthcare professionalsmust be able to recognize its features, treat an episode promptly and appropriately, and be able to provide recommendations to prevent future episodes. Epinephrine, administered immediately, is the drug of choice for acute anaphylaxis. The discussion provides an overview of one set of evidence-based and consensus parameters for the diagnosis and management of anaphylaxis.

  13. Severe anaphylaxis: the secret ingredient.

    Science.gov (United States)

    Buergi, Andreas; Jung, Barbara; Padevit, Christian; John, Hubert; Ganter, Michael T

    2014-02-01

    In this case report, we describe a healthy urological patient who suffered severe intraoperative anaphylaxis to chlorhexidine, an ingredient contained in frequently used lubricants (Instillagel, Endosgel). Chlorhexidine is a well-known skin disinfectant and antiseptic component in mouthwash or other over the counter antiseptic pharmaceuticals. There is little awareness that commonly used lubricants may contain hidden chlorhexidine. After severe intraoperative anaphylaxis, it is important to investigate all potential (including hidden) agents that might have caused this life-threatening reaction. PMID:25611155

  14. The mechanisms, causes, and treatment of anaphylaxis.

    Science.gov (United States)

    Montanaro, Anthony; Bardana, Emil J

    2002-01-01

    Anaphylaxis is a severe life-threatening systemic reaction that offers many challenges to the clinician. The incidence of anaphylaxis is significant in the general population and an important cause of morbidity and mortality. While the most common causes of anaphylaxis include drugs, foods, and venoms, other important etiologies must be considered. The etiology of anaphylaxis is classically based on IgE mediated hypersensitivity but multiple mechanisms may be involved. The clinical presentation of anaphylaxis may be extremely variable with a broad differential diagnosis which will be outlined. Although the diagnosis of anaphylaxis can many times be based on a careful history and physical examination, there are laboratory and skin tests which may be helpful in establishing a diagnosis in some cases. The cornerstone of treatment of anaphylaxis remains epinephrine. Other supportive therapies will be discussed. PMID:12109526

  15. A Case of Anaphylaxis to Oral Minocycline

    OpenAIRE

    Jang, Ji Woong; Bae, Yun-Jeong; Kim, Yong Giun; Jin, Young-Joo; Park, Kyung Sun; Cho, You Sook; Moon, Hee-Bom; Kim, Tae-Bum

    2010-01-01

    Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. To date, there has been only one case report of anaphylaxis to minocycline. We report here a case of anaphylaxis to oral minocycline. A 56-yr-old woman visited our hospital after three episodes of recurrent anaphylaxis. We performed an oral challenge test, the standard method for diagnosing drug allergies, with minocycline, one of the drugs she had taken previously. She developed urtic...

  16. Exercise-induced anaphylaxis and antileukotriene montelukast

    OpenAIRE

    Sapna Gajbhiye; Rajendra Prasad Agrawal; Shubham Atal; Vikalp Tiwari; Pradeep Phadnis

    2015-01-01

    We report a rare case of exercise-induced anaphylaxis (EIA), occurring exclusively with exercise, without any other associated trigger, detected in the prodromal phase, and prevented from additional anaphylaxis episodes by treatment with cetirizine and 10 mg daily of antileukotriene montelukast to date. EIA is a syndrome in which patients experience a spectrum of the symptoms of anaphylaxis ranging from mild cutaneous signs to severe systemic manifestations such as hypotension, syncope, and e...

  17. Anaphylaxis and cardiovascular disease: therapeutic dilemmas.

    Science.gov (United States)

    Lieberman, P; Simons, F E R

    2015-08-01

    Cardiovascular disease (CVD) increases the risk of severe or fatal anaphylaxis, and some medications for CVD treatment can exacerbate anaphylaxis. The aim of this article is to review the effect of anaphylaxis on the heart, the potential impact of medications for CVD on anaphylaxis and anaphylaxis treatment, and the cardiovascular effects of epinephrine. The therapeutic dilemmas arising from these issues are also discussed and management strategies proposed. PubMed searches were performed for the years 1990-2014 inclusive, using terms such as angiotensin-converting enzyme (ACE) inhibitors, adrenaline, allergic myocardial infarction, anaphylaxis, angiotensin-receptor blockers (ARBs), beta-adrenergic blockers, epinephrine, and Kounis syndrome. Literature analysis indicated that: cardiac mast cells are key constituents of atherosclerotic plaques; mast cell mediators play an important role in acute coronary syndrome (ACS); patients with CVD are at increased risk of developing severe or fatal anaphylaxis; and medications for CVD treatment, including beta-adrenergic blockers and ACE inhibitors, potentially exacerbate anaphylaxis or make it more difficult to treat. Epinephrine increases myocardial contractility, decreases the duration of systole relative to diastole, and enhances coronary blood flow. Its transient adverse effects include pallor, tremor, anxiety, and palpitations. Serious adverse effects (including ventricular arrhythmias and hypertension) are rare, and are significantly more likely after intravenous injection than after intramuscular injection. Epinephrine is life-saving in anaphylaxis; second-line medications (including antihistamines and glucocorticoids) are not. In CVD patients (especially those with ACS), the decision to administer epinephrine for anaphylaxis can be difficult, and its benefits and potential harms need to be carefully considered. Concerns about potential adverse effects need to be weighed against concerns about possible death from

  18. The epidemiology of anaphylaxis in Europe

    DEFF Research Database (Denmark)

    Panesar, S S; Javad, S; de Silva, D;

    2013-01-01

    anaphylaxis. This systematic review aimed to (1) understand and describe the epidemiology of anaphylaxis and (2) describe how these characteristics vary by person, place, and time. METHODS: Using a highly sensitive search strategy, we identified systematic reviews of epidemiological studies, descriptive and...... all-cause anaphylaxis ranged from 1.5 to 7.9 per 100,000 person-years. These data indicated that an estimated 0.3% (95% CI 0.1-0.5) of the population experience anaphylaxis at some point in their lives. Food, drugs, stinging insects, and latex were the most commonly identified triggers. CONCLUSIONS...

  19. Anaphylaxis related to fentanyl citrate

    Directory of Open Access Journals (Sweden)

    Gaurav Singh Tomar

    2012-01-01

    Full Text Available Anaphylaxis is a fulminant, unexpected, immunoglobulin E-mediated allergic reaction that can be triggered by multiple agents. Common causative agents include neuromuscular blocking drugs, latex, antibiotics, colloids, hypnotics, and opioids. Fentanyl citrate, however, is an extremely unusual cause of anaphylaxis. Pulmonary edema, although uncommon in anaphylaxis, can be a prominent feature, as was in one of the patient. An adverse drug reaction is a noxious or unintended reaction to a drug that is administered in standard doses by the proper route for the purpose of prophylaxis, diagnosis, or treatment. Reactions are classified into two major subtypes: type A, which are dose dependent and predictable; and type B, which are not dose dependent and unpredictable. Unpredictable reactions include immune (allergic or no immune drug hypersensitivity reactions and are related to genetic susceptibilities or undefined mechanisms (formally called idiosyncratic and intolerance reactions. A drug allergy is always associated with an immune mechanism for which evidence of drug-specific antibodies or activated T lymphocytes can be shown. In the last few years, many novel drugs have entered clinical practice (i.e., biologic agents generating novel patterns of drug hypersensitivity reactions. As old drugs continue to be used, new clinical and biologic techniques enable improvement in the diagnosis of these reactions.

  20. Anaphylaxis and Anaphylactoid Reactions: Diagnosis and Management.

    Science.gov (United States)

    Luskin, Allan T.; Luskin, Susan S.

    1996-07-01

    Anaphylaxis is an acute fatal or potentially fatal hypersensitivity reaction. Anaphylaxis represent a clinical diagnosis based on history and physical examination and includes symptoms of airway obstruction, generalized skin reactions, particularly flushing, itching, urticaria, angioedema cardiovascular symptoms including hypotension and gastrointestinal symptoms. These symptoms result from the action of mast cell mediators, especially histamine and lipid mediators such as leukotrienes and platelet activating factor on shock tissue. The shock tissue includes blood vessels, mucous glands, smooth muscle, and nerve endings. Anaphylaxis follows the typical immediate hypersensitivity time course, with a reaction beginning within minutes of antigen exposure. A late-phase reaction hours after the initial reaction may occur. Mast cell mediator release can be triggered by both IgE and non--IgE-mediated factors. Therefore, anaphylaxis may be termed anaphylaxis (IgE mediated) or anaphylactoid (non--IgE mediated). The most common IgE-mediated triggers are drugs, typically penicillin or other beta-lactam antibiotics, foods, most commonly nuts, peanuts, fish and shellfish, or hymenoptera stings. Non-IgE-mediated causes include factors causing marked complement activation such as plasma proteins or compounds which act directly on the mast cell membrane, such as vancomycin, quinolone antibiotics, or radiographic contrast media. The pathophysiology of some trigger factors, such as aspirin, remains unclear. Therapy of anaphylaxis revolves around patient education, avoidance, desensitization or pharmacologic pretreatment when agents causing anaphylaxis need to be readministered, and early recognition and prompt therapy of reactions should they occur. PMID:11862283

  1. Anaphylaxis

    Science.gov (United States)

    ... serious allergic reactions should wear a medical ID tag. If you have a history of serious allergic ... to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein ...

  2. Anaphylaxis to hyperallergenic functional foods

    Directory of Open Access Journals (Sweden)

    Ameratunga Rohan

    2010-12-01

    Full Text Available Abstract Background Food allergy can cause life threatening reactions. Currently, patients with severe food allergy are advised to avoid foods which provoke allergic reactions. This has become increasingly difficult as food proteins are being added to a broader range of consumer products. Patients and methods Here we describe our investigations into the allergenicity of a new drink when two cow's milk allergic children suffered anaphylaxis after consuming Wh2ole®. Results Our studies have shown that in comparison with cow's milk, Wh2ole® contains at least three times the concentration of β-lactoglobulin. β-lactoglobulin is one of the dominant allergens in bovine milk. Conclusions These studies have shown that modern technology allows the creation of "hyperallergenic" foods. These products have the potential to cause severe reactions in milk allergic persons. Avoiding inadvertent exposure is the shared responsibility of allergic consumers, regulatory authorities and the food industry.

  3. The management of anaphylaxis in childhood

    DEFF Research Database (Denmark)

    Muraro, A; Roberts, G; Clark, A;

    2007-01-01

    such as volume support, nebulized bronchodilators, antihistamines or corticosteroids are supplementary to adrenaline. There are no absolute contraindications to administering adrenaline in children. Allergy assessment is mandatory in all children with a history of anaphylaxis because it is essential to...

  4. Knowledge of anaphylaxis among Emergency Department staff

    OpenAIRE

    Ibrahim, Irwani; Chew, Bao Li; Zaw, Wai Wai; Van Bever, Hugo P

    2014-01-01

    Background Anaphylaxis is an emergency condition that requires immediate, accurate diagnosis and appropriate management. However, little is known about the level of knowledge of doctors and nurses treating these patients in the Emergency Department. Objective To determine the knowledge of doctors and nurses in the Emergency Department on the recent definition and treatment recommendations of anaphylaxis. Methods We surveyed doctors and nurses of all grades in a tertiary Hospital Emergency Dep...

  5. Anaphylaxis due to thiopental sodium anesthesia.

    OpenAIRE

    Dolovich, J; Evans, S.; Rosenbloom, D; Goodacre, R; Rafajac, F O

    1980-01-01

    Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions t...

  6. A case of anaphylaxis to peppermint

    OpenAIRE

    Bayat, Roian; Borici-Mazi, Rozita

    2014-01-01

    Background Anaphylaxis, a form of IgE mediated hypersensitivity, arises when mast cells and possibly basophils are provoked to secrete mediators with potent vasoactive and smooth muscle contractile activities that evoke a systemic response. We report a case of IgE mediated anaphylaxis to peppermint (Mentha piperita) in a male shortly after sucking on a candy. Case presentation A 69 year old male developed sudden onset of lip and tongue swelling, throat tightness and shortness of breath within...

  7. THE RARE CAUSE OF THE ANAPHYLAXIS: EXERCISE

    OpenAIRE

    Sami OZTURK; Caliskaner, Zafer; KARAAYVAZ, Mehmet; Gulec, Mustafa

    2005-01-01

    Introduction: Exercise-induced anaphylaxis (EIA) is a rare syndrome. We described two patients experienced anaphylaxis after exercise. Case 1: A 24 -year-old male patient, recruited to army as a private 6 months ago. The medical history was suggestive of an anaphylactic reaction which was developed about 30 minute after a vigorous exercise. Case 2: A 42-year old female, was referred to our clinic because of the recurrent episodes of generalized pruritus, nausea, vomiting, swelling on extremit...

  8. [Approach and Registry of Anaphylaxis in Portugal].

    Science.gov (United States)

    Mota, Inês; Pereira, Ana Margarida; Pereira, Celso; Tomaz, Elza; Ferreira, Manuel Branco; Sabino, Filipa; Coelho, Anabela; Santos, Anabela; Martins, Henrique; Morais-Almeida, Mário

    2015-01-01

    Anaphylaxis has a growing incidence, especially in children. It represents a medical emergency and its successful therapy depends on early and proper intervention. Intramuscular epinephrine, with dose adjustment according to weight and age, is the drug of choice for anaphylaxis treatment. After resolution of the acute reaction, the patient should be kept under clinical surveillance for 6 to 24 hours, due to possible biphasic reactions. Prescription of an epinephrine auto injectable device should be considered in all patients with diagnosed or suspected anaphylaxis; additionally these patients should always be referred to an Immunoallergy consultation, to perform adequate investigation and management in order to reduce future risk. All anaphylaxis episodes must be recorded in The Portuguese Catalogue of Allergies and other Adverse Reactions (Catálogo Português de Alergias e outras Reações Adversas, CPARA), which represents a fundamental tool to share clinical information within the Health System. The present manuscript intends to disclose the most recent Portuguese guidelines for the diagnosis and treatment of anaphylaxis, making its clinical approach more effective and homogeneous, and to promote the use of The Portuguese Catalogue of Allergies and other Adverse Reactions as an essential tool to register and share information on anaphylaxis in Portugal. PMID:26849768

  9. Exercise–induced Anaphylaxis: the Role of Cofactors

    Science.gov (United States)

    Zogaj, Dukagjin; Ibranji, Alkerta; Hoxha, Mehmet

    2014-01-01

    Introduction: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening generalized or systemic hypersensitivity reaction. Based on immunologic mechanism the anaphylaxis is divided in IgE, IgG, complement, or immune complexes-mediated vs non allergic anaphylaxis. There are a lot of etiologic factors of anaphylaxis, but the three principal immunologic triggers are drugs, insect stings, and foods. Regarding the clinical severity there are several proposed grading systems. The diagnosis of anaphylaxis is mainly clinical. Discussion: The anaphylaxis markers measured in clinical laboratories are total tryptase and histamine. There are some conditions that modulate the onset of anaphylaxis, acting as co- or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. The well-documented cofactors of anaphylaxis are physical exercise, alcohol consumption, some foods, co-administration of nonsteroidal anti-inflammatory drugs (NSAID), and concomitant infectious diseases. Development of anaphylaxis depends on the sensitization pattern, the proportion of the involved immunoglobulin classes, characteristics of the allergen, the proportion of the involved immunoglobulin classes, the avidity and affinity of immunoglobulins to bind an allergen, the route of allergen application, and, last but not least, the presence of cofactors of anaphylaxis. Conclusion: Anaphylaxis remains a continuous challenge for the diagnosis and treatment. The adequate management of anaphylaxis requires rapid diagnosis, implementation of primary and secondary prevention measures, and immediate administration of subcutaneous epinephrine. PMID:25685088

  10. Exercise–induced Anaphylaxis: the Role of Cofactors

    OpenAIRE

    Zogaj, Dukagjin; Ibranji, Alkerta; Hoxha, Mehmet

    2014-01-01

    Introduction: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening generalized or systemic hypersensitivity reaction. Based on immunologic mechanism the anaphylaxis is divided in IgE, IgG, complement, or immune complexes-mediated vs non allergic anaphylaxis. There are a lot of etiologic factors of anaphylaxis, but the three principal immunologic triggers are drugs, insect stings, and foods. Regarding the clinical severity there are several proposed grading syste...

  11. Exercise-induced anaphylaxis and antileukotriene montelukast.

    Science.gov (United States)

    Gajbhiye, Sapna; Agrawal, Rajendra Prasad; Atal, Shubham; Tiwari, Vikalp; Phadnis, Pradeep

    2015-01-01

    We report a rare case of exercise-induced anaphylaxis (EIA), occurring exclusively with exercise, without any other associated trigger, detected in the prodromal phase, and prevented from additional anaphylaxis episodes by treatment with cetirizine and 10 mg daily of antileukotriene montelukast to date. EIA is a syndrome in which patients experience a spectrum of the symptoms of anaphylaxis ranging from mild cutaneous signs to severe systemic manifestations such as hypotension, syncope, and even death after increased physical activity. Many people have triggers, such as, a variety of foods, various medications, alcohol, cold weather, humidity, and seasonal and hormonal changes along with exercise that cause the symptoms. Typically, either exercise or the specific trigger alone will rarely cause symptoms. It is differentiated from cholinergic urticaria by the absence of response to passive body warming and emotional stress. PMID:26312002

  12. Exercise-induced anaphylaxis and antileukotriene montelukast

    Directory of Open Access Journals (Sweden)

    Sapna Gajbhiye

    2015-01-01

    Full Text Available We report a rare case of exercise-induced anaphylaxis (EIA, occurring exclusively with exercise, without any other associated trigger, detected in the prodromal phase, and prevented from additional anaphylaxis episodes by treatment with cetirizine and 10 mg daily of antileukotriene montelukast to date. EIA is a syndrome in which patients experience a spectrum of the symptoms of anaphylaxis ranging from mild cutaneous signs to severe systemic manifestations such as hypotension, syncope, and even death after increased physical activity. Many people have triggers, such as, a variety of foods, various medications, alcohol, cold weather, humidity, and seasonal and hormonal changes along with exercise that cause the symptoms. Typically, either exercise or the specific trigger alone will rarely cause symptoms. It is differentiated from cholinergic urticaria by the absence of response to passive body warming and emotional stress.

  13. Management of anaphylaxis : a systematic review

    NARCIS (Netherlands)

    Dhami, S.; Panesar, S. S.; Roberts, G.; Muraro, A.; Worm, M.; Bilo, M. B.; Cardona, V.; Dubois, A. E. J.; DunnGalvin, A.; Eigenmann, P.; Fernandez-Rivas, M.; Halken, S.; Lack, G.; Niggemann, B.; Rueff, F.; Santos, A. F.; Vlieg-Boerstra, B.; Zolkipli, Z. Q.; Sheikh, A.

    2014-01-01

    To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted t

  14. Anaphylaxis related to avocado ingestion: a case and review

    OpenAIRE

    Abrams Elissa M; Becker Allan B; Gerstner Thomas V

    2011-01-01

    Abstract Anaphylaxis to avocado, independent of latex sensitization, has been rarely reported in the literature. This case report describes a 15 year old male who experienced anaphylaxis within half an hour after eating avocado-containing food. Avocado consumption is common in both North America and South America. It is important to consider avocado as a cause of anaphylaxis, even in patients not sensitized to latex.

  15. Anaphylaxis after accidental ingestion of kiwi fruit

    OpenAIRE

    Gawrońska-Ukleja, Ewa; Różalska, Anna; Ukleja-Sokołowska, Natalia; Żbikowska-Gotz, Magdalena; Bartuzi, Zbigniew

    2013-01-01

    Numerous cases of anaphylaxis after ingestion of kiwi fruit, after the skin tests and during oral immunotherapy were described. The article describes the case of severe anaphylactic reaction that occurred in a 55-year-old patient after accidental ingestion of kiwi. Allergy to kiwi fruit was confirmed by a native test with fresh kiwi fruit. After the test, the patient experienced generalized organ response in the form of headache, general weakness and rashes on the neck and breast, and dyspnea...

  16. Allergen-Specific Immunotherapy in Food Anaphylaxis

    OpenAIRE

    Kerzl, Regina; Mempel, Martin; Ring, Johannes

    2008-01-01

    Specific immunotherapy (SIT) protocols for nutritional allergens have only recently been established with a focus on oral allergy syndrome because of pollen cross-reacting antibodies. For these patients, a substantial number of studies have been published suggesting benefits from SIT. The situation in true anaphylaxis to food allergens such as peanut allergy is more complex, and therapeutic strategies are based on individual protocols rather than controlled studies. However, in defined cases,...

  17. THE RARE CAUSE OF THE ANAPHYLAXIS: EXERCISE

    Directory of Open Access Journals (Sweden)

    Sami OZTURK

    2005-02-01

    Full Text Available Introduction: Exercise-induced anaphylaxis (EIA is a rare syndrome. We described two patients experienced anaphylaxis after exercise. Case 1: A 24 -year-old male patient, recruited to army as a private 6 months ago. The medical history was suggestive of an anaphylactic reaction which was developed about 30 minute after a vigorous exercise. Case 2: A 42-year old female, was referred to our clinic because of the recurrent episodes of generalized pruritus, nausea, vomiting, swelling on extremities and breathing difficultly. She was experienced with symptoms after moderate exercises which were performed to losing weight. Evaluation: The complete diagnostic procedures including skin tests with foods and inhalant allergens were performed. In Case 2, positive skin test results were detected in food allergens (apricot, tomato, vanilla and inhalant allergens (house-dust mites and cockroach. Management: In Case 1, he was first experienced EIA symptoms with the military training. For this reason, he exempted from vigorous exercises during his remaining compulsory military service and self-injectable epinephrine kit and antihistamine were prescribed him. In Case 2, she advised to avoid from vigorous exercises. Conclusion: EIA should be considered in cases of anaphylaxis with uncertain etiology. [TAF Prev Med Bull 2005; 4(1.000: 46-49

  18. Exercise-induced anaphylaxis: A clinical view

    Directory of Open Access Journals (Sweden)

    Povesi Dascola Carlotta

    2012-09-01

    Full Text Available Abstract Exercise-induced anaphylaxis (EIA is a distinct form of physical allergy. The development of anaphylaxis during exertion often requires the concomitant exposure to triggering factors such as intake of foods (food dependent exercise-induced anaphylaxis or drugs prior to exercise, extreme environmental conditions. EIA is a rare, but serious disorder, which is often undetected or inadequately treated. This article summarizes current evidences on pathophysiology, diagnosis and management. We reviewed recent advances in factors triggering the release of mediators from mast cells which seems to play a pathogenetic role. A correct diagnosis is essential to avoid unnecessary restricted diet, to allow physical activity in subjects with EIA dependent from triggering factors such as food, and to manage attacks. An algorithm for diagnosing EIA based on medical history, IgE tests and exercise challenge test has been provided. In the long-term management of EIA, there is a need for educating patients and care-givers to avoid exposure to precipitating factors and to recognize and treat episodes. Future researches on existing questions are discussed.

  19. Implementation of anaphylaxis management guidelines: a register-based study.

    Directory of Open Access Journals (Sweden)

    Linus Grabenhenrich

    Full Text Available BACKGROUND: Anaphylaxis management guidelines recommend the use of intramuscular adrenaline in severe reactions, complemented by antihistamines and corticoids; secondary prevention includes allergen avoidance and provision of self-applicable first aid drugs. Gaps between recommendations and their implementation have been reported, but only in confined settings. Hence, we analysed nation-wide data on the management of anaphylaxis, evaluating the implementation of guidelines. METHODS: Within the anaphylaxis registry, allergy referral centres across Germany, Austria and Switzerland provided data on severe anaphylaxis cases. Based on patient records, details on reaction circumstances, diagnostic workup and treatment were collected via online questionnaire. Report of anaphylaxis through emergency physicians allowed for validation of registry data. RESULTS: 2114 severe anaphylaxis patients from 58 centres were included. 8% received adrenaline intravenously, 4% intramuscularly; 50% antihistamines, and 51% corticoids. Validation data indicated moderate underreporting of first aid drugs in the Registry. 20% received specific instructions at the time of the reaction; 81% were provided with prophylactic first aid drugs at any time. CONCLUSION: There is a distinct discrepancy between current anaphylaxis management guidelines and their implementation. To improve patient care, a revised approach for medical education and training on the management of severe anaphylaxis is warranted.

  20. Patient's perspective and public policy regarding anaphylaxis.

    Science.gov (United States)

    Muñoz-Furlong, Anne

    2004-01-01

    It is estimated that dose to 7 million Americans have food allergy. The incidence of food allergy, particularly peanut allergy, is believed to be on the rise. Several studies have shown that in spite of a patient's best efforts to avoid ingesting the allergy-causing food, reactions will occur. These reactions occur from incorrect ingredient information in food service or restaurant settings, incorrect product labels, or mistakes in label reading. In the hospital setting, patients are sometimes treated for an anaphylactic reaction in the emergency room but are not given instructions to see a specialist to determine the cause of their reaction, nor are they given a prescription for epinephrine to arm them to treat future allergic emergencies. Two studies of fatal and near fatal allergic reactions concluded that a delay in administration of epinephrine could have been a factor in the fatal outcomes. However, schools often do not have written emergency action plans in place for children with documented food allergy, and patients and caregivers often report not knowing when to use the epinephrine kit or how to use it. Until there is a cure for food allergy and anaphylaxis, avoidance of the allergen is key. There is much work to be done in education and public policy regarding anaphylaxis. PMID:15025404

  1. A 4-month-old baby boy presenting with anaphylaxis to a banana: a case report

    OpenAIRE

    O’Keefe, Andrew W; Ben-Shoshan, Moshe

    2014-01-01

    Introduction Food allergy is the most common cause of anaphylaxis in children and recent studies suggest increased prevalence of both food allergy and anaphylaxis. Among foods, fruits are rarely implicated as the cause of anaphylaxis. Furthermore, anaphylaxis to fruit in the first months of life is rare. Although banana allergy has been well described in adults, there are only two case reports of anaphylaxis to banana in children. Case presentation A 4-month-old Hispanic baby boy with a histo...

  2. Anaphylaxis cases presenting to primary care paramedics in Quebec.

    Science.gov (United States)

    Kimchi, Nofar; Clarke, Ann; Moisan, Jocelyn; Lachaine, Colette; La Vieille, Sebastien; Asai, Yuka; Joseph, Lawrence; Mill, Chris; Ben-Shoshan, Moshe

    2015-12-01

    Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of the anaphylaxis. Univariate and multivariate logistic regressions were compared to assess factors associated with severity of reactions and epinephrine use. Among 33,788 ambulance calls of which 23,486 required transport, 104 anaphylaxis cases were identified (anaphylaxis rate of 0.31% [95%CI, 0.25%, 0.37%] among all ambulance calls and 0.44% [95%CI, 0.36%, 0.54%] among those requiring transport). The median age was 46.8 years and 41.3% were males. The common triggers included food (32.7% [95%CI, 24.0%, 42.7%]), drugs (24.0% [16.4%, 33.6%]), and venom (17.3% [10.8%, 26.2%]). Among all reactions, 37.5% (95%CI, 28.4%, 47.6%) were severe. Epinephrine was not administered in 35.6% (95%CI, 26.6%, 45.6%) of all cases. Males were more likely to have severe reactions (Odds ratio [OR]: 2.50 [95%CI, 1.03, 6.01]). Venom-induced reactions and severe anaphylaxis were more likely to be managed with epinephrine (OR: 6.9 [95%CI, 1.3, 35.3] and 4.2 [95%CI, 1.5, 12.0], respectively). This is the first prospective study evaluating anaphylaxis managed by paramedics. Anaphylaxis accounts for a substantial proportion of the cases managed by paramedics in Outaouais, Quebec and exceeds prior reports of the proportion of Quebec emergency room visits attributed to anaphylaxis. Although guidelines recommend prompt use of epinephrine for all cases of anaphylaxis, more than a third of cases did not receive epinephrine. It is crucial to develop educational programs targeting paramedics to promote the use of epinephrine in all cases of anaphylaxis regardless of the specific trigger. PMID:26734462

  3. EAACI Food Allergy and Anaphylaxis Guidelines

    DEFF Research Database (Denmark)

    Muraro, A; Werfel, T; Hoffmann-Sommergruber, K;

    2014-01-01

    previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence-based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists, this......Food allergy can result in considerable morbidity, impact negatively on quality of life, and prove costly in terms of medical care. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group, building on...... document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management of...

  4. Clinical observation of anaphylaxis after treated with Sweet BV

    Directory of Open Access Journals (Sweden)

    Ki Rok Kwon

    2009-06-01

    Full Text Available Objectives : Sweet bee venom(SBV is pure melittin, the main component of bee venom, made by removing another components through gel filtration chromatography and propionic acid/urea polyacrylamide gel electrophoresis. In the using SBV, 2 patients were experienced anaphylaxis by SBV. So, we reported the process of anaphylaxis and consider these situation. Methods : We observed 2 patients suffered from anaphylaxis after treated with SBV in the Korean Medical Hospital, Sangji University. Results : Though SBV was removed allergen from bee venom, it is not possible to complete prevention of anaphylactic shock in the clinics. So, Korean medical doctor using BV or SBV must be prepare the system consider a countermeasure by anaphylaxis.

  5. Anaphylaxis to Pegylated Liposomal Doxorubicin: A Case Report

    Science.gov (United States)

    Sharma, LR; Subedi, A; Shah, BK

    2014-01-01

    Liposomal doxorubicin is used for the treatment of various cancers like epithelial ovarian cancers, multiple myeloma and sarcomas. We report the first case of anaphylaxis to pegylated liposomal doxorubicin. PMID:25429486

  6. Anaphylaxis to Pegylated Liposomal Doxorubicin: A Case Report

    OpenAIRE

    Sharma, LR; A. Subedi; Shah, BK

    2014-01-01

    Liposomal doxorubicin is used for the treatment of various cancers like epithelial ovarian cancers, multiple myeloma and sarcomas. We report the first case of anaphylaxis to pegylated liposomal doxorubicin.

  7. Recent advances in mast cell clonality and anaphylaxis

    OpenAIRE

    Akin, Cem

    2009-01-01

    Clonal expansion of mast cells carrying the D816V c-kit mutation results in mastocytosis. Recent studies identified the presence of clonal mast cells carrying this mutation in patients with anaphylaxis without classic diagnostic findings of systemic mastocytosis.

  8. Elevated exhaled nitric oxide in anaphylaxis with respiratory symptoms

    Directory of Open Access Journals (Sweden)

    Yoichi Nakamura

    2015-10-01

    Conclusions: Elevation of FeNO was related to respiratory symptoms observed in anaphylactic patients without asthma. Although the mechanism of increased FeNO level is unclear, its usefulness for diagnosis of anaphylaxis must be examined in prospective studies.

  9. A Case of Anaphylaxis After the Ingestion of Yacon

    OpenAIRE

    Yun, Eun Young; Kim, Hyun Sik; Kim, You Eun; Kang, Min Kyu; Ma, Jeong Eun; Lee, Gi Dong; Cho, Yu Ji; Kim, Ho Cheol; Lee, Jong Deok; Hwang, Young Sil; Jeong, Yi Yeong

    2010-01-01

    Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large...

  10. Human heart as a shock organ in anaphylaxis

    OpenAIRE

    Marone, Gianni; Genovese, Arturo; Varricchi, Gilda; Granata, Francescopaolo

    2014-01-01

    Summary Anaphylaxis is a potentially fatal, immediate hypersensitivity reaction. Mast cells and basophils, by elaborating vasoactive mediators and cytokines, are the main primary effector cells of anaphylaxis. Mast cells have been identified in human heart between myocardial fibers, perivascularly, in the adventitia, and in the arterial intima. Mast cells isolated from human heart tissue (HHMC) of patients undergoing cardiac transplantation express high affinity immunglobulin E (IgE) receptor...

  11. Omalizumab: Practical considerations regarding the risk of anaphylaxis

    OpenAIRE

    Kim Harold L; Leigh Richard; Becker Allan

    2010-01-01

    Abstract Omalizumab has demonstrated efficacy among patients with moderate to severe persistent allergic asthma, whose symptoms are inadequately controlled with other controller agents. This therapy is generally well tolerated, but there are some safety considerations, the most important of which is the rare, but potentially life-threatening, occurrence of omalizumab-associated anaphylaxis. In Canada, data from the manufacturer of omalizumab indicate that the frequency of anaphylaxis attribut...

  12. CLINICAL FACTORS FOR DEVELOPING SHOCK IN RADIOCONTRAST MEDIA INDUCED ANAPHYLAXIS.

    Science.gov (United States)

    Kim, Sang Min; Ko, Byuk Sung; Kim, Ji Yeon; Ha, Sang Ook; Ahn, Shin; Sohn, Chang Hwan; Seo, Dong Woo; Kim, Tae-Bum; Kim, Won Young

    2016-03-01

    The aim of this study was to investigate the time interval between radiocontrast media (RCM) administration and the development of anaphylactic shock, and risk factors associated with RCM-induced anaphylactic shock. We reviewed the medical records of 154 patients with RCM-induced anaphylaxis presenting to the emergency department of a tertiary care hospital between January 2005 and December 2014. Clinical features of RCM-induced anaphylaxis were analyzed, and patients were categorized into shock and non-shock groups to identify associated factors in affected patients. Of the 154 cases of RCM-induced anaphylaxis, 101 (65.9%) patients experienced shock. The median time between RCM exposure and the onset of shock was 11 min (interquartile range, 7.0-18.8). In patients with RCM-induced anaphylaxis accompanying shock, the median time from RCM to the first symptom onset was 6 min (interquartile range, 5.0-10.0). In the multivariate analysis, age, neurological manifestations, and allergy history except RCM were associated with the development of shock. RCM-induced anaphylaxis was commonly accompanied with shock, and the time interval between RCM exposure and the onset of shock was short. Physicians should pay attention to the development of potential cardiovascular collapse in anaphylaxis patients of old age and with neurologic manifestations. PMID:26506069

  13. Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time

    OpenAIRE

    Liew, Woei Kang; Chiang, Wen Chin; Goh, Anne EN; Lim, Hwee Hoon; Chay, Oh Moh; Chang, Serena; Tan, Jessica HY; Shih, E'Ching; Kidon, Mona

    2013-01-01

    Background We have noticed changes in paediatric anaphylaxis triggers locally in Singapore. Objective We aimed to describe the demographic characteristics, clinical features, causative agents and management of children presenting with anaphylaxis. Methods This is a retrospective study of Singaporean children presenting with anaphylaxis between January 2005 and December 2009 to a tertiary paediatric hospital. Results One hundred and eight cases of anaphylaxis in 98 children were included. Food...

  14. A regional approach to unmet needs in anaphylaxis.

    Science.gov (United States)

    Minale, P; Bignardi, D; Troise, C; Voltolini, S; Dignetti, P

    2016-05-01

    Allergic diseases are under-diagnosed and undertreated despite their wide prevalence, and particularly anaphylaxis is often under-estimated. Evidence-based anaphylaxis guidelines developed by principal allergy organizations agree on increased prevalence of anaphylaxis, especially in patients younger than 18 years (18-27,30): this trend highlights the need for actions on anaphylaxis management and prevention (3,4). Lack of prompt connection between emergency department and allergy unit after discharge, and of a dedicated ICD-9th identification code (18-26), can delay diagnosis and treatment of anaphylaxis (28,29). Also in the experience of our Allergy Unit, patients reach the allergist office after several attacks treated in ED (17), without a previous evaluation and risk assessment. Keeping in mind unmet needs in anaphylaxis (4), we focused on regional approaches to health care delivery. The key point of our project was to establish an active collaboration between allergist clinicians and their counterparts in emergency medicine, with a system of quick filing report of patients discharged from ED with the suspect of anaphylactic reaction, directed to a central allergy unit, acting in a hub and spoke model with the Ligurian allergy network (31). Aim of the project was to improve epidemiological data collection via direct connection among ED and allergy network; moreover, we tried to provide a quick and proper evaluation of all reported patients, identifying, when possible, the agent responsible for anaphylaxis, to provide instructions on how to minimize future exposure; as all individuals at risk for anaphylaxis should carry and know how to self-administer epinephrine, we managed to provide auto injector and proper training when appropriate. A follow up on readmissions was carried out during the study and four months later. In a 20 months observation period (2013/2014), 205 patients were reported: it was possible to reach a diagnosis and risk assessment in 64

  15. Anaphylaxis Caused By Hydatid Cyst in Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Bahanur Cekic

    2015-11-01

    Full Text Available There are many reasons for developing anaphylaxis under anesthesia. This risk increase in patients with hydatid cyst surgery. Hydatid cyst is a parasitic disease that is caused by Echinecocus granulosus. It is usually observed between the ages of 35-50. High antigenic hydatid cyst fluid spreads as a result of surgical manipulation or post-traumatic rupture. Hydatid cyst fluid causes anaphylactic reactions (urticarial, rash, shock, and cardiovascular collapse and progress mortal. Diagnosis and treatment of anaphylaxis or anaphylactoid reaction may become more difficult for the anesthetist, especially in patients with concomitant diseases such as cardiopulmonary disorders. In this case report, we presented early detection, rapid intervention and treatment of anaphylaxis on patient with severe chronic obstructive pulmonary disease (asthma and bronchiectasis.

  16. Fatal and near-fatal anaphylaxis: factors that can worsen or contribute to fatal outcomes.

    Science.gov (United States)

    Greenberger, Paul A

    2015-05-01

    Anaphylaxis implies a risk of death even in patients whose prior episodes have been considered mild and managed easily. Anaphylaxis occurs in all age groups, from infants to the elderly, but most deaths occur in adults. Factors or circumstances associated with near-fatal or fatal anaphylaxis are reviewed from the following 10 perspectives: accidents and mishaps, adulterated products, age, allergens, atopy, comorbidities, Munchausen syndrome or contrived anaphylaxis, patient factors, route of administration, and treatment-related issues. There are no absolute contraindications to self-injectable epinephrine, and epinephrine can be administered for anaphylaxis to elderly patients or to those patients receiving beta-adrenergic blockers. PMID:25841558

  17. A case of anaphylaxis after the ingestion of yacon.

    Science.gov (United States)

    Yun, Eun Young; Kim, Hyun Sik; Kim, You Eun; Kang, Min Kyu; Ma, Jeong Eun; Lee, Gi Dong; Cho, Yu Ji; Kim, Ho Cheol; Lee, Jong Deok; Hwang, Young Sil; Jeong, Yi Yeong

    2010-04-01

    Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots. PMID:20358031

  18. Munchausen stridor-a strong false alarm of anaphylaxis.

    Science.gov (United States)

    Bahna, Sami L; Oldham, Jennifer L

    2014-11-01

    The diagnosis of anaphylaxis is often based on reported symptoms which may not be accurate and lead to major psychosocial and financial impacts. We describe two adult patients who were diagnosed as having recurrent anaphylaxis witnessed by multiple physicians based on recurrent laryngeal symptoms. The claimed cause was foods in one and drugs in the other. We questioned the diagnosis because of absent documentation of objective findings to support anaphylaxis, and the symptoms occurred during skin testing though the test sites were not reactive. Our initial skin testing with placebos reproduced the symptoms without objective findings. Subsequent skin tests with the suspected allergens were negative yet reproduced the symptoms without objective findings. Disclosing the test results markedly displeased one patient but reassured the other who subsequently tolerated the suspected allergen. In conclusion, these 2 patients' symptoms and evaluation were not supportive of their initial diagnosis of recurrent anaphylaxis. The compatible diagnosis was Munchausen stridor which requires psychiatric evaluation and behavior modification, but often rejected by patients. PMID:25374759

  19. Omalizumab: Practical considerations regarding the risk of anaphylaxis

    Directory of Open Access Journals (Sweden)

    Kim Harold L

    2010-12-01

    Full Text Available Abstract Omalizumab has demonstrated efficacy among patients with moderate to severe persistent allergic asthma, whose symptoms are inadequately controlled with other controller agents. This therapy is generally well tolerated, but there are some safety considerations, the most important of which is the rare, but potentially life-threatening, occurrence of omalizumab-associated anaphylaxis. In Canada, data from the manufacturer of omalizumab indicate that the frequency of anaphylaxis attributed to Xolair in post-marketing use is approximately 0.2%. Other researchers, including the American Omalizumab Joint Task Force (OJTF, have suggested a lower overall frequency of 0.09%. This paper provides a summary of the epidemiologic research carried out to date and presents a concise, practical set of recommendations for the prevention, monitoring and management of omalizumab-associated anaphylaxis. Prevention tips include advice on patient education measures, concomitant medications and optimal administration. For the first three injections, the recommendation is to monitor in clinic for two hours after the omalizumab injection; for subsequent injections, the monitoring period should be 30 minutes or an appropriate time agreed upon by the individual patient and healthcare professional. In the event that a patient does experience omalizumab-associated anaphylaxis, the paper provides recommendations for handling the situation in-clinic and recommendations on how to counsel patients to recognize the potential signs and symptoms in the community and react appropriately.

  20. Exercise-induced anaphylaxis related to specific foods.

    Science.gov (United States)

    Tilles, S; Schocket, A; Milgrom, H

    1995-10-01

    We describe the case, documented by challenge results, of a 16-year-old girl with exercise-induced anaphylaxis associated with eating pizza and a cheese sandwich. Patients in whom a specific coprecipitating food has been identified should avoid it for at least 12 hours before exercise. All patients should be instructed to avoid eating 6 to 8 hours before exercise, discontinue exercise at the first sign of symptoms, and exercise only with a companion prepared to administer epinephrine. PMID:7562280

  1. Anaphylaxis Caused By Hydatid Cyst in Asthmatic Patients

    OpenAIRE

    Bahanur Cekic

    2015-01-01

    There are many reasons for developing anaphylaxis under anesthesia. This risk increase in patients with hydatid cyst surgery. Hydatid cyst is a parasitic disease that is caused by Echinecocus granulosus. It is usually observed between the ages of 35-50. High antigenic hydatid cyst fluid spreads as a result of surgical manipulation or post-traumatic rupture. Hydatid cyst fluid causes anaphylactic reactions (urticarial, rash), shock, and cardiovascular collapse and progress mortal. Diagnosis an...

  2. Anaphylaxis to husband's seminal plasma and treatment by local desensitization

    OpenAIRE

    Park Chul; Huh Jung-Sik; Chung Young-Bae; Kim Miok; Kim Sohyung; Lee Jaechun; Lee Keun; Kim Jeong

    2008-01-01

    Abstract Hypersensitivity to human seminal fluid is rare but can be life threatening. We report a case of IgE-mediated anaphylaxis to seminal plasma that was diagnosed by skin prick tests and successfully treated by local desensitization. A 32-year-old woman suffering from angioedema and hypotension after exposure to semen was treated with epinephrine upon admission. Skin prick tests and immunoblotting for IgE binding components showed that she was sensitized to her husband's seminal plasma. ...

  3. Anaphylaxis at image-guided epidural pain block secondary to corticosteroid compound.

    LENUS (Irish Health Repository)

    Moran, Deirdre E

    2012-09-01

    Anaphylaxis during image-guided interventional procedures is a rare but potentially fatal event. Anaphylaxis to iodinated contrast is an established and well-recognized adverse effect. However, anaphylaxis to some of the other frequently administered medications given during interventional procedures, such as corticosteroids, is not common knowledge. During caudal epidural injection, iodinated contrast is used to confirm needle placement in the epidural space at the level of the sacral hiatus. A combination of corticosteroid, local anesthetic, and saline is subsequently injected. We describe a very rare case of anaphylaxis to a component of the steroid medication instilled in the caudal epidural space.

  4. Cow’s Milk Anaphylaxis in Children First Report of Iranian Food Allergy Registry

    OpenAIRE

    Pegah Teymourpour; Zahra Pourpak; Mohammad Reza Fazlollahi; Saeideh Barzegar; Raheleh Shokouhi; Rosita Akramian; Masoud Movahedi; Mahboobeh Mansouri; Bahram Mirsaeedghazi; Mostafa Moin

    2012-01-01

    Cow’s  milk  anaphylaxis is  the  most  common  food-induced  anaphylaxis in  Iranian children. The clinical and laboratory findings of cow’s milk anaphylaxis are evaluated in this study. All children who had experienced cow’s  milk anaphylaxis and had been referred to Immunology, asthma and allergy research center during a 5-year period were considered. After fulfilling a questionnaire, patients underwent measurement of total IgE and cow’s milk- specific IgE by Immunocap test and Skin prick ...

  5. Food-dependent exercise-induced anaphylaxis: is wheat unique?

    Science.gov (United States)

    Wong, Gabriel K; Krishna, Mamidipudi T

    2013-12-01

    This review draws comparisons between wheat-dependent exercise-induced anaphylaxis (WDEIA) and other food-dependent exercise-induced anaphylaxis (FDEIAs) and discusses the importance of co-factors in its pathophysiology. FDEIA remains an enigmatic condition since it was first described 30 years ago. The sporadic and unpredictable nature of its reactions has puzzled clinicians and scientists for decades, but recent studies on WDEIA have enlightened us about the pathophysiology of this condition. The identification of defined allergic epitopes such as Tri a 19, α-gliadin, β-gliadin and γ-gliadin in WDEIA enables it to become the perfect model for studying FDEIA, but WDEIA is by no means a unique condition. On a larger scale, FDEIA represents a crucial link between IgE-mediated and anaphylactoid reactions and provides supportive evidence for the concept of 'summation anaphylaxis' and the need to overcome the 'allergen threshold'. Future work should focus on identifying more of the FDEIA epitopes and understanding their distinct molecular properties. The development of a biomarker in order to identify patients susceptible to co-factor influences would be invaluable. PMID:24127054

  6. Why Do People Die of Anaphylaxis?—A Clinical Review

    OpenAIRE

    Arvind Kumar; Teuber, Suzanne S.; M. Eric Gershwin

    2005-01-01

    Anaphylaxis is a source of anxiety for patients and healthcare providers. It is a medical emergency that presents with a broad array of symptoms and signs, many of which can be deceptively similar to other diseases such as myocardial infarction, asthma, or panic attacks. In addition to these diagnostic challenges, anaphylaxis presents management difficulties due to rapid onset and progression, lack of appropriate ...

  7. Anaphylaxis : Guidelines from the European Academy of Allergy and Clinical Immunology

    NARCIS (Netherlands)

    Muraro, A.; Roberts, G.; Worm, M.; Bilo, M. B.; Brockow, K.; Fernandez Rivas, M.; Santos, A. F.; Zolkipli, Z. Q.; Bellou, A.; Beyer, K.; Bindslev-Jensen, C.; Cardona, V.; Clark, A. T.; Demoly, P.; Dubois, A. E. J.; DunnGalvin, A.; Eigenmann, P.; Halken, S.; Harada, L.; Lack, G.; Jutel, M.; Niggemann, B.; Rueff, F.; Timmermans, F.; Vlieg-Boerstra, B. J.; Werfel, T.; Dhami, S.; Panesar, S.; Akdis, C. A.; Sheikh, A.

    2014-01-01

    Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidenc

  8. Anaphylaxis to honey in pollinosis to mugwort: a case report.

    Science.gov (United States)

    Fuiano, N; Incorvaia, C; Riario-Sforza, G G; Casino, G

    2006-12-01

    A case of anaphylaxis to honey in a 19 year old female sensitized to Compositae pollen is described. The patient suffered from summer rhinoconjunctivitis since seven years; in January 2006, ten minutes after eating bread and honey she developed angioedema of the lips and tongue, runny nose, cough, dyspnoea, and collapse, requiring hospitalization and treatment with high dose corticosteroids and anti-histamines. After two weeks, skin prick tests (SPT) with a standard panel of inhalant allergens and prick + prick with a number of kinds of honey were performed. SPTs were positive to mugwort, ragweed, dandelion, and goldenrod. Concerning honey, the prick + prick was positive to "Millefiori" (obtained from bees foraging on Compositae) and also to sunflower, limetree, and gum tree honey, while was negative for other kinds of honey, including the frequently used chestnut honey and acacia honey. The allergenic component responsible of anaphylaxis in this case seems to be a molecule occurring in Compositae pollens, as previously reported for other three reports, but also in pollen from plants of different families. Honey contains a large number of components derived from bees, such as gland secretions and wax, as well as from substances related to their foraging activity, such flower nectar and pollens (1, 2). Honey as a food has been associated to allergic reactions and particularly to anaphylaxis (3-6). Among the pollens, the role of Compositae is somewhat controversial, since its responsibility is clear in some studies (3, 5, 6) but considered negligible in others (7). Here we present the case of a patient sensitized to Compositae pollen who had an anaphylactic reaction to the ingestion of honey obtained from bees foraging on Compositae flowers and was tested with a number of different varieties of honey. PMID:17274522

  9. Chloramine-induced anaphylaxis while showering: a case report

    Directory of Open Access Journals (Sweden)

    D’Alò Simona

    2012-09-01

    Full Text Available Abstract Introduction Sodium-N-chlorine-p-toluene sulfonamide, commonly known as chloramine-T, is a derivative of chlorine which is widely used as a disinfectant. For many years, chloramine-T has been described as a cause of immediate-type hypersensitivity, especially with regard to asthma and rhinitis, and as a cause of occupational dermatoses in cleaning personnel in hospitals, although no anaphylactic reaction has yet been reported. Hence, to the best of our knowledge we present the first case of anaphylaxis to chloramine-T with evidence of specific immunoglobulin E antibodies. Case presentation We describe the case of a 25-year-old Caucasian woman who was in good health and with a negative history for atopy, including no respiratory symptoms of rhinitis or asthma, and with no professional exposure to chloramine-T. She, while showering, applied a chloramine-T solution to a skin area with folliculitis on her leg, and within a few minutes developed generalized urticaria and angioedema, followed by vomiting and collapse with loss of consciousness. A skin prick test with a chloramine-T solution at 10mg/mL concentration was positive, and specific immunoglobulin E to chloramine-T was quantified at a value of 2.9 optical density as measured by the enzyme allergosorbent test technique. Conclusion The strict cause-effect relationship and the results of the skin test and the in vitro test make certain the causative role of chloramine-T in this case of anaphylaxis. This suggests that chloramine-T, based on its wide use as a disinfectant, should be considered a possible cause in anaphylaxis of unknown origin.

  10. Anaphylaxis to husband's seminal plasma and treatment by local desensitization

    Directory of Open Access Journals (Sweden)

    Park Chul

    2008-12-01

    Full Text Available Abstract Hypersensitivity to human seminal fluid is rare but can be life threatening. We report a case of IgE-mediated anaphylaxis to seminal plasma that was diagnosed by skin prick tests and successfully treated by local desensitization. A 32-year-old woman suffering from angioedema and hypotension after exposure to semen was treated with epinephrine upon admission. Skin prick tests and immunoblotting for IgE binding components showed that she was sensitized to her husband's seminal plasma. Local desensitization, which persisted for six months, was achieved by intravaginal administration of serial dilutions of her husband's seminal plasma.

  11. Why Do People Die of Anaphylaxis?—A Clinical Review

    Directory of Open Access Journals (Sweden)

    Arvind Kumar

    2005-01-01

    Full Text Available Anaphylaxis is a source of anxiety for patients and healthcare providers. It is a medical emergency that presents with a broad array of symptoms and signs, many of which can be deceptively similar to other diseases such as myocardial infarction, asthma, or panic attacks. In addition to these diagnostic challenges, anaphylaxis presents management difficulties due to rapid onset and progression, lack of appropriate self-treatment education and implementation by patients, severity of the allergic response, exacerbating medications or concurrent disease, and unpredictability. The most common causes of anaphylaxis are food allergies, stinging insects and immunotherapy (allergy shots but idiopathic anaphylaxis, latex allergy and drug hypersensitive all contribute to the epidemiology. Reactions to IVP and other dyes are coined anaphylactoid reactions but have identical pathophysiology and treatment, once the mast cell has been degranulated. As many antigens can be the trigger for fatal anaphylaxis, it is useful to examine the features of each etiology individually, highlighting factors common to all fatal anaphylaxis and some specific to certain etiologies. Generally what distinguishes a fatal from non fatal reaction is often just the rapidity to apply correct therapy. Prevention is clearly the key and should identify high-risk patients in an attempt to minimize the likely of a severe reaction. Although fatal anaphylaxis is rare, it is likely underreported.

  12. Why Do People Die of Anaphylaxis?—A Clinical Review

    Science.gov (United States)

    Kumar, Arvind; Teuber, Suzanne S.; Gershwin, M. Eric

    2005-01-01

    Anaphylaxis is a source of anxiety for patients and healthcare providers. It is a medical emergency that presents with a broad array of symptoms and signs, many of which can be deceptively similar to other diseases such as myocardial infarction, asthma, or panic attacks. In addition to these diagnostic challenges, anaphylaxis presents management difficulties due to rapid onset and progression, lack of appropriate self-treatment education and implementation by patients, severity of the allergic response, exacerbating medications or concurrent disease, and unpredictability. The most common causes of anaphylaxis are food allergies, stinging insects and immunotherapy (allergy shots) but idiopathic anaphylaxis, latex allergy and drug hypersensitive all contribute to the epidemiology. Reactions to IVP and other dyes are coined anaphylactoid reactions but have identical pathophysiology and treatment, once the mast cell has been degranulated. As many antigens can be the trigger for fatal anaphylaxis, it is useful to examine the features of each etiology individually, highlighting factors common to all fatal anaphylaxis and some specific to certain etiologies. Generally what distinguishes a fatal from non fatal reaction is often just the rapidity to apply correct therapy. Prevention is clearly the key and should identify high-risk patients in an attempt to minimize the likely of a severe reaction. Although fatal anaphylaxis is rare, it is likely underreported. PMID:16584114

  13. Use of alpha-agonists for management of anaphylaxis occurring under anaesthesia: case studies and review.

    Science.gov (United States)

    Heytman, M; Rainbird, A

    2004-12-01

    Anaphylaxis is an uncommon but serious complication of anaesthesia. Most current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of cardiovascular collapse. We present two cases of anaphylaxis under anaesthesia where return of spontaneous circulation was refractory to epinephrine, but occurred following the administration of the alpha-agonist metaraminol. Potential advantages and disadvantages of using epinephrine in this setting, the role of alpha-agonists and some potential mechanisms accounting for their role in successful management are reviewed. PMID:15549981

  14. Food-dependent exercise-induced anaphylaxis due to wheat in a young woman.

    OpenAIRE

    Hamid Ahanchian; Reza Farid; Elham Ansari; Hamid Reza Kianifar; Farahzad Jabbari Azad; Seyed Ali Jafari; Reza Purreza; Shadi Noorizadeh

    2013-01-01

    Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported  by laboratory tests such as serum tryptase and positive skin test  results  for  specific IgE  to  potential  triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen.  Food-exercise challenge test  may be  an acceptable method  for...

  15. A case of taurine-containing drink induced anaphylaxis.

    Science.gov (United States)

    Lee, Seung-Eun; Lee, Suh-Young; Jo, Eun-Jung; Kim, Mi-Young; Yang, Min-Suk; Chang, Yoon-Seok; Kim, Sae-Hoon

    2013-01-01

    Taurine is one of most abundant free amino acids in mammalian tissue. It has been used for various health functional foods as a main ingredient in food industry. A 33-year-old female patient repeatedly experienced generalized itching, urticaria, dyspnea and dizziness after drinking taurine-containing drinks. The patient showed positive response to oral challenge tests with taurine-containing drinks. The patient also showed positive response with synthetic taurine but not with natural taurine. Skin prick test and basophil activation test with the synthetic taurine were negative. To our knowledge, there has been no report of taurine-induced hypersensitivity reactions. We herein report the first case of taurine-containing drink induced anaphylaxis, especially by synthetic taurine. PMID:23404176

  16. Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark

    DEFF Research Database (Denmark)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens; Husum, Bent; Malling, Hans-Jørgen; Mosbech, Holger

    2011-01-01

    BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment is...... important. METHODS:: A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock with......, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). CONCLUSION:: Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence...

  17. Increased regional vascular albumin permeation in the rat during anaphylaxis

    International Nuclear Information System (INIS)

    The changes in vascular albumin permeation induced by systemic anaphylaxis were studied simultaneously in 21 different tissues of the same animal. Before Ag challenge sensitized rats were injected i.v. with 125I-albumin (test tracer), 51Cr-RBC (vascular space marker) and 57Co-EDTA (extravascular space marker). The index of vascular permeation used was the tissue to blood isotope ratio (tbir), which was obtained by dividing the ratio of 125I/51Cr counts in each tissue by the ratio of the same isotopes in the arterial blood sample. After Ag challenge, the increase in the tbir varied considerably among the different tissues. The most pronounced increase was noted in the lymph node (ninefold) followed by the aorta and mesentery (six- to sevenfold) and the various parts of the gastrointestinal tract (four- to sixfold). In the skin less than skeletal muscle less than lung less than liver and eye two- to fourfold increases occurred. Relatively minor increases in albumin permeation (less than twofold) were observed in the brain less than kidney less than heart and less than spleen. The testis was the only organ in which no significant change occurred. For some of the tissues there was also an increase in the tbir for 57Co/51Cr (an index of the extracellular fluid space) suggesting edema formation. The highest increase was noted in the aorta (fourfold). Minor increases occurred in the atrium of the heart, stomach, duodenum, and lymph nodes. There was also a 36% increase in hematocrit. Therefore, systemic anaphylaxis caused extensive extravasation of albumin and hemoconcentration

  18. Anaphylaxis to muscle relaxants: rational for skin tests.

    Science.gov (United States)

    Moneret-Vautrin, D A; Kanny, G

    2002-09-01

    IgE-dependent allergy to muscle relaxants (MR) has an estimated prevalence of 1 out of 6500 General Anesthesias (GA). 62% of anaphylaxis during surgery are due to MR anaphylaxis. All the molecules are divalent, carrying two NH4+ epitopes (quaternary ammonium ions), either structurally or after rapid in vivo protonization (vecuronium). The excellent overall performance of skin test makes them the golden standard for the diagnosis of anaphylactoid reactions. Techniques include intradermal tests and prick-tests. The current localizations are the forearm and the back. Positivity criteria are 3 mm for prick-tests. For IDTs, the criterium is the doubling of the size of the injection papula, when 0.02 to 0.04 ml is injected: 8 mm. The recommended concentrations are not falsely negative. Commercial concentrations can be tested by prick tests, except for mivacurium and atracurium tested of 1:10 dilution. A scale of concentrations is advised for IDT starting with 1:10,000, up to a normally non reactive concentration that is: 100 micrograms/ml (succinylcholine), 200 micrograms/ml (gallamine), 10 micrograms/ml (atracurium), 2 micrograms/ml (mivacurium), 200 micrograms/ml (pancuronium), 400 micrograms/ml (vecuronium), 1,000 micrograms/ml (rocuronium), 200 micrograms/ml (cis atracurium). The specificity and sensitivity of the skin tests to MRs are greater than 95%. The reproducibility over years is 88%. The overall concordance of PT and IDR is 97%. Both types of tests can be used for the diagnosis. IDT have to be carried out for the search of the cross sensitization. 84% of patients do have cross sensitization to MRs but only 16% react to all MRs. The further use of MRs selected by negative IDTs has been proved to be safe. PMID:12389445

  19. [Bupivacaine-induced Anaphylaxis in a Parturient Undergoing Cesarean Section].

    Science.gov (United States)

    Iwasaki, Mitsuo; Tachibana, Kazuya; Mitsuda, Nobuaki; Kinouchi, Keiko

    2015-02-01

    We describe a case of anaphylaxis that occurred in a 33-year-old gravida 1, para 1 term woman scheduled for cesarean delivery for breech presentation. Her past history was unremarkable except for orciprenaline allergy. Spinal anesthesia was performed at L3-4 using 2.5 ml of 0.5% hyperbaric bupivacaine and 0.1 mg morphine. Seven minutes after spinal anesthesia, she complained of hoarseness and difficulty in breathing and 3 minutes later, blood pressure decreased to 76/51 mmHg, and oxygen saturation to 87% with supplemental oxygen. Skin flushing was noted in the face and trunk of the body and anaphylaxis was diagnosed. She was treated with a rapid intravenous infusion and iv administration of phenylephrine (total dose 0.4 mg), ephedrine (total dose 25 mg), hydrocortisone and famotidine. Cesarean section was started 23 minutes after spinal anesthesia when blood pressure and oxygen saturation recovered. A male infant was delivered (18 minutes after the onset of anaphylactic event) with Apgar scores of 2 and 5 at 1 and 5 min, respectively and resuscitated with mask ventilation. Umbilical artery blood gas analysis revealed pH 6.85, base excess -20.3 mmol x l (-1) and lactate 109 mg x dl (-1). The mother was discharged from the hospital on the 6th postoperative day. The baby's electroencephalogram, however, demonstrated a pattern consistent with mild hypoxic-ischemic encephalopathy. Lymphocyte stimulation test revealed that she was allergic to bupivacaine. If maternal hypotension persists, i.m. or i.v. adrenaline should be administered immediately because maternal hypotension and hypoxemia may cause significant fetal morbidity and mortality and prompt cesarean section should be considered. PMID:26121818

  20. The Severe Adverse Reaction to Vitamin K1 Injection Is Anaphylactoid Reaction but Not Anaphylaxis

    OpenAIRE

    Mi, Yan-Ni; Ping, Na-Na; Xiao, Xue; Zhu, Yan-Bing; Liu, Jing; Cao, Yong-xiao

    2014-01-01

    The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first ...

  1. Anaphylaxis to Iodinated Contrast Media: Clinical Characteristics Related with Development of Anaphylactic Shock

    OpenAIRE

    Kim, Min-Hye; Lee, Suh-Young; Lee, Seung-Eun; Yang, Min-Suk; Jung, Jae-Woo; Park, Chang Min; Lee, Whal; Cho, Sang-Heon; Kang, Hye-Ryun

    2014-01-01

    Objective Anaphylaxis is the most severe form of radiocontrast media (RCM) induced hypersensitivity and can be life-threatening if profound hypotension is combined. With increased use of iodine based RCM, related hypersensitivity is rapidly growing. However, the clinical characteristics and risk factors of RCM induced anaphylaxis accompanied by hypotension (anaphylactic shock) are not clearly defined. This study was performed to investigate the risk factors of RCM induced anaphylactic shock a...

  2. Regulatory CD4+Foxp3+ T cells control the severity of anaphylaxis.

    OpenAIRE

    Reem Kanjarawi; Michel Dy; Emilie Bardel; Tim Sparwasser; Bertrand Dubois; Salah Mecheri; Dominique Kaiserlian

    2013-01-01

    OBJECTIVE: Anaphylaxis is a life-threatening outcome of immediate-type hypersensitivity to allergen, consecutive to mast cell degranulation by allergen-specific IgE. Regulatory T cells (Treg) can control allergic sensitization and mast cell degranulation, yet their clinical benefit on anaphylactic symptoms is poorly documented. Here we investigated whether Treg action during the effector arm of the allergic response alleviates anaphylaxis. METHODS: We used a validated model of IgE-mediated pa...

  3. Acute and preventive management of anaphylaxis in German primary school and kindergarten children

    OpenAIRE

    Kilger, Magdalena; Range, Ursula; Vogelberg, Christian

    2015-01-01

    Background Anaphylaxis is a severe, life-threatening situation. However, little is known about real-life anaphylactic management in children, especially in kindergarten and school settings, where a large number of anaphylaxes take place. Methods Parents, school teachers and child-care providers of 86 primary schools and kindergartens in the city of Dresden, Germany, received questionnaires to report their experience with anaphylaxis in children. The main foci of interest were symptoms, allerg...

  4. Beware of the caterpillar: Anaphylaxis to the spotted tussock moth caterpillar, Lophocampa maculata

    OpenAIRE

    DuGar, Brandon; Sterbank, Julie; Tcheurekdjian, Haig; Hostoffer, Robert

    2014-01-01

    We present a case report of a 5-year-old boy with presumed anaphylaxis to the caterpillar, Lophocampa maculata, manifesting as the acute development of diffuse urticaria and progressive dyspnea. This reaction required prompt treatment with antihistamines and a bronchodilator. Allergen scratch testing with a homogenized caterpillar extract suggests that immunoglobulin E–mediated type I hypersensitivity as the pathophysiological mechanism responsible for the boy's anaphylaxis. This case report ...

  5. A Case of Anaphylaxis Induced by Contact with Young Radish (Raphanus sativus L)

    OpenAIRE

    Lee, Yung-Hee; Lee, Jae-Hyoung; Kang, Hye-Ran; Ha, Jung-Hoon; Lee, Byoung-Hoon; Kim, Sang-Hoon

    2014-01-01

    Young radish (Raphanus sativus L), a member of the mustard family (Cruciferae), is a common ingredient of Kimchi. Although few reports have described anaphylaxis to cruciferous vegetables, we report the case of anaphylaxis induced by contact with young radish. A 46-year-old female with a history of contact allergy to metal presented to our emergency room (ER) with dizziness, generalized eruption and gastrointestinal upset. Her symptoms developed after re-exposure to young radish while choppin...

  6. Anaphylaxis following intravenous ranitidine: A rare adverse reaction of a common drug

    Directory of Open Access Journals (Sweden)

    Deepti Chopra

    2014-01-01

    Full Text Available Ranitidine hydrochloride is a widely used drug that is generally well-tolerated. Anaphylaxis is rarely observed with ranitidine. We report a case who developed severe anaphylaxis following single dose of intravenous ranitidine. The article highlights the importance of recognition of this serious adverse event and re-emphasizes the need for cautious use of drugs, especially in those with known history of allergy.

  7. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology.

    Science.gov (United States)

    Muraro, A; Roberts, G; Worm, M; Bilò, M B; Brockow, K; Fernández Rivas, M; Santos, A F; Zolkipli, Z Q; Bellou, A; Beyer, K; Bindslev-Jensen, C; Cardona, V; Clark, A T; Demoly, P; Dubois, A E J; DunnGalvin, A; Eigenmann, P; Halken, S; Harada, L; Lack, G; Jutel, M; Niggemann, B; Ruëff, F; Timmermans, F; Vlieg-Boerstra, B J; Werfel, T; Dhami, S; Panesar, S; Akdis, C A; Sheikh, A

    2014-08-01

    Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis. While the primary audience is allergists, these guidelines are also relevant to all other healthcare professionals. The development of these guidelines has been underpinned by two systematic reviews of the literature, both on the epidemiology and on clinical management of anaphylaxis. Anaphylaxis is a potentially life-threatening condition whose clinical diagnosis is based on recognition of a constellation of presenting features. First-line treatment for anaphylaxis is intramuscular adrenaline. Useful second-line interventions may include removing the trigger where possible, calling for help, correct positioning of the patient, high-flow oxygen, intravenous fluids, inhaled short-acting bronchodilators, and nebulized adrenaline. Discharge arrangements should involve an assessment of the risk of further reactions, a management plan with an anaphylaxis emergency action plan, and, where appropriate, prescribing an adrenaline auto-injector. If an adrenaline auto-injector is prescribed, education on when and how to use the device should be provided. Specialist follow-up is essential to investigate possible triggers, to perform a comprehensive risk assessment, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy. Training for the patient and all caregivers is essential. There are still many gaps in the evidence base for anaphylaxis. PMID:24909803

  8. Incidence of fatal food anaphylaxis in people with food allergy: a systematic review and meta-analysis

    OpenAIRE

    Umasunthar, T; Leonardi-Bee, J; Hodes, M; Turner, P J; Gore, C.; Habibi, P; Warner, J. O.; Boyle, R. J.

    2013-01-01

    Background Food allergy is a common cause of anaphylaxis, but the incidence of fatal food anaphylaxis is not known. The aim of this study was to estimate the incidence of fatal food anaphylaxis for people with food allergy and relate this to other mortality risks in the general population. Methods We undertook a systematic review and meta-analysis, using the generic inverse variance method. Two authors selected studies by consensus, independently extracted data and assessed the quality of inc...

  9. Food-dependent exercise-induced anaphylaxis due to wheat in a young woman.

    Science.gov (United States)

    Ahanchian, Hamid; Farid, Reza; Ansari, Elham; Kianifar, Hamid Reza; Jabbari Azad, Farahzad; Jafari, Seyed Ali; Purreza, Reza; Noorizadeh, Shadi

    2013-03-01

    Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported by laboratory tests such as serum tryptase and positive skin test results for specific IgE to potential triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen. Food-exercise challenge test may be an acceptable method for diagnosis of Food Dependent Exercise-Induced Allergy and dietary elimination of food is recommended to manage it. In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative.The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet. In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis. PMID:23454785

  10. Level of knowledge about anaphylaxis and its management among health care providers

    Directory of Open Access Journals (Sweden)

    H S Drupad

    2015-01-01

    Full Text Available Objectives: This study was conducted to assess the level of knowledge of health care providers regarding anaphylaxis and its management at a tertiary care teaching hospital. Materials and Methods: A pretested structured questionnaire was administered to interns, MBBS Phase II students, and nursing students. The subjects were asked to answer the questionnaire, which included questions regarding anaphylaxis and its management. Results: Of 265 subjects, 151 (56.9% of subjects answered correctly that adrenaline is the first line of drug for the treatment of anaphylaxis. Among 151 subjects, 40 (26.4% answered the correct dose of adrenaline, of which 25 (16.5% subjects selected intramuscular injection as the most appropriate route of administration. Medical students′ performance was better than interns and nursing students on questions regarding dose, route, and site of adrenaline administration. Conclusion: Knowledge regarding the management of anaphylaxis was inadequate in almost all the health care providers who were included in the study. Improved education and training of health care providers are necessary for better management of anaphylaxis.

  11. Anti-histamine effect of Rubia tibetica, used to treat anaphylaxis caused by tick bites in the Pamir Mountains, Afghanistan

    DEFF Research Database (Denmark)

    Jeppesen, Anne S.; Kristiansen, Uffe; Soelberg, Jens;

    2012-01-01

    The roots of Rubia tibetica are chewed as an antidote to anaphylaxis caused by bites of the tick Ornithodoros lahorensis by the Wakhi people in Afghanistan.......The roots of Rubia tibetica are chewed as an antidote to anaphylaxis caused by bites of the tick Ornithodoros lahorensis by the Wakhi people in Afghanistan....

  12. Pathophysiological mechanisms of exercise-induced anaphylaxis: an EAACI position statement.

    Science.gov (United States)

    Ansley, L; Bonini, M; Delgado, L; Del Giacco, S; Du Toit, G; Khaitov, M; Kurowski, M; Hull, J H; Moreira, A; Robson-Ansley, P J

    2015-10-01

    This document is the result of a consensus on the mechanisms of exercise-induced anaphylaxis (EIAn), an unpredictable and potentially fatal syndrome. A multidisciplinary panel of experts including exercise physiologists, allergists, lung physicians, paediatricians and a biostatistician reached the given consensus. Exercise-induced anaphylaxis (EIAn) describes a rare and potentially fatal syndrome in which anaphylaxis occurs in conjunction with exercise. The pathophysiological mechanisms underlying EIAn have not yet been elucidated although a number of hypotheses have been proposed. This review evaluates the validity of each of the popular theories in relation to exercise physiology and immunology. On the basis of this evidence, it is concluded that proposed mechanisms lack validity, and it is recommended that a global research network is developed with a common approach to the diagnosis and treatment of EIAn in order to gain sufficient power for scientific evaluation. PMID:26100553

  13. Differences in hospital attendance for anaphylaxis between immigrants and non-immigrants

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Sheikh, Aziz; Dynnes Svendsen, Kira;

    2016-01-01

    -born individuals (n=740,600). Personal identification numbers were cross-linked to the Danish National Patient Registry identifying all first-time hospital attendances for anaphylaxis from January 1,1994 and December 31, 2010. Incidence rate ratios were estimated stratified for sex and region of birth, adjusting...... showed a decreased risk (RR=0.65; 95%CI: 0.34;1.25). Compared to Danish-born, non-Western immigrants who obtained residence permission as children had a decreased risk of hospital attendance for anaphylaxis (RR=0.48; 95%CI: 0.25;0.91). CONCLUSION: This Danish register-based study using nationwide data...... revealed fewer hospital attendances for anaphylaxis among non-Western immigrants compared to Danish-born; however this protection was lost over time....

  14. Differences in hospital attendance for anaphylaxis between immigrants and non-immigrants: a cohort study

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Sheikh, Aziz; Dynnes Svendsen, Kira;

    2016-01-01

    -born individuals (n=740,600). Personal identification numbers were cross-linked to the Danish National Patient Registry identifying all first-time hospital attendances for anaphylaxis from January 1,1994 and December 31, 2010. Incidence rate ratios were estimated stratified for sex and region of birth, adjusting...... showed a decreased risk (RR=0.65; 95%CI: 0.34;1.25). Compared to Danish-born, non-Western immigrants who obtained residence permission as children had a decreased risk of hospital attendance for anaphylaxis (RR=0.48; 95%CI: 0.25;0.91). CONCLUSION: This Danish register-based study using nationwide data...... revealed fewer hospital attendances for anaphylaxis among non-Western immigrants compared to Danish-born; however this protection was lost over time....

  15. Regulatory CD4+Foxp3+ T cells control the severity of anaphylaxis.

    Directory of Open Access Journals (Sweden)

    Reem Kanjarawi

    Full Text Available OBJECTIVE: Anaphylaxis is a life-threatening outcome of immediate-type hypersensitivity to allergen, consecutive to mast cell degranulation by allergen-specific IgE. Regulatory T cells (Treg can control allergic sensitization and mast cell degranulation, yet their clinical benefit on anaphylactic symptoms is poorly documented. Here we investigated whether Treg action during the effector arm of the allergic response alleviates anaphylaxis. METHODS: We used a validated model of IgE-mediated passive systemic anaphylaxis, induced by intravenous challenge with DNP-HSA in mice passively sensitized with DNP-specific IgE. Anaphylaxis was monitored by the drop in body temperature as well as plasma histamine and serum mMCP1 levels. The role of Treg was analyzed using MHC class II-deficient (Aβ(°/° mice, treatment with anti-CD25 or anti-CD4 mAbs and conditional ablation of Foxp3(+ Treg in DEREG mice. Therapeutic efficacy of Treg was also evaluated by transfer experiments using FoxP3-eGFP knock-in mice. RESULTS: Anaphylaxis did not occur in mast cell-deficient W/W(v mutant mice and was only moderate and transient in mice deficient for histamine receptor-1. Defects in constitutive Treg, either genetic or induced by antibody or toxin treatment resulted in a more severe and/or sustained hypothermia, associated with a rise in serum mMCP1, but not histamine. Adoptive transfer of Foxp3(+ Treg from either naïve or DNP-sensitized donors similarly alleviated body temperature loss in Treg-deficient DEREG mice. CONCLUSION: Constitutive Foxp3(+ Treg can control the symptomatic phase of mast cell and IgE-dependent anaphylaxis in mice. This might open up new therapeutic avenues using constitutive rather than Ag-specific Treg for inducing tolerance in allergic patients.

  16. Risk of solid cancer, cardiovascular disease, anaphylaxis, osteoporosis and fractures in patients with systemic mastocytosis

    DEFF Research Database (Denmark)

    Broesby-Olsen, Sigurd; Farkas, Dóra Körmendiné; Vestergaard, Hanne;

    2016-01-01

    In patients with systemic mastocytosis (SM), several aspects of morbidity remain poorly understood. We assessed the risk of solid cancers, cardiovascular disease, anaphylaxis, osteoporosis, and fractures in SM patients. Using Danish medical registries, we conducted a nationwide population.......2 (95% CI 0.9-1.6) and the 10-year AR was 5.9% (95% CI 3.9-8.4). SM patients are at increased risk of solid cancers - especially melanoma and NMSC-and cardiovascular disease. The risk of anaphylaxis and osteoporosis is clearly increased in SM, though absolute risk was low in this population-based study...

  17. Serious Shortcomings in the Management of Children with Anaphylaxis in Scottish Schools

    OpenAIRE

    Rankin, Kirsty E; Sheikh, Aziz

    2006-01-01

    Editors' Summary Background. Anaphylaxis is a severe allergic reaction that can cause a drop in blood pressure and swelling of the body tissues (swelling of the neck and throat and narrowing of the airways can make it hard to breathe). The reaction can be triggered by foods, such as peanuts or eggs, or by bee stings, natural latex (rubber), and certain drugs such as penicillin. Foods are the most common trigger in children. In the United Kingdom, thousands of people develop anaphylaxis each y...

  18. Allergy/Anaphylaxis Management in the School Setting. Position Statement. Revised

    Science.gov (United States)

    Zacharski, Susan; DeSisto, Marie; Pontius, Deborah; Sheets, Jodi; Richesin, Cynthia

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that the safe and effective management of allergies and anaphylaxis in schools requires a collaborative, multidisciplinary team approach. The registered professional school nurse (hereinafter referred to as the school nurse), is the leader in a comprehensive management approach…

  19. Spontaneous Intraperitoneal Rupture of a Hepatic Hydatid Cyst with Subsequent Anaphylaxis: A Case Report

    Directory of Open Access Journals (Sweden)

    Benjamin Tinsley

    2013-01-01

    Full Text Available Hydatid cyst rupture into the abdomen is a serious complication of cystic hydatid disease of the liver (Cystic Echinococcosis with an incidence of up to 16% in some series and can result in anaphylaxis or anaphylactoid reactions in up to 12.5% of cases. At presentation, 36–40% of hydatid cysts have ruptured or become secondarily infected. Rupture can be microscopic or macroscopic and can be fatal without surgery. Hydatid disease of the liver is primarily caused by the tapeworm Echinococcus granulosus and occurs worldwide, with incidence of up to 200 per 100,000 in endemic areas. Our case describes a 24-year-old Bulgarian woman presenting with epigastric pain and evidence of anaphylaxis. Abdominal CT demonstrated a ruptured hydatid cyst in the left lobe of the liver. A partial left lobe hepatectomy, cholecystectomy, and peritoneal washout was performed with good effect. She was treated for anaphylaxis and received antihelminthic treatment with Albendazole and Praziquantel. She made a good recovery following surgery and medical treatment and was well on follow-up. Intraperitoneal rupture with anaphylaxis is a rare occurrence, and there do not seem to be any reported cases from UK centres prior to this.

  20. Spontaneous intraperitoneal rupture of a hepatic hydatid cyst with subsequent anaphylaxis: a case report.

    Science.gov (United States)

    Tinsley, Benjamin; Abbara, Aula; Kadaba, Raghunandan; Sheth, Hemant; Sandhu, Gurjinder

    2013-01-01

    Hydatid cyst rupture into the abdomen is a serious complication of cystic hydatid disease of the liver (Cystic Echinococcosis) with an incidence of up to 16% in some series and can result in anaphylaxis or anaphylactoid reactions in up to 12.5% of cases. At presentation, 36-40% of hydatid cysts have ruptured or become secondarily infected. Rupture can be microscopic or macroscopic and can be fatal without surgery. Hydatid disease of the liver is primarily caused by the tapeworm Echinococcus granulosus and occurs worldwide, with incidence of up to 200 per 100,000 in endemic areas. Our case describes a 24-year-old Bulgarian woman presenting with epigastric pain and evidence of anaphylaxis. Abdominal CT demonstrated a ruptured hydatid cyst in the left lobe of the liver. A partial left lobe hepatectomy, cholecystectomy, and peritoneal washout was performed with good effect. She was treated for anaphylaxis and received antihelminthic treatment with Albendazole and Praziquantel. She made a good recovery following surgery and medical treatment and was well on follow-up. Intraperitoneal rupture with anaphylaxis is a rare occurrence, and there do not seem to be any reported cases from UK centres prior to this. PMID:25431702

  1. Comparison of School Food Allergy Emergency Plans to the Food Allergy and Anaphylaxis Network's Standard Plan

    Science.gov (United States)

    Powers, Jill; Bergren, Martha Dewey; Finnegan, Lorna

    2007-01-01

    Eighty-four percent of children with food allergies have a reaction in school, and 25% of first food reactions occur in schools. An evaluation was conducted comparing food allergy emergency plans to the Food Allergy and Anaphylaxis Network's (FAAN) Food Allergy Action Plan. Of the 94 respondents, 60 provided food allergy emergency plans for…

  2. EAACI Food Allergy and Anaphylaxis Guidelines : Food allergy health-related quality of life measures

    NARCIS (Netherlands)

    Muraro, A.; Dubois, Anthony; DunnGalvin, A.; Hourihane, J. O'B.; de Jong, N. W.; Meyer, R.; Panesar, S. S.; Roberts, G.; Salvilla, S.; Sheikh, A.; Worth, A.; Flokstra-de Blok, B. M. J.

    2014-01-01

    Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a sy

  3. Nitric oxide decreases intestinal haemorrhagic lesions in rat anaphylaxis independently of mast cell activation

    Directory of Open Access Journals (Sweden)

    J. Carvalho Tavares

    1997-01-01

    Full Text Available The purpose of this study is to assess the role of nitric oxide (NO in the intestinal lesions of passive anaphylaxis, since this experimental model resembles necrotizing enterocolitis. Sprague-Dawley rats were sensitized with IgE anti-dinitrophenol monoclonal antibody. Extravasation of protein-rich plasma and haemorrhagia were measured in the small intestine. Plasma histamine was measured to assess mast cell activation. The effect of exogenous NO on the lesions was assessed by using two structurally unrelated NO-donors: sodium nitroprusside and S-nitroso-Nacetyl-penicillamine (SNAP. An increased basal production of NO was observed in cells taken after anaphylaxis, associated with a reduced response to platelet-activating factor, interleukin 1beta, and IgE/DNP-bovine serum albumin complexes. The response to bacterial lipopolysaccharide and dibutyryl cyclic adenosine monophosphate (AMP was enhanced 24 h after challenge, but at earlier times was not significantly different from that observed in controls. Treatment with either sodium nitroprusside or SNAP produced a significant reduction of the haemorrhagic lesions, which are a hallmark of rat anaphylaxis. The extravasation of protein-rich plasma was not influenced by NO-donors. The increase of plasma histamine elicited by the anaphylactic challenge was not influenced by SNAP treatment. NO-donors protect intestinal haemorrhagic lesions of rat anaphylaxis by a mechanism apparently independent of mast cell histamine release.

  4. Delayed Anaphylaxis to the flu vaccine unrelated to known non-viral components.

    Science.gov (United States)

    David, J; Horbal, J; Tcheurekdjian, H; Sher, T H; Hostoffer, R

    2015-09-01

    On February 4, 2010 the CDC's Advisory Committee on Immunization Practices voted for universal flu vaccination to expand protection against the flu throughout the United States. In addition to this administration expansion, six new influenza vaccines have been introduced into the market possibly introducing new allergenic potentials. We report two cases of delayed anaphylaxis to the flu vaccine. PMID:26357001

  5. Transfusion-associated anaphylaxis during anaesthesia and surgery--a retrospective study

    DEFF Research Database (Denmark)

    Lindsted, G; Larsen, R; Krøigaard, M;

    2014-01-01

    BACKGROUND AND OBJECTIVES: Transfusion-associated anaphylaxis (TAA) is a severe adverse reaction reported to occur in 1:9000-90 000 transfusions. According to the Danish Registration of Transfusion Risks (DART), the frequency is 1:300 000 transfusions, which suggests insufficient reporting of TAA...

  6. Anaphylaxis Imaging: Non-Invasive Measurement of Surface Body Temperature and Physical Activity in Small Animals.

    Directory of Open Access Journals (Sweden)

    Krisztina Manzano-Szalai

    Full Text Available In highly sensitized patients, the encounter with a specific allergen from food, insect stings or medications may rapidly induce systemic anaphylaxis with potentially lethal symptoms. Countless animal models of anaphylaxis, most often in BALB/c mice, were established to understand the pathophysiology and to prove the safety of different treatments. The most common symptoms during anaphylactic shock are drop of body temperature and reduced physical activity. To refine, improve and objectify the currently applied manual monitoring methods, we developed an imaging method for the automated, non-invasive measurement of the whole-body surface temperature and, at the same time, of the horizontal and vertical movement activity of small animals. We tested the anaphylaxis imaging in three in vivo allergy mouse models for i milk allergy, ii peanut allergy and iii egg allergy. These proof-of-principle experiments suggest that the imaging technology represents a reliable non-invasive method for the objective monitoring of small animals during anaphylaxis over time. We propose that the method will be useful for monitoring diseases associated with both, changes in body temperature and in physical behaviour.

  7. The danger of chlorhexidine in lignocaine gel: A case report of anaphylaxis during urinary catheterisation

    OpenAIRE

    Stewart, Michael; Lenaghan, Daniel

    2015-01-01

    This article describes a case of anaphylaxis secondary to chlorhexidine during urethral catheterisation. Despite little evidence for the use of antiseptic lubricants in preventing catheter-associated urinary tract infections, the distribution and use of such products continues to be widespread. Chlorhexidine-free lubricating gel is widely available and should be used for urological procedures wherever possible.

  8. Two episodes of anaphylaxis following exposure to hydroxypropyl methylcellulose during cataract surgery

    DEFF Research Database (Denmark)

    Munk, Sofie J; Heegaard, Steffen; Mosbech, Holger;

    2013-01-01

    UNLABELLED: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly...

  9. Food-dependent exercise-induced anaphylaxis due to wheat in a young woman.

    Directory of Open Access Journals (Sweden)

    Hamid Ahanchian

    2013-03-01

    Full Text Available Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported  by laboratory tests such as serum tryptase and positive skin test  results  for  specific IgE  to  potential  triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen.  Food-exercise challenge test  may be  an acceptable method  for  diagnosis of  Food  ependent  Exercise-Induced Allergy and dietary elimination of food is recommended to manage it.In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative.The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet.In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis.

  10. Cow’s Milk Anaphylaxis in Children First Report of Iranian Food Allergy Registry

    Directory of Open Access Journals (Sweden)

    Pegah Teymourpour

    2012-03-01

    Full Text Available Cow’s  milk  anaphylaxis is  the  most  common  food-induced  anaphylaxis in  Iranian children. The clinical and laboratory findings of cow’s milk anaphylaxis are evaluated in this study. All children who had experienced cow’s  milk anaphylaxis and had been referred to Immunology, asthma and allergy research center during a 5-year period were considered. After fulfilling a questionnaire, patients underwent measurement of total IgE and cow’s milk- specific IgE by Immunocap test and Skin prick test (SPT with cow’s milk extract. Patients with a convincing history and one positive cow’s milk-specific IgE test (SPT or Immunocap test and patients with both positive tests were enrolled, in this study.Out of 49 patients, 59.2% were male. Patients’ mean age was 5 years old and their mean age at the  time of  first attack was 5.7 months  (SD =  4.3. Most  of  the  patients  have experienced more than one episode of anaphylaxis (79.5% and in 85.7% of all cases, first attack occurred during the first year of life. Severity grading 1-5 were 2%, 6.1%, 18.4%,69.4%, 4.1% respectively. Most common manifestations were cutaneous 98%, Respiratory91.8%, Gastrointestinal  55.1%, Cardiovascular 46.9% and  neurologic  46.9%  signs  and symptoms  respectively. Twenty four  patients showed positive SPT. Mean total IgE  was 239.6±3.3  (IU/mL  and  mean  cow’s  milk-specific IgE  was 19.28±27.2  (IU/mL.  Most patients showed reactions only after ingestion of cow’s milk or after dairy foods (81.6%.It  is concluded  that  cow’s milk anaphylaxis may happen  early in life. Regarding the severity of attacks and remarkable number of patients with several attacks, poor knowledge about this disorder is evident.

  11. Should adrenaline be used in patients with hemodynamically stable anaphylaxis? Incident case control study nested within a retrospective cohort study.

    Science.gov (United States)

    Ko, Byuk Sung; Kim, Ji Yeon; Seo, Dong-Woo; Kim, Won Young; Lee, Jae Ho; Sheikh, Aziz; Bates, David W

    2016-01-01

    Although adrenaline (epinephrine) is a cornerstone of initial anaphylaxis treatment, it is not often used. We sought to assess whether use of adrenaline in hemodynamically stable patients with anaphylaxis could prevent the development of hypotension. We conducted a retrospective cohort study of 761 adult patients with anaphylaxis presenting to the emergency department (ED) of a tertiary care hospital over a 10-year period. We divided the patients into two groups according to the occurrence of hypotension and compared demographic characteristics, clinical features, treatments and outcomes. Of the 340 patients with anaphylaxis who were normotensive at first presentation, 40 patients experienced hypotension during their ED stay. The ED stay of the hypotension group was significantly longer than that of patients who did not experience hypotension (496 min vs 253 min, P = 0.000). Adrenaline use in hemodynamically stable anaphylaxis patient was independently associated with a lower risk of developing in-hospital occurrence of hypotension: OR, 0.254 [95% CI, 0.091-0.706]. Adrenaline use in hemodynamically stable anaphylaxis patients was associated with a reduced risk of developing in-hospital occurrence of hypotension. Adverse events induced by adrenaline were rare when the intramuscular route was used. PMID:26837822

  12. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia

    DEFF Research Database (Denmark)

    Kroigaard, M; Garvey, L H; Gillberg, L;

    2007-01-01

    The present approach to the diagnosis, management and follow-up of anaphylaxis during anaesthesia varies in the Scandinavian countries. The main purpose of these Scandinavian Clinical Practice Guidelines is to increase the awareness about anaphylaxis during anaesthesia amongst anaesthesiologists....... It is hoped that increased focus on the subject will lead to prompt diagnosis, rapid and correct treatment, and standardised management of patients with anaphylactic reactions during anaesthesia across Scandinavia. The recommendations are based on the best available evidence in the literature, which...... incremental titration of adrenaline (epinephrine) and fluid therapy as first-line treatment. Recommendations for primary and secondary follow-up are given, bearing in mind that there are variations in geography and resources in the different countries. A list of National Centres from which anaesthesiologists...

  13. Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults.

    Science.gov (United States)

    Herbert, Linda J; Dahlquist, Lynnda M

    2008-12-01

    This study examined autonomy, anxiety, depression, and perceptions of parental behavior in 86 food allergic young adults and 344 healthy young adults between the ages of 18 and 22. Participants completed an online survey measuring self-reported autonomy, anxiety, depression, and perceptions of parental behavior. Results indicated that, as a group, food allergic young adults did not differ from healthy peers. However, food allergic young adults who reported having experienced an anaphylactic reaction described their disease as more severe, reported more worry about their disease, and rated their parents as more overprotective than food allergic young adults who reported never having experienced anaphylaxis. The experience of anaphylaxis may be a reliable indicator of food allergic individuals who are at risk for psychological distress. PMID:19104982

  14. Severe anaphylaxis to Propofol: first case of evidence of sensitization to soy oil.

    Science.gov (United States)

    Richard, C; Beaudouin, E; Moneret-Vautrin, D A; Kohler, C; Nguyen-Grosjean, V M; Jacquenet, S

    2016-05-01

    The growing worldwide prevalence of food allergies is drawing attention to the risk of allergenic proteins found in intravenous medicinal products, particularly anaesthetics. Propofol induced anaphylaxis has been described. The presence of soybean oil and egg lecithins in the lipid emulsion highlights their suspected responsibility in certain cases. We report a case of anaphylaxis to propofol in an adult patient without food allergy to soy, but with a latent sensitization to soy. An IgE-dependent allergy to propofol was established by a basophil activation test. Here, we document for the first time the existence of specific IgEs to a 65kDa protein, found in soybean oil and soy flour. In the absence of data on the reactogenic threshold for allergenic food proteins injected intravenously, a risk appears to be established and leads us to recommend a systematic detection for proteins in the refined soybean oil used in the pharmaceutical industry for intravenous products. PMID:27152608

  15. HYDATID CYST LIVER EXCISION: THE TWIN PROBLEMS OF ANAPHYLAXIS AND HYPERNATREMIA

    Directory of Open Access Journals (Sweden)

    Anand Rampure Vittal

    2015-05-01

    Full Text Available Hydatid cyst infestation is most commonly encountered in liver. Though several procedures have been described in the treatment of hepatic echinococcal cysts ranging from simple puncture to liver resection , radical surgery ( T otal pericystectomy or partial hepatectomy is indicated for liver cyst. Prevention of spillage into the peritoneal cavity and wound edges by injecting a scolicidal agent into the unopened cyst and walling off the operative field with sponges soaked in a scolicidal agent are the two most commonly employed measures. 20% hypertonic saline is one of the recommended scolicidal agent , but can be associated with hypernatremia. Anaphylaxis during hydatid cyst resection is one of the rare occurrences. We hereby de scribe the twin problem of Anaphylaxis intraoperatively and hypernatremia postoperatively and its management.

  16. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus

    OpenAIRE

    Rahul Ramesh Bhoite; Girija Ramesh Bhoite; Dayanand N Bagdure; Himmatrao S Bawaskar

    2015-01-01

    Mesobuthus tamulus is an Indian red scorpion that is responsible for numerous cases of scorpion stings in the Indian subcontinent. Antivenin, vasodilators, and benzodiazepines are medications of choice in the treatment of scorpion bites. Adverse reactions such as anaphylaxis to antivenin have been infrequently described in the literature. We, herein, present a case of a 42-year-old man stung by Indian red scorpion while gardening at home in India, who presented with extreme pain at the sting ...

  17. Inhibitory effects of guarana seed extract on passive cutaneous anaphylaxis and mast cell degranulation.

    Science.gov (United States)

    Jippo, Tomoko; Kobayashi, Yuko; Sato, Harumi; Hattori, Atsushi; Takeuchi, Hiroaki; Sugimoto, Keiichiro; Shigekawa, Munekazu

    2009-09-01

    This study investigated the effects of guarana seed extract (GSE) on an anti-allergic mechanism. GSE orally administered inhibited the anti-dinitrophenol IgE-induced passive cutaneous anaphylaxis reaction in mice. Furthermore, it inhibited the degranulation of rat basophilic leukemia RBL-2H3 cells. It had no cytotoxicity on RBL-2H3 cells. These results show that GSE is a candidate for effective therapeutic material for allergic diseases. PMID:19734657

  18. Spontaneous Intraperitoneal Rupture of a Hepatic Hydatid Cyst with Subsequent Anaphylaxis: A Case Report

    OpenAIRE

    Benjamin Tinsley; Aula Abbara; Raghunandan Kadaba; Hemant Sheth; Gurjinder Sandhu

    2013-01-01

    Hydatid cyst rupture into the abdomen is a serious complication of cystic hydatid disease of the liver (Cystic Echinococcosis) with an incidence of up to 16% in some series and can result in anaphylaxis or anaphylactoid reactions in up to 12.5% of cases. At presentation, 36–40% of hydatid cysts have ruptured or become secondarily infected. Rupture can be microscopic or macroscopic and can be fatal without surgery. Hydatid disease of the liver is primarily caused by the tapeworm Echinococcu...

  19. An Allergic Reaction (Anaphylaxis) Observed Before Open Heart Surgery in the Operating Room

    OpenAIRE

    Altın, Fırat; Aydın, Selim; Eygi, Börteçin; Güneş, Tevfik; Erkoç, Kamuran; Kutas, Barış

    2012-01-01

    Anaphylaxis and anaphylactoid reactions under general anesthesia are serious events and are often regarded as life threatening situations. A 57-year-old woman was admitted to cardiothora-cic surgery clinic for coronary artery by-pass grafting procedure with a diagnosis of coronary artery disease following a diagnostic coronary artery angiography. Upon arrival to the operating room, after necessary monitoring, general anesthesia was administered. Sterile placement of a central venous catheter ...

  20. Anaphylaxis Triggered by Benzyl Benzoate in a Preparation of Depot Testosterone Undecanoate

    OpenAIRE

    Ong, Gregory S. Y.; Somerville, Colin P.; Jones, Timothy W; Walsh, John P.

    2012-01-01

    We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle). While considered to have a favourable safety profile, serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components. As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, ...

  1. Exercise-induced anaphylaxis in a cardiopathic patient on chronic aspirin therapy.

    Science.gov (United States)

    Micucci, C; Amico, D; Braconi, M; Pareo, C; Cimarelli, M E; Subiaco, S

    2014-03-01

    We report the case of a 73 year old man on chronic aspirin therapy who went in anaphylactic shock during his daily farm chores following a meal rich in wheat products. The serum specific IgE assay (ImmunoCAP) showed strong positive specific IgE responses to ω-5 gliadin. A two-year period avoiding wheat meals 3 hours prior to exercise, resulted in a lack of further anaphylaxis; this results aided us in making the diagnosis. PMID:24739129

  2. The acute and long-term management of anaphylaxis: protocol for a systematic review

    OpenAIRE

    Dhami, Sangeeta; Panesar, Sukhmeet S; Rader, Tamara; Muraro, Antonella; Roberts, Graham; Worm, Margitta; Sheikh, Aziz

    2013-01-01

    Background: The European Academy of Allergy and Clinical Immunology is in the process of developing its Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform clinical recommendations.The aims...

  3. Infection with influenza a virus leads to flu antigen-induced cutaneous anaphylaxis in mice.

    Science.gov (United States)

    Grunewald, Susanne M; Hahn, Christian; Wohlleben, Gisela; Teufel, Martin; Major, Tamas; Moll, Heidrun; Bröcker, Eva-B; Erb, Klaus J

    2002-04-01

    It is well established, that viral infections may trigger urticaria or allergic asthma; however, as viral infections induce T helper 1 polarized responses, which lead to the inhibition of T helper 2 cell development, the opposite would be plausible. We wanted to investigate how viral infections may mediate allergic symptoms in a mouse model; therefore, we infected BALB/C mice with influenza A virus intranasally. Histologic analyses of lung sections and bronchoalveolar lavages were performed. In addition, cells from the mediastinal lymph nodes were restimulated in vitro to analyze which types of cytokines were induced by the flu infection. Furthermore, flu-specific antibody titers were determined and local anaphylaxis was measured after rechallenge with flu antigen. We found that airways inflammation consisted predominately of macrophages and lymphocytes, whereas only a few eosinophils were observed. interferon-gamma but no interleukin-4 and little interleukin-5 could be detected in the culture supernatants from in vitro restimulated T cells from the draining lymph nodes. The antibody response was characterized by high levels of virus-specific IgG2a, IgG2b, and IgG1 and, surprisingly, low levels of virus-specific IgE antibodies. Interestingly, flu-infected mice developed active and passive cutaneous anaphylaxis after rechallenge with flu-antigen. As the passive cutaneous anaphylaxis reaction persisted over 48 h and was significantly lower after passive transfer of the serum, which was IgE depleted, local anaphylaxis seemed to be mediated predominately by specific IgE antibodies. Taken together, our results demonstrate that mice infected with flu virus develop virus-specific mast cell degranulation in the skin. Our results may also have implications for the pathogenesis of urticaria or other atopic disorders in humans. PMID:11918711

  4. Bee Pollen-Induced Anaphylaxis: A Case Report and Literature Review

    OpenAIRE

    Choi, Jeong-Hee; Jang, Young-Sook; Oh, Jae-Won; Kim, Cheol-Hong; Hyun, In-Gyu

    2014-01-01

    Bee pollen is pollen granules packed by honey bees and is widely consumed as natural healthy supplements. Bee pollen-induced anaphylaxis has rarely been reported, and its allergenic components have never been studied. A 40-year-old male came to the emergency room with generalized urticaria, facial edema, dyspnea, nausea, vomiting, abdominal pain, and diarrhea 1 hour after ingesting one tablespoon of bee pollen. Oxygen saturation was 91%. His symptoms resolved after injection of epinephrine, c...

  5. Tick-induced allergies: mammalian meat allergy, tick anaphylaxis and their significance

    OpenAIRE

    van Nunen, Sheryl

    2015-01-01

    Serious tick-induced allergies comprise mammalian meat allergy following tick bites and tick anaphylaxis. Mammalian meat allergy is an emergent allergy, increasingly prevalent in tick-endemic areas of Australia and the United States, occurring worldwide where ticks are endemic. Sensitisation to galactose-α-1,3-galactose (α-Gal) has been shown to be the mechanism of allergic reaction in mammalian meat allergy following tick bite. Whilst other carbohydrate allergens have been identified, this a...

  6. A case of anaphylaxis apparently induced by sugammadex and rocuronium in successive surgeries.

    Science.gov (United States)

    Yamada, Yuko; Yamamoto, Takuji; Tanabe, Kumiko; Fukuoka, Naokazu; Takenaka, Motoyasu; Iida, Hiroki

    2016-08-01

    Rocuronium is the agent most frequently involved in perioperative anaphylaxis, and sugammadex has also been known to induce anaphylactic reactions. We describe a case of successive anaphylactic episodes that seemed to be induced by clinical doses of rocuronium and sugammadex. The patient was a 19-year-old woman who had a medical history of asthma, but no history of surgery. She had been injured in a fall, and several surgeries were scheduled for multiple bone fractures. At the first surgery under general anesthesia, she developed anaphylaxis 5 min after sugammadex administration. A second general anesthesia for treatment of calcaneal fracture was induced uneventfully without neuromuscular blockade after 10 days. A third general anesthesia was scheduled to reinforce the spinal column 12 days after the first surgery. She developed anaphylaxis 8 min after rocuronium administration. The level of plasma histamine was elevated, but serum tryptase level remained normal. This surgery was canceled and rescheduled without use of a neuromuscular blockade. Skin tests were performed in a later investigation. The patient showed positive results on intradermal tests for sugammadex and rocuronium, supporting a diagnosis of allergic reactions to both drugs. Clinicians must be aware that anaphylactic reactions can be induced by both sugammadex and rocuronium. PMID:27290941

  7. Excess subcutaneous tissue may preclude intramuscular delivery when using adrenaline autoinjectors in patients with anaphylaxis.

    Science.gov (United States)

    Johnstone, J; Hobbins, S; Parekh, D; O'Hickey, S

    2015-06-01

    Intramuscular adrenaline is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphylaxis. Patients already prescribed adrenaline autoinjectors (AAIs) for anaphylaxis were examined with ultrasound, and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. Twenty-eight patients (23 female, 5 male) with an age range of 18-75 took part in the study, and in 68%, the STMD was greater than AAI needle length (15.02 mm), using the anterolateral thigh as the recommended administration site. The key predictors for increased STMD were female gender (P=0.0003) and a BMI > 30 (P=0.04). AAIs require longer needles to ensure intramuscular administration, and ultrasound at point of prescription would aid needle length selection. PMID:25676800

  8. A Case of Anaphylaxis Induced by Contact with Young Radish (Raphanus sativus L).

    Science.gov (United States)

    Lee, Yung-Hee; Lee, Jae-Hyoung; Kang, Hye-Ran; Ha, Jung-Hoon; Lee, Byoung-Hoon; Kim, Sang-Hoon

    2015-01-01

    Young radish (Raphanus sativus L), a member of the mustard family (Cruciferae), is a common ingredient of Kimchi. Although few reports have described anaphylaxis to cruciferous vegetables, we report the case of anaphylaxis induced by contact with young radish. A 46-year-old female with a history of contact allergy to metal presented to our emergency room (ER) with dizziness, generalized eruption and gastrointestinal upset. Her symptoms developed after re-exposure to young radish while chopping it. Hypotensive blood pressures were noted. Three days prior, the patient had experienced generalized urticaria with pruritus immediately after chopping the fresh young radish, which resolved spontaneously. In the ER, her symptoms improved by the administration of epinephrine (0.3 mL), antihistamine (chlorpheniramine) and isotonic saline hydration. A skin prick test with young radish extract showed positive reactivity. The same skin test was negative in five adult controls. IgE-mediated hypersensitivity could be an important immunologic mechanism in the development of young radish-induced anaphylaxis. PMID:25553270

  9. A Simple Allergist-Led Intervention Improves Resident Training in Anaphylaxis

    Science.gov (United States)

    Jongco, Artemio M.; Bina, Sheila; Sporter, Robert J.; Cavuoto Petrizzo, Marie A.; Kaplan, Blanka; Kline, Myriam; Schuval, Susan J.

    2016-01-01

    Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants' demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest. A follow-up test assessed long-term knowledge retention twelve weeks later. 159 residents participated in the pretest, 152 participated in the posttest, and 86 participated in the follow-up test. There were no significant differences by specialty or site. With a possible score of 10, the mean pretest score (7.31 ± 1.50) was lower than the posttest score (8.79 ± 1.29) and follow-up score (8.17 ± 1.72) (P < 0.001 for both). Although participants' perceived confidence in diagnosing or managing anaphylaxis improved from baseline to follow-up (P < 0.001 for both), participants' self-reported clinical experience with ADAM or autoinjector use was unchanged. Allergist-led face-to-face educational intervention improves residents' short-term knowledge and perceived confidence in ADAM. Limited clinical experience or reinforcement contributes to the observed decreased knowledge. PMID:26997960

  10. Severe reactions to iodinated contrast agents: is anaphylaxis responsible?; Reactions severes avec les produits de contraste iodes: l'anaphylaxie est-elle responsable?

    Energy Technology Data Exchange (ETDEWEB)

    Dewachter, P.; Mouton-Faivre, C. [Hopital Central, Service Anesthesie-Reanimation Chirurgicale, 54 - Nancy (France)

    2001-09-01

    The etiology of severe reactions following injection of iodinated contrast agent is the subject of controversy. No consensus has been established regarding the management of patients at risk, risk factors and pre-medication because in most cases published no diagnostic exploration has been carried out on patients who have experienced a severe reaction. Diagnosis of drug anaphylaxis is based on clinical history, proof of mediator release and drug specific IgE antibodies (when the technique is available) or cutaneous tests (when direct technique is not available). This approach has been adopted for etiologic diagnosis of 5 clinical cases of severe anaphylactoid reactions (including one death) following the injection of ionic and non ionic contrast agents. Clinical symptoms, biology and cutaneous tests are consistent with anaphylaxis. Any patient who has had a severe anaphylactoid reaction following injection of a contrast agent should undergo an allergology assessment to confirm the diagnosis and identify the culprit contrast agent. Indeed, no pre-medication has proved efficient for the prevention of subsequent allergic reactions. (author)

  11. Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis-a systematic literature review.

    Science.gov (United States)

    Neumayr, Andreas; Troia, Giuliana; de Bernardis, Chiara; Tamarozzi, Francesca; Goblirsch, Sam; Piccoli, Luca; Hatz, Christoph; Filice, Carlo; Brunetti, Enrico

    2011-06-01

    Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects. PMID:21695106

  12. Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis-a systematic literature review.

    Directory of Open Access Journals (Sweden)

    Andreas Neumayr

    2011-06-01

    Full Text Available Percutaneous treatment (PT emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE. Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects.

  13. Justified Concern or Exaggerated Fear: The Risk of Anaphylaxis in Percutaneous Treatment of Cystic Echinococcosis—A Systematic Literature Review

    Science.gov (United States)

    Neumayr, Andreas; Troia, Giuliana; de Bernardis, Chiara; Tamarozzi, Francesca; Goblirsch, Sam; Piccoli, Luca; Hatz, Christoph; Filice, Carlo; Brunetti, Enrico

    2011-01-01

    Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects. PMID:21695106

  14. The tripeptide feG ameliorates systemic inflammatory responses to rat intestinal anaphylaxis

    Directory of Open Access Journals (Sweden)

    Davison Joseph S

    2002-08-01

    Full Text Available Abstract Background Food allergies are generally associated with gastrointestinal upset, but in many patients systemic reactions occur. However, the systemic effects of food allergies are poorly understood in experimental animals, which also offer the opportunity to explore the actions of anti-allergic drugs. The tripeptide D-phenylalanine-D-glutamate-Glycine (feG, which potentially alleviates the symptoms of systemic anaphylactic reactions, was tested to determine if it also reduced systemic inflammatory responses provoked by a gastric allergic reaction. Results Optimal inhibition of intestinal anaphylaxis was obtained when 100 μg/kg of feG was given 20 min before the rats were challenged with antigen. The increase in total circulating neutrophils and accumulation of neutrophils in the heart, developing 3 h and 24 h, respectively, after antigen challenge were reduced by both feG and dexamethasone. Both anti-inflammatory agents reduced the increase in vascular permeability induced by antigen in the intestine and the peripheral skin (pinna, albeit with different time courses. Dexamethasone prevented increases in vascular permeability when given 12 h before antigen challenge, whereas feG was effective when given 20 min before ingestion of antigen. The tripeptide prevented the anaphylaxis induced up regulation of specific antibody binding of a cell adhesion molecule related to neutrophil activation, namely CD49d (α4 integrin. Conclusions Aside from showing that intestinal anaphylaxis produces significant systemic inflammatory responses in non-intestinal tissues, our results indicate that the tripeptide feG is a potent inhibitor of extra-gastrointestinal allergic reactions preventing both acute (30 min and chronic (3 h or greater inflammatory responses.

  15. The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis.

    Science.gov (United States)

    Mi, Yan-Ni; Ping, Na-Na; Xiao, Xue; Zhu, Yan-Bing; Liu, Jing; Cao, Yong-Xiao

    2014-01-01

    The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K1 injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K1 injection-sensitized dogs were challenged with a vitamin K1-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K1 challenge. Following treatment with vitamin K1 injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K1 injection in vivo. However, the dogs in the vitamin K1-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K1 injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K1 injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer. PMID:24594861

  16. The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis.

    Directory of Open Access Journals (Sweden)

    Yan-Ni Mi

    Full Text Available The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K1 injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K1 injection-sensitized dogs were challenged with a vitamin K1-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K1 challenge. Following treatment with vitamin K1 injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K1 injection in vivo. However, the dogs in the vitamin K1-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K1 injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K1 injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer.

  17. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009.

    Science.gov (United States)

    Sicherer, Scott H; Leung, Donald Y M

    2010-01-01

    This review highlights some of the research advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells, complement, platelet-activating factor, and effector cells in the development and expression of food allergy were explored in several murine models and human studies. Delayed anaphylaxis to mammalian meats appears to be related to IgE binding to the carbohydrate moiety galactose-alpha-1,3-galactose, which also has implications for hypersensitivity to murine mAb therapeutics containing this oligosaccharide. Oral immunotherapy studies continue to show promise for the treatment of food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum tryptase levels might inform the risk of venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic allergen sensitization in patients with atopic dermatitis, as well as increased propensity of skin infections in these patients. The use of increased doses of nonsedating antihistamines and potential usefulness of omalizumab for chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future. PMID:20109740

  18. The pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    OpenAIRE

    Florvaag, E.; Johansson, SGO

    2012-01-01

    The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody leve...

  19. Anaphylaxis Triggered by Benzyl Benzoate in a Preparation of Depot Testosterone Undecanoate

    Directory of Open Access Journals (Sweden)

    Gregory S. Y. Ong

    2012-01-01

    Full Text Available We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle. While considered to have a favourable safety profile, serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components. As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, individual components of pharmaceuticals should be tested when investigating drug allergies. Doctors should be alert to the potential for serious reactions to any of the components of Reandron 1000.

  20. 422 A Rare Case of Food-induced Anaphylaxis to Pink Peppercorns

    OpenAIRE

    Kim, John; Minikes, Neil

    2012-01-01

    Background The incidence and prevalence of food allergies appear to be on the rise over the past 20 years. The most common foods to produce an IgE mediated hypersensitivity reaction in adults include peanut, tree nuts, and seafood. The increased use of spices in the U.S. has resulted in a growing number of patients presenting with hypersensitivity reactions. Methods We report a case of a 26 year-old-female who developed anaphylaxis after ingesting pink peppercorn seasoning. The patient was di...

  1. Signs and Symptoms of Food Allergy and Food-Induced Anaphylaxis.

    Science.gov (United States)

    Sharma, Hemant P; Bansil, Shweta; Uygungil, Burcin

    2015-12-01

    Food allergies are increasing in prevalence. In order for pediatric clinicians to appropriately diagnose and manage food allergies, the characteristic signs and symptoms of these potentially severe reactions must be recognized. Unlike nonimmunologic adverse food reactions (such as lactose intolerance and food poisoning), food allergies by definition are immune-mediated responses that occur reproducibly on food ingestion. The varying clinical presentations of food allergy include IgE-mediated disorders, mixed IgE- and cell-mediated disorders, and cell-mediated food allergies. This review describes the clinical manifestations of each of these categories of food allergy, with special emphasis on recognition of food-induced anaphylaxis. PMID:26456438

  2. Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment

    OpenAIRE

    Jo, Eun-Jung; Yang, Min-Suk; Kim, Yoon-Jeong; Kim, Hyun-Suk; Kim, Mi-Yeong; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2012-01-01

    Food-dependent exercise-induced anaphylaxis (FDEIA) is a type of exercise-induced anaphylaxis associated with postprandial exercise. We describe a 19-year-old man with FDEIA. Our patient complained of urticaria, angioedema, dizziness and hypotension associated with exercise after ingestion of walnut-containing foods in a warm environment. Skin prick test and prick to prick test were positive for walnut antigen. The attack didn't occur by free running outside for 10 min 2 h after taking walnut...

  3. Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis

    Directory of Open Access Journals (Sweden)

    Geunwoong Noh

    2013-01-01

    Full Text Available Anaphylaxis induced by exercise after the intake of certain foods is referred to as food-dependent exercise-induced anaphylaxis (FDEIA. Only the preventive medication such as oral sodium cromoglycate and oral combined cetirizine-montelukast was tried in FDEIA. Specific oral tolerance induction (SOTI using IFN-gamma was tried in 2 cases of FDEIA for wheat. Merely, exercise accompanied every treatment just after the intake of allergenic foods during treatment. Patients acquired tolerance for wheat in both cases successfully. After treatment, two patients take wheat in their food living freely. Conclusively, SOTI using IFN-gamma was effective as the causative treatment for allergenic foods in FDEIA.

  4. Management of levofloxacin induced anaphylaxis and acute delirium in a palliative care setting

    Directory of Open Access Journals (Sweden)

    Arunangshu Ghoshal

    2015-01-01

    Full Text Available Levofloxacin is a commonly prescribed antibiotic for managing chest and urinary tract infections in a palliative care setting. Incidence of Levofloxacin-associated anaphylaxis is rare and delirium secondary to Levofloxacin is a seldom occurrence with only few published case reports. It is an extremely rare occurrence to see this phenomenon in combination. Early identification and prompt intervention reduces both mortality and morbidity. A 17-year-old male with synovial sarcoma of right thigh with chest wall and lung metastasis and with no prior psychiatric morbidity presented to palliative medicine outpatient department with community-acquired pneumonia. He was initiated on intravenous (IV Ceftriaxone and IV Levofloxacin. Post IV Levofloxacin patient developed anaphylaxis and acute delirium necessitating IV Hydrocortisone, IV Chlorpheneramine, Oxygen and IV Haloperidol. Early detection and prompt intervention helped in complete recovery. Patient was discharged to hospice for respite after 2 days of hospitalization and then discharged home. Acute palliative care approach facilitated management of two life-threatening medical complications in a palliative care setting improving both quality and length of life.

  5. [Animal experimental studies on immunogenicity, humoral response and danger of anaphylaxis in parenteral administration of hyaluronidase].

    Science.gov (United States)

    Storch, H; Dellas, T; Bellmann, H

    1978-01-01

    The widespread intravenous application of hyaluronidase rises questions for its potential immunogenicity, formation of humoral antibodies, and danger of anaphylaxis. In experiments on 21 rabbits and 40 rats, the authors searched for precipitating antibodies after subcutaneous, intramuscular, and intravenous application of hyaluronidase in doses equivalent to the human. Intravenous and intramuscular shots of 150 to 75 000 IU of Hylase were applied in order to test anaphylaxis. By all proving procedures antibodies against Hylase were found. The formation of antibodies occurred earlier and in higher concentrations after subcutaneous and intramuscular application. The antibodies belonged to the IgG group. One third of the animals showed anaphylactic responses at doses which were 13 to 630 times as high. 26 per cent of human patients developed antibodies after application of Hylase. No anaphylactic reactions were observed in 17 patients with antibodies when intravenous application of hyaluronidase was continued. In the dosage used in the man anaphylactic response is obviously rare though it is possible. PMID:654375

  6. Skin testing with food, codeine, and histamine in exercise-induced anaphylaxis.

    Science.gov (United States)

    Lin, R Y; Barnard, M

    1993-06-01

    A 33-year-old Chinese woman with exercise-induced anaphylaxis after ingesting Chinese seafood noodle soup, was studied for skin test reactivity to food, histamine, and codeine. Prick skin tests were negative for shrimp, wheat, and chicken soup base, but were positive at 5 to 6 mm (wheal diameter) to the whole broth after it had been combined with the other ingredients. No significant (> 3 mm) wheals were observed in eight controls who were simultaneously tested with the broth. To assess the role of exercise, three series of skin tests were performed with histamine, codeine, and whole broth before and after aerobic exercise on two occasions. Codeine elicited consistent increases in wheal size after exercise compared with pre-exercise skin tests. Histamine and whole broth wheal sizes did not increase significantly. Three control subjects also had codeine and histamine skin tests before and after exercise, No exercise-associated increases were noted for codeine. Potential insights into mast cell abnormalities in exercise-induced anaphylaxis may be gained by skin testing patterns with codeine and other mast cell degranulating agents. PMID:8507042

  7. Fullerene carbon-70 derivatives dampen anaphylaxis and allergic asthma pathogenesis in mice

    Science.gov (United States)

    Norton, Sarah Brooke

    Fullerenes are carbon nanospheres that can be solublized by the addition of polar chemical groups to the carbon cage, forming fullerene derivatives. One specifically derivatized fullerene compound, termed C 70-Tetragylocolate (C70-TGA), has been shown to stabilize mast cell responses in vitro thus we hypothesized it may have an effect on mast cell-driven diseases such as asthma and systemic anaphylaxis. To observe the effects of C70-TGA on systemic anaphylaxis, mice were subjected to a model of passive systemic anaphylaxis. In this model, mice were injected with DNP-specific IgE 16 hours prior to challenge, then treated with C 70-TGA. Immediately prior to DNP challenge, mice were subjected to a second injection of C70-TGA. Following DNP challenge, body temperature was recorded and blood was collected for quantitation of histamine levels. Treatment with C70-TGA significantly reduced body temperature drop associated with systemic anaphylaxis and serum histamine levels. To observe the effects of C70-TGA on chronic features of asthma in vivo, we utilized a heavily MC influenced model of asthma pathogenesis. Mice were sensitized by intraperitoneal (i.p.) injection of ovalbumin (OVA) in saline, challenged intranasally (i.n.) with OVA, and one of two treatment strategies was pursued. In one, C70-TGA was given i.n. throughout disease development. In the other, C70-TGA was given following an initial set of challenges to allow disease to develop prior to treatment; mice were then re-challenged with OVA to assess the effect on established disease. We found that C70-TGA treatment significantly reduced airway inflammation and eosinophilia and dramatically reduced bronchoconstriction in either model. Cytokines IL-4 and IL-5 and serum IgE levels are significantly reduced in C70-TGA treated animals. Interestingly, we also saw an increase in the anti-inflammatory eicosanoid 11, 12-epoxyeicosatreinoic acid (11,12-EET) in the BAL fluid, suggesting the involvement of this mediator in

  8. Evaluation of IgE Antibodies to Omalizumab (Xolair®) and Their Potential Correlation to Anaphylaxis.

    Science.gov (United States)

    Baker, Dana L; Nakamura, Gerald R; Lowman, Henry B; Fischer, Saloumeh Kadkhodayan

    2016-01-01

    Omalizumab (Xolair®) is a recombinant humanized monoclonal antibody that selectively binds to human immunoglobulin E (IgE). Omalizumab is used to treat IgE-mediated diseases such as chronic idiopathic urticaria (CIU) and moderate to severe allergic asthma. In pre-marketing clinical trials in patients with asthma, anaphylaxis was reported in 3 of 3,507 (0.1%) patients. In post-marketing spontaneous reports, the frequency of anaphylaxis attributed to omalizumab use was estimated to be at least 0.2% of patients based on an estimated exposure of about 57,300 patients from June 2003 through December 2006. To better understand the risk of anaphylaxis in patients with allergic asthma receiving omalizumab, a post-marketing pharmacosurveillance study was initiated in 2009. As part of this study, an assay was developed to detect antibodies of IgE isotype to omalizumab. Serum samples from patients in the study were evaluated using this assay. Our results indicated that there was no observable correlation between either anaphylaxis or skin test reactivity and the presence of antibodies of IgE isotype to omalizumab. Here, we discuss the development of this assay as well as the results of the immunogenicity assessment. PMID:26340860

  9. Do epinephrine auto-injectors have an unsuitable needle length in children and adolescents at risk for anaphylaxis from food allergy?

    OpenAIRE

    Dreborg, Sten; Wen, Xia; Kim, Laura; Tsai, Gina; Nevis, Immaculate; Potts, Ryan; Chiu, Jack; Dominic, Arunmozhi; Kim, Harold

    2016-01-01

    Background Food allergy is the most common cause of anaphylaxis in children. Intramuscular delivery of epinephrine auto-injectors (EAI) is the standard of care for the treatment of anaphylaxis. We examined if children and adolescents at risk of anaphylaxis weighing 15–30 kg and >30 kg would receive epinephrine into the intramuscular space with the currently available EAI in North America and Europe. Methods The distance from skin to muscle (STMD) and skin to bone (STBD) on the mid third anter...

  10. Diagnostic utility of two case definitions for anaphylaxis: a comparison using a retrospective case notes analysis in the UK.

    Science.gov (United States)

    Erlewyn-Lajeunesse, Michel; Dymond, Sandra; Slade, Ingrid; Mansfield, Helen L; Fish, Rosie; Jones, Owen; Benger, Jonathan R

    2010-01-01

    Anaphylaxis is a clinical diagnosis with no gold-standard test. Recent case definitions have attempted to provide objective criteria for diagnosis. The aim of this study was to compare the diagnostic concordance of the Brighton Collaboration case definition (the 'Brighton' case definition) to the consensus case definition from the Second Symposium on the Definition and Management of Anaphylaxis (the 'Symposium' definition). The study setting was a hospital-based emergency department in the UK. We identified cases of anaphylaxis by physicians' discharge diagnoses over a 2-year period from 2005 to 2006, and used randomly selected cases of allergic reaction, asthma and urticaria as a control group. Data was extracted by clinicians (who were unaware of the content of either case definition), and the two case definitions were applied by Boolean operators in a Microsoft Excel spreadsheet. Concordance between the case definitions was measured using Cohen's kappa (kappa) statistic. We reviewed 128 sets of notes, with 47 cases of anaphylaxis. Brighton and Symposium definitions had sensitivities of 0.681 and 0.671, respectively, and specificities of 0.790 and 0.704, respectively. A discordant result was found in 36/128 cases (28.1%; kappa = 0.414 [95% CI 0.253, 0.574]), which represents a moderate level of agreement between case definitions. The Brighton case definition has a similar diagnostic concordance to the Symposium case definition. It does not seem to over- or underestimate cases and is sufficiently unique that the identification of an allergic trigger does not have to form part of the case definition. This will be important in the recognition of anaphylaxis resulting from the administration of drug and vaccines, where causality should be examined separately from case ascertainment. PMID:20000867

  11. Curcumin Ingestion Inhibits Mastocytosis and Suppresses Intestinal Anaphylaxis in a Murine Model of Food Allergy.

    Directory of Open Access Journals (Sweden)

    Shannon R M Kinney

    Full Text Available IgE antibodies and mast cells play critical roles in the establishment of allergic responses to food antigens. Curcumin, the active ingredient of the curry spice turmeric, has anti-inflammatory properties, and thus may have the capacity to regulate Th2 cells and mucosal mast cell function during allergic responses. We assessed whether curcumin ingestion during oral allergen exposure can modulate the development of food allergy using a murine model of ovalbumin (OVA-induced intestinal anaphylaxis. Herein, we demonstrate that frequent ingestion of curcumin during oral OVA exposure inhibits the development of mastocytosis and intestinal anaphylaxis in OVA-challenged allergic mice. Intragastric (i.g. exposure to OVA in sensitized BALB/c mice induced a robust IgE-mediated response accompanied by enhanced OVA-IgE levels, intestinal mastocytosis, elevated serum mMCP-1, and acute diarrhea. In contrast, mice exposed to oral curcumin throughout the experimental regimen appeared to be normal and did not exhibit intense allergic diarrhea or a significant enhancement of OVA-IgE and intestinal mast cell expansion and activation. Furthermore, allergic diarrhea, mast cell activation and expansion, and Th2 responses were also suppressed in mice exposed to curcumin during the OVA-challenge phase alone, despite the presence of elevated levels of OVA-IgE, suggesting that curcumin may have a direct suppressive effect on intestinal mast cell activation and reverse food allergy symptoms in allergen-sensitized individuals. This was confirmed by observations that curcumin attenuated the expansion of both adoptively transferred bone marrow-derived mast cells (BMMCs, and inhibited their survival and activation during cell culture. Finally, the suppression of intestinal anaphylaxis by curcumin was directly linked with the inhibition of NF-κB activation in curcumin-treated allergic mice, and curcumin inhibited the phosphorylation of the p65 subunit of NF-κB in BMMCs. In

  12. Anaphylaxis due to spontaneous rupture of primary isolated splenic hydatid cyst.

    Science.gov (United States)

    Ozkan, Fuat; Yesilkaya, Yakup; Peker, Onur; Yuksel, Murvet

    2013-04-01

    Echinococcosis is a helminthic zoonosis mainly caused by Echinococcus granulosus and commonly encountered in endemic areas. The liver and lung are the most frequently involved organs. A primary isolated hydatid cyst of spleen is an extremely rare disease even in endemic areas. Anaphylactic reaction is a known complication of cystic hydatid disease, a parasitic infestation caused by the larval/cyst stage of E. granulosus that usually occurs after trauma or during interventions. To the best of our knowledge, anaphylaxis with spontaneous rupture of primary isolated splenic hydatidoses had not been reported previously. The main purpose of this report is to highlight life-threatening complications such as anaphylactic shock that should be considered due to primary isolated splenic cyst hydatid rupture in especially endemic regions. PMID:23961460

  13. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy

    DEFF Research Database (Denmark)

    Muraro, A; Halken, S; Arshad, S H;

    2014-01-01

    Food allergy can have significant effects on morbidity and quality of life and can be costly in terms of medical visits and treatments. There is therefore considerable interest in generating efficient approaches that may reduce the risk of developing food allergy. This guideline has been prepared...... by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Prevention and is part of the EAACI Guidelines for Food Allergy and Anaphylaxis. It aims to provide evidence-based recommendations for primary prevention of food allergy. A wide range of antenatal, perinatal, neonatal......, and childhood strategies were identified and their effectiveness assessed and synthesized in a systematic review. Based on this evidence, families can be provided with evidence-based advice about preventing food allergy, particularly for infants at high risk for development of allergic disease. The...

  14. Aspirin-Exacerbated Diseases: Advances in Asthma with Nasal Polyposis, Urticaria, Angioedema, and Anaphylaxis.

    Science.gov (United States)

    Stevens, Whitney; Buchheit, Kathleen; Cahill, Katherine N

    2015-12-01

    Aspirin-exacerbated diseases are important examples of drug hypersensitivities and include aspirin-exacerbated respiratory disease (AERD), aspirin- or non-steroidal anti-inflammatory drug (NSAID)-induced urticaria/angioedema, and aspirin- or NSAID-induced anaphylaxis. While each disease subtype may be distinguished by unique clinical features, the underlying mechanisms that contribute to these phenotypes are not fully understood. However, the inhibition of the cyclooxygenase-1 enzyme is thought to play a significant role. Additionally, eosinophils, mast cells, and their products, prostaglandins and leukotrienes, have been identified in the pathogenesis of AERD. Current diagnostic and treatment strategies for aspirin-exacerbated diseases remain limited, and continued research focusing on each of the unique hypersensitivity reactions to aspirin is essential. This will not only advance the understanding of these disease processes, but also lead to the subsequent development of novel therapeutics that patients who suffer from aspirin-induced reactions desperately need. PMID:26475526

  15. The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection.

    Science.gov (United States)

    Florvaag, E; Johansson, S G O

    2012-07-01

    : The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody levels and IgE by around 100-fold. PHO is monovalent for 2 non-cross-reacting epitopes the quaternary ammonium ion (QAI), the main allergenic epitope of NMBA, and a non-QAI epitope. Thus, PHO most unlikely would initiate an allergic inflammatory response. Consequently, IgE sensitization is not revealed by obvious clinical signs, neither through tests based on IgE-sensitized effector cells. Therefore, it will escape detection if not assayed serologically. However, when subjected to general anesthesia, and thus the IgE-sensitized individual is administered a bivalent NMBA intravenously, the unrecognized presence of serum IgE antibodies to QAI may increase the risk of anaphylaxis 200- to 300-fold. Severe damages to patient's health can result, and mortality rates of 3 to 10% are reported. The Scandinavian experience indicates that the chain of events can efficiently be avoided by stopping PHO exposure: Within 1 year, the prevalence of IgE sensitization to PHO and QAI decreases significantly, and after 2 to 3 years, the numbers of reported anaphylactic reactions decreases equally so. PMID:23283141

  16. A novel model of IgE-mediated passive pulmonary anaphylaxis in rats.

    Directory of Open Access Journals (Sweden)

    Eva Wex

    Full Text Available Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a novel model of passive pulmonary anaphylaxis in rats. Rats were passively sensitized by concurrent intratracheal and intradermal (ear application of an anti-DNP IgE antibody. Intravenous application of the antigen, DNP-BSA in combination with Evans blue dye, led to mast cell degranulation in both tissues. Quantification of mast cell degranulation in the lung was determined by (1 mediator release into bronchoalveolar lavage, (2 extravasation of Evans blue dye into tracheal and bronchial lung tissue and (3 invasive measurement of antigen-induced bronchoconstriction. Quantification of mast cell degranulation in the ear was determined by extravasation of Evans blue dye into ear tissue. We pharmacologically validated our model using the SYK inhibitor Fostamatinib, the H1-receptor antagonist Desloratadine, the mast cell stabilizer disodium cromoglycate (DSCG and the β2-adrenergic receptor agonist Formoterol. Fostamatinib was equally efficacious in lung and ear. Desloratadine effectively inhibited bronchoconstriction and ear vascular leakage, but was less effective against pulmonary vascular leakage, perhaps reflecting the differing roles for histamine receptor sub-types. DSCG attenuated both vascular leakage in the lung and bronchoconstriction, but with a very short duration of action. As an inhaled approach, Formoterol was more effective in the lung than in the ear. This model of passive pulmonary anaphylaxis provides a tissue relevant readout of early mast cell

  17. A novel model of IgE-mediated passive pulmonary anaphylaxis in rats.

    Science.gov (United States)

    Wex, Eva; Thaler, Eva; Blum, Sylvia; Lamb, David

    2014-01-01

    Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a novel model of passive pulmonary anaphylaxis in rats. Rats were passively sensitized by concurrent intratracheal and intradermal (ear) application of an anti-DNP IgE antibody. Intravenous application of the antigen, DNP-BSA in combination with Evans blue dye, led to mast cell degranulation in both tissues. Quantification of mast cell degranulation in the lung was determined by (1) mediator release into bronchoalveolar lavage, (2) extravasation of Evans blue dye into tracheal and bronchial lung tissue and (3) invasive measurement of antigen-induced bronchoconstriction. Quantification of mast cell degranulation in the ear was determined by extravasation of Evans blue dye into ear tissue. We pharmacologically validated our model using the SYK inhibitor Fostamatinib, the H1-receptor antagonist Desloratadine, the mast cell stabilizer disodium cromoglycate (DSCG) and the β2-adrenergic receptor agonist Formoterol. Fostamatinib was equally efficacious in lung and ear. Desloratadine effectively inhibited bronchoconstriction and ear vascular leakage, but was less effective against pulmonary vascular leakage, perhaps reflecting the differing roles for histamine receptor sub-types. DSCG attenuated both vascular leakage in the lung and bronchoconstriction, but with a very short duration of action. As an inhaled approach, Formoterol was more effective in the lung than in the ear. This model of passive pulmonary anaphylaxis provides a tissue relevant readout of early mast cell activity and

  18. Mesenchymal stromal stem cell therapy in advanced interstitial lung disease - Anaphylaxis and short-term follow-up.

    Science.gov (United States)

    Thangakunam, Balamugesh; Christopher, Devasahayam Jesudas; Mathews, Vikram; Srivastava, Alok

    2015-01-01

    There are limited treatment options for advanced interstitial lung disease (ILD). We describe a patient of ILD treated with mesenchymal stromal stem cell infusion. The index patient had end-stage ILD due to a combination of insults including treatment with radiotherapy and a tyrosine kinase inhibitor Erlotinib. He was oxygen-dependent and this was hampering his quality of life. He tolerated the first infusion stem cells without any problem. During the second infusion he developed anaphylactic shock, which was appropriately managed. At 6-months follow-up he had no improvement in oxygenation, pulmonary function or CT scan parameters. In view of anaphylaxis, further infusions of MSC were withheld. A longer follow-up may reveal long-term benefits or side effects, if any. However the occurrence of anaphylaxis is of concern suggesting that further trials should be conducted with intensive monitoring. PMID:26628765

  19. Mesenchymal stromal stem cell therapy in advanced interstitial lung disease - Anaphylaxis and short-term follow-up

    Directory of Open Access Journals (Sweden)

    Balamugesh Thangakunam

    2015-01-01

    Full Text Available There are limited treatment options for advanced interstitial lung disease (ILD. We describe a patient of ILD treated with mesenchymal stromal stem cell infusion. The index patient had end-stage ILD due to a combination of insults including treatment with radiotherapy and a tyrosine kinase inhibitor Erlotinib. He was oxygen-dependent and this was hampering his quality of life. He tolerated the first infusion stem cells without any problem. During the second infusion he developed anaphylactic shock, which was appropriately managed. At 6-months follow-up he had no improvement in oxygenation, pulmonary function or CT scan parameters. In view of anaphylaxis, further infusions of MSC were withheld. A longer follow-up may reveal long-term benefits or side effects, if any. However the occurrence of anaphylaxis is of concern suggesting that further trials should be conducted with intensive monitoring.

  20. A Case of Korean Ginseng-Induced Anaphylaxis Confirmed by Open Oral Challenge and Basophil Activation Test

    OpenAIRE

    Lee, Jae-Young; Jin, Hyun Jung; Park, Jung-Won; Jung, Soon Kwang; Jang, Jeng-Yun; Park, Hae-Sim

    2011-01-01

    Two case reports discussing Korean ginseng-induced allergic reactions have been published; both were inhalation-induced respiratory allergies in occupational settings. In this report we discuss the first case of anaphylaxis that developed after an oral intake of ginseng, confirmed by an open oral challenge, a skin prick test (SPT), and a basophil activation test (BAT). A 44-year-old man experienced rhinorrhea and nasal stiffness, followed by respiratory difficulty with wheeze and abdominal pa...

  1. Role of mast cell-derived mediators for leukocyte/endothelium-interactions and microvascular mechanisms in inflammation and in anaphylaxis.

    OpenAIRE

    Guo, Yancai

    2003-01-01

    The overall objective of this thesis was to study the roles of mast cell-derived mediators for leukocyte/endothelium interactions and microvascular mechanisms in inflammation and in anaphylaxis, using mast cell-deficient Ws/Ws rats and their wild-type +/+ littermates. The efflux of endogenous histamine and edema formation evoked by subplantar injection of compound 48/80 in rat hindpaws was dose-dependent in +/+ rats, and was essentially lacking in Ws/Ws rats. These findings...

  2. [Clinical courses of 18 cases with food-dependent exercise-induced anaphylaxis].

    Science.gov (United States)

    Kano, H; Juji, F; Shibuya, N; Narita, M; Naritaka, S; Suko, M; Morita, Y; Iwata, T

    2000-06-01

    Eighteen cases (7 males and 11 females) of food-dependent exercise-induced anaphylaxis were observed for several years. The age of the patients at the first visit to our hospital ranged from 9 to 43 years (average 24.3 years). The offending foods were wheat in 9 cases, shrimp in 2 cases, shellfish in 1 case, fish in 1 case, and unknown foods in 5 cases. The inducing exercises were ball play games, running, riding a bicycle, swimming, kendo (Japanese fencing), walking, and so on. We advised these patients to avoid eating offending foods or taking exercises, or to take antiallergic medicine such as DSCG, and repirinast. We observed their clinical courses and laboratory data for 2 to 10 years. Only a few cases relapsed anaphylactoid reactions, but all cases have improved until now. In some cases, IgE RAST scores for wheat decreased. In other cases, the rate of histamine release on anti-IgE stimulation decreased after taking DSCG. PMID:10916885

  3. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets.

    Science.gov (United States)

    Le, Thuy-My; Knulst, André C; Röckmann, Heike

    2014-12-01

    Spirulina (Arthrospira platensis), blue-green microalgae, has high content in proteins, γ-linoleic acid and vitamins and therefore gained popularity as food supplement. According to the Food and Agriculture Organization of the United Nations Spirulina is also an interesting alternative and sustainable protein source with the growing world population. We present a case of a 17-year-old male, who developed anaphylaxis the first time he ingested a Spirulina tablet. Skin prick test with diluted Spirulina tablet was positive. Further skin prick testing with separated ingredients (Spirulina platensis algae, silicon dioxide, inulin and magnesium stearate) was only positive for Spirulina platensis algae and negative in controls, confirming the allergy was caused by Spirulina and not by one of the additives. This case report shows that diagnosis of Spirulina allergy can safely be made by skin prick test with dilutions of the A. platensis or even more simple by skin prick test with the diluted tablet. Since Spirulina has gained popularity as food and nutritional supplement, it is important to realize the potential risk of this dietary supplement. Before Spirulina is produced and consumed on a wider scale, allergenicity risk assessment should be performed, including investigation of potential crossreactivity with well-known inhalant allergens and foods. PMID:25445756

  4. Protective effect of relaxin in cardiac anaphylaxis: involvement of the nitric oxide pathway

    Science.gov (United States)

    Masini, E; Zagli, G; Ndisang, J F; Solazzo, M; Mannaioni, P F; Bani, D

    2002-01-01

    Relaxin (RLX) is a multifunctional hormone best known for its role in pregnancy and parturition, that has been also shown to influence coronary perfusion and mast cell activation through the generation of endogenous nitric oxide (NO). In this study we report on the effects of RLX on the biochemical and mechanical changes of ex vivo perfused hearts isolated from ovalbumin-sensitized guinea-pigs induced by challenge with the specific antigen. The possible involvement of NO in the RLX action has been also investigated. A 30-min perfusion with RLX (30 ng ml−1) before ovalbumin challenge fully abated the positive chronotropic and inotropic effects evoked by anaphylactic reaction to the antigen. RLX also blunted the short-term coronary constriction following to antigen challenge. Conversely, perfusion with chemically inactivated RLX had no effect. The release of histamine in the perfusate and the accumulation of calcium in heart tissue induced by antigen challenge were significantly decreased by RLX, while the amounts of nitrites in the perfusate were significantly increased, as were NO synthase activity and expression and cGMP levels in heart tissue. These findings indicate that RLX has a protective effect in cardiac anaphylaxis which involves an up-regulation of the NO biosynthetic pathway. PMID:12237253

  5. [A case of food-dependent exercise-induced anaphylaxis caused by ingestion of orange].

    Science.gov (United States)

    Ono, Rintaro; Motomura, Chikako; Takamatsu, Nobue; Kondo, Yasuto; Akamine, Yuko; Matsuzaki, Hiroshi; Murakami, Yoko; Amimoto, Yuko; Taba, Naohiko; Honjyo, Satoshi; Shibata, Rumiko; Odajima, Hiroshi

    2015-02-01

    The patient was a 10-year-old girl who presented with a history of anaphylactic episodes on three occasions, that developed in association with exercise after she ate citrus fruit. She underwent tolerance tests, as food-dependent exercise-induced anaphylaxis (FDEIA) induced by citrus fruit was suspected. The result of the test for the combination of intake of oranges and exercise was negative. The patient presented with swollen eyelid and wheezing following combined intake of orange and aspirin, based on which she was diagnosed as having FDEIA. Many patients developing an allergic reaction to fruit are diagnosed as having oral allergy syndrome (OAS), and only few cases of FDEIA are reported. Immunoblot tests revealed antigens of 9 kDa, 39 kDa and 53 kDa in this patient, and an inhibition study with oranges revealed that the 39 kDa and 53 kDa antigens were probably antigen-specific allergens. Although the studied patient showed a strongly positive result for IgE antibodies specifically directed at cedar pollen, no common antigenicity with cedar pollen could be recognized. The final diagnosis was a type of FDEIA caused by 39 kDa and 53 kDa proteins, which are different from antigens previously identified in patients with citrus fruits allergy. It should be the first report of such a case. PMID:25924908

  6. FORMATION OF SLOW-REACTING SUBSTANCE OF ANAPHYLAXIS IN HUMAN LUNG TISSUE AND CELLS BEFORE RELEASE

    Science.gov (United States)

    Lewis, Robert A.; Wasserman, Stephen I.; Goetzl, Edward J.; Austen, K. Frank

    1974-01-01

    The capacity to extract slow-reacting substance of anaphylaxis (SRS-A) from human lung tissue or cells after immunologic activation, together with the measurement of SRS-A in both the extract and the surrounding fluid, permits study of total SRS-A generation. That the material extracted is SRS-A was established by both differential bioassay and purification. SRS-A accumulation was entirely intracellular after limited IgE-dependent direct or reversed anaphylactic activation. Intracellular accumulation also generally preceded release, with generation of SRS-A continuing well beyond a plateau in the cellular SRS-A level and the release of preformed mediators. The quantity of SRS-A generated after immunologic activation was modulated by the introduction of exogenous cyclic nucleotides, revealing a site of cyclic nucleotide action distinct from that on mediator release. The capacity to determine not only the release of preformed mediators but also the generation of a newly formed mediator, the sum of SRS-A in cells and supernate, adds an additional dimension to the analysis of the cellular events of immediate hypersensitivity. PMID:4378429

  7. Utility of rotational thromboelastometry for the diagnosis of asymptomatic hyperfibrinolysis secondary to anaphylaxis.

    Science.gov (United States)

    Koami, Hiroyuki; Sakamoto, Yuichiro; Furukawa, Takashi; Imahase, Hisashi; Iwamura, Takashi; Inoue, Satoshi

    2016-06-01

    We present a case of hyperfibrinolysis induced by oxaliplatin-derived anaphylactic shock, which was diagnosed with rotational thromboelastometry (ROTEM). A 57-year-old male patient underwent a second course of oxaliplatin (126 mg/m/course)-based chemotherapy for stage IV metastatic rectal cancer. Two minutes after the infusion of oxaliplatin, the patient lost consciousness and developed generalized urticarial lesions, followed by hemodynamic instability and respiratory insufficiency. He was diagnosed anaphylactic shock and transported to emergency department (ED) after intramuscular injection of 0.2 mg of adrenaline, an intravenous injection of 100 mg of hydrocortisone, and 500 mg of methylprednisolone. After arriving in the ED, the patient remained in shock and early resuscitation with administration of 5 mg of D-chlorpheniramine maleate and 20 mg of famotidine was performed. He recovered from his state of shock 30 min after the resuscitation. ROTEM findings showed fulminant hyperfibrinolysis with minimal changes in standard coagulation tests (SCTs) and no remarkable coagulopathy. Seven hours after the attack, he became asymptomatic and follow-up ROTEM revealed values within normal limits with the exception of sustained slight abnormalities of SCTs. He was discharged the next day without any signs of spontaneous bleeding and has continued his outpatient chemotherapy uneventfully. A review of the literature on anaphylaxis-induced hyperfibrinolysis and a discussion of the mechanism between anaphylactic shock and hyperfibrinolysis were performed. Although administration of tissue-type plasminogen activator can play a vital role in anaphylactic shock-induced hyperfibrinolysis, early effective resuscitation is imperative to prevent severe hemorrhagic complications. Therefore, ROTEM is a useful tool that can detect these dynamic changes faster and more accurately than SCTs. PMID:26569513

  8. Bee Pollen-Induced Anaphylaxis: A Case Report and Literature Review.

    Science.gov (United States)

    Choi, Jeong Hee; Jang, Young Sook; Oh, Jae Won; Kim, Cheol Hong; Hyun, In Gyu

    2015-09-01

    Bee pollen is pollen granules packed by honey bees and is widely consumed as natural healthy supplements. Bee pollen-induced anaphylaxis has rarely been reported, and its allergenic components have never been studied. A 40-year-old male came to the emergency room with generalized urticaria, facial edema, dyspnea, nausea, vomiting, abdominal pain, and diarrhea 1 hour after ingesting one tablespoon of bee pollen. Oxygen saturation was 91%. His symptoms resolved after injection of epinephrine, chlorpheniramine, and dexamethasone. He had seasonal allergic rhinitis in autumn. Microscopic examination of the bee pollen revealed Japanese hop, chrysanthemum, ragweed, and dandelion pollens. Skin-prick with bee pollen extracts showed positive reactions at 0.1 mg/mL (A/H ratio > 3+). Serum specific IgE to ragweed was 25.2, chrysanthemum 20.6, and dandelion 11.4 kU/L; however, Japanese hop, honey-bee venom and yellow-jacket venom were negative (UniCAP®, Thermo Fisher Scientific, Uppsala, Sweden). Enzyme-linked immunosorbent assay (ELISA) confirmed serum specific IgE to bee-pollen extracts, and an ELISA inhibition assay for evaluation of cross-allergenicity of bee pollen and other weed pollens showed more than 90% of inhibition with chrysanthemum and dandelion and ~40% inhibition with ragweed at a concentration of 1 μg/mL. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblot analysis revealed 9 protein bands (11, 14, 17, 28, 34, 45, 52, 72, and 90 kDa) and strong IgE binding at 28-34 kDa, 45 and 52 kDa. In conclusion, healthcare providers should be aware of the potential risk of severe allergic reactions upon ingestion of bee pollen, especially in patients with pollen allergy. PMID:25749764

  9. PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS.

    Science.gov (United States)

    Alshaeri, Taghreed; Gupta, Deepak; Nagabhushana, Ananthamurthy

    2016-02-01

    Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine. Continuous infusion of epinephrine was initiated. After aborting surgical procedure, the patient was transferred to ICU on continuous intravenous infusion of epinephrine. Venous blood sampling showed elevated troponin level. Echocardiography revealed ejection fraction of 25% suspicious of Takotsubo cardiomyopathy (mid cavitary variant). Tracheal extubation was only possible after three days. Subsequently, patient was discharged home with a cardiology follow-up appointment and a referral to an allergy specialist. Unfortunately at our institution (an academic university hospital in United States) along with neighboring institutions in near-by areas, the only allergy skin tests available are for local anesthetics and antibiotics, while neuromuscular blocking agents (NMBAs) cannot be tested (the suspected anaphylactic agent in our case was presumably rocuronium). In summary, PAA requires and responds to emergent diagnosis and immediate treatment; however there is still a long way to go to ensure post-PAA testing for inciting anesthesia-related allergens. PMID:27382817

  10. Spontaneous rupture of a splenic hydatid cyst with anaphylaxis in a patient with multi-organ hydatid disease.

    Science.gov (United States)

    Constantin, V; Popa, F; Socea, B; Carâp, A; Bălălău, C; Motofei, I; Banu, P; Costea, D

    2014-01-01

    Hidatid cysts of the spleen are a rare occurrence, the spleen being the third most common organ for the development of Echinococcus Granulosus. Splenic hydatid cysts are commonly part of multi-organ hydatid disease. Diagnosis is often established when investigating a splenomegaly or by chance during an unrelated consult. It can also be diagnosed after rupture, be it following trauma (the most common occurrence)or spontaneous. Splenic hydatid cyst rupture requires immediate action and is a life-threatening condition. It results, most often, in splenectomy. We present the case of a patient with multi-organ hydatid disease that presented with a ruptured splenic cyst and developed anaphylaxis. The case was resolved by splenectomy and recovered well. PMID:24956347

  11. Training and administration of epinephrine auto-injectors for anaphylaxis treatment in US schools: results from the EpiPen4Schools® pilot survey

    Science.gov (United States)

    Hogue, Susan L; Goss, Diana; Hollis, Kelly; Silvia, Suyapa; White, Martha V

    2016-01-01

    Background Anaphylaxis is a serious, potentially life-threatening condition. Adequate preparation for anaphylaxis management is imperative for school personnel. This descriptive pilot study assessed preparedness of US schools to manage anaphylactic reactions. Methods An exploratory, cross-sectional, web-based, pilot survey assessed the occurrence and characteristics of anaphylactic events, as well as training provided to school personnel for the recognition and treatment of anaphylaxis. Eligible US schools were participants in the EpiPen4Schools® program during the 2013–2014 school year. EpiPen4Schools provides EpiPen® (epinephrine injection) Auto-Injectors and training materials to qualifying US schools. Survey data were parsed by US Census Bureau region and state and were evaluated using descriptive statistics. Results Schools from all 50 states and the District of Columbia participated in the survey (N=6,019). Among schools that provided information on anaphylactic events, 11% (607/5,683) reported the occurrence of one or more events, with significant variability in incidence across census regions and among states. A total of 5,613 schools provided information regarding which staff members were trained to recognize the signs and symptoms of anaphylaxis. Thirty-six percent of schools (2,022/5,613) indicated that only the school nurse and select staff were trained in anaphylaxis recognition. The proportion of schools in which most or all school staff received such training differed by region/state (range, 13%–100%). A total of 5,578 schools provided information on which staff were permitted to administer epinephrine. The majority of schools (54%; 3,024/5,578) permitted only the school nurse and select staff to administer epinephrine, although percentages varied by region/state (range, 4%–100%). Conclusion Schools differed substantially in their preparedness to manage anaphylaxis, with significant disparities in staff training and permission to treat. Given

  12. 424 Wheat-dependent Exercise-induced Anaphylaxis Occurred in OAS Patient after Using Soap Containing Hydrolyzed Wheat Proteins: Effect of Soap on Keratinocyte Inflammasome

    OpenAIRE

    Tanaka, Aya; Itoi, Saori; Terao, Mika; Matsui, Saki; Tani, Mamori; Hanafusa, Takaaki; Igawa, Ken; Murota, Hiroyuki; Katayama, Ichiro; Chinuki, Yuko; Morita, Eishin

    2012-01-01

    Background We present a case of Wheat-dependent Exercise-induced anaphylaxis (WDEIA) occurred in a patient previously suffering from atopic dermatitis (AD), pollen allergy and Oral allergy syndrome (OAS) after using face soap containing hydrolyzed wheat proteins (HWP) . Methods A 16-year old woman had contact urticaria after using face soap containing HWP and developed urticaria and dyspnea after ingestion of wheat products. We performed skin prick test, provocation test and serum IgE analysi...

  13. Giant Asian honeybee or Bambara stings causing myocardial infarction, bowel gangrene and fatal anaphylaxis in Sri Lanka:a case series

    Institute of Scientific and Technical Information of China (English)

    Budagoda BDSS; Kularatne SAM; Kodikara KAS; Kularatne WKS; Mudiyanse RM; Edussuriya DH; Edirisinghe JP; Karunaratne IP; Weerakoon KGAD; Medagedara SC

    2010-01-01

    The sting of Giant Asian honeybee (Apis dorsata) or Bambara in Sinhala and Karunge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions, which could be fatal in sensitized individuals. We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’ skin.

  14. Evaluation of anti-allergic properties of caffeic acid phenethyl ester in a murine model of systemic anaphylaxis

    International Nuclear Information System (INIS)

    Caffeic acid phenethyl ester (CAPE) is an active component of honeybee propolis extracts. It has several positive effects, including anti-inflammatory, anti-oxidation, anti-cancer, anti-bacterial, anti-viral, anti-fungal, and immunomodulatory effects. In particular, the suppressive effect of NF-κB may disrupt a component of allergic induction. The principal objective of this experimental study was to evaluate the effects of CAPE on the active systemic anaphylaxis induced by ovalbumin (OVA) challenge in mice. Mice were intraperitoneally sensitized and intravenously challenged with OVA. Histopathological analysis, nuclear factor (NF)-κB activation, and the plasma levels of histamine and total IgE after allergen challenge were evaluated. After challenges, all of the sham-treated mice developed anaphylactic symptoms, increased plasma levels of histamine and OVA-specific IgE, marked vascular leakage, NF-κB activation, platelet-activating factor (PAF) production, and histological changes including pulmonary edema and hemorrhage in the renal medullae within 20 min. By way of contrast, a reduction in the plasma levels of histamine and OVA-specific IgE and an inhibition of NF-κB activation and PAF release were observed in the CAPE-treated mice. In addition, a significant prevention of hemoconcentration and OVA-induced pathological changes were noted. These results indicate that CAPE demonstrates an anti-allergic effect, which may be the result of its protective effects against IgE-mediated allergy

  15. Acute Onset of Vancomycin Anaphylaxis With Disseminated Intravascular Coagulation in an Orthopedic Patient Despite Prior Repeated Exposure.

    Science.gov (United States)

    Adams, Brock; Roboubi, Babak; Henshaw, Robert

    2015-12-01

    Vancomycin is a glycopeptide antibiotic that exhibits bactericidal activity against gram-positive cocci. It is commonly recommended for surgical prophylaxis in cases of suspected bacterial resistance or penicillin allergy. There are 2 main types of hypersensitivity reactions associated with vancomycin. Red man syndrome is an anaphylactoid reaction caused by direct release of histamine. The second is an anaphylactic reaction, which is an immunoglobulin E-mediated response. We present the case of a 55-year-old woman with a history of metastatic giant cell tumor of the right proximal tibia. She had undergone multiple surgeries for this and other nonorthopedic conditions. The patient received vancomycin for the majority of these procedures and extended courses of vancomycin on 2 separate occasions. In the present case, the patient was taken to the operating room for a prosthetic infection, and vancomycin was given after cultures were taken. The patient immediately developed signs consistent with anaphylaxis and disseminated intravascular coagulation. This was treated acutely with hemodynamic resuscitation, replacement of blood components, steroids, and repeated boluses of epinephrine. She recovered and was taken back to the operating room during that same admission without incident. The patient has since been treated with systemic daptomycin and a tobramycin cement spacer without further incident. PMID:26665256

  16. Polydatin (PD) inhibits IgE-mediated passive cutaneous anaphylaxis in mice by stabilizing mast cells through modulating Ca{sup 2+} mobilization

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Meichun [Department of Pathophysiology, School of Medicine, Shenzhen University, Shenzhen 518060 (China); Department of Physiology, Hubei University of Medicine, Shiyan (China); Li, Jianjie [State Key Laboratory of Respiratory Disease for Allergy at Shengzhen University, Shenzhen 518060 (China); Lv, Jingzhang [Shenzhen Entry-Exit Inspection and Quarantine Bureau, Shenzhen 518045 (China); Mo, Xucheng; Yang, Chengbin [State Key Laboratory of Respiratory Disease for Allergy at Shengzhen University, Shenzhen 518060 (China); Chen, Xiangdong [Department of Pathophysiology, School of Medicine, Shenzhen University, Shenzhen 518060 (China); Liu, Zhigang [State Key Laboratory of Respiratory Disease for Allergy at Shengzhen University, Shenzhen 518060 (China); Liu, Jie, E-mail: ljljz@yahoo.com [Department of Pathophysiology, School of Medicine, Shenzhen University, Shenzhen 518060 (China)

    2012-11-01

    Mast cells play a key role in the pathogenesis of asthma and are a promising target for therapeutic intervention in asthma. This study investigated the effects of polydatin (PD), a resveratrol glucoside, on mast cell degranulation upon cross-linking of the high-affinity IgE receptors (FcεRI), as well as the anti-allergic activity of PD in vivo. Herein, we demonstrated that PD treatment for 30 min suppressed FcεRI-mediated mast cell degranulation in a dose-dependent manner. Concomitantly, PD significantly decreased FcεRI-mediated Ca{sup 2+} increase in mast cells. The suppressive effects of PD on FcεRI-mediated Ca{sup 2+} increase were largely inhibited by using LaCl{sub 3} to block the Ca{sup 2+} release-activated Ca{sup 2+} channels (CRACs). Furthermore, PD significantly inhibited Ca{sup 2+} entry through CRACs evoked by thapsigargin (TG). Knocking down protein expression of Orai1, the pore-forming subunit of CRACs, significantly decreased PD suppression of FcεRI-induced intracellular Ca{sup 2+} influx and mast cell degranulation. In a mouse model of mast cell-dependent passive cutaneous anaphylaxis (PCA), in vivo PD administration suppressed mast cell degranulation and inhibited anaphylaxis. Taken together, our data indicate that PD stabilizes mast cells by suppressing FcεRI-induced Ca{sup 2+} mobilization mainly through inhibiting Ca{sup 2+} entry via CRACs, thus exerting a protective effect against PCA. -- Highlights: ► Polydatin can prevent the pathogenesis of passive cutaneous anaphylaxis in mice. ► Polydatin stabilizes mast cells by decreasing FcεRI-mediated degranulation. ► Polydatin suppresses Ca{sup 2+} entry through CRAC channels in mast cells.

  17. Management of anaphylaxis in schools: Evaluation of an epinephrine auto-injector (EpiPen® use by school personnel and comparison of two approaches of soliciting participation

    Directory of Open Access Journals (Sweden)

    Nguyen Luu Nha

    2012-07-01

    Full Text Available Abstract Background There has been no large study characterizing selection bias in allergy and evaluating school personnel’s ability to use an epinephrine auto-injector (EpiPen®. Our objective was to determine if the consent process introduces selection bias by comparing 2 methods of soliciting participation of school personnel in a study evaluating their ability to demonstrate the EpiPen®. Methods School personnel from randomly selected schools in Quebec were approached using a 1 partial or 2 full disclosure approach and were assessed on their ability to use the EpiPen® and identify anaphylaxis. Results 343 school personnel participated. In the full disclosure group, the participation rate was lower: 21.9% (95%CI, 19.0%-25.2% versus 40.7% (95%CI, 36.1%-45.3%, but more participants achieved a perfect score: 26.3% (95%CI, 19.6%-33.9% versus 15.8% (95%CI, 10.8%-21.8%, and identified 3 signs of anaphylaxis: 71.8% (95%CI, 64.0%-78.7% versus 55.6% (95%CI, 48.2%-62.9%. Conclusions Selection bias is suspected as school personnel who were fully informed of the purpose of the assessment were less likely to participate; those who participated among the fully informed were more likely to earn perfect scores and identify anaphylaxis. As the process of consent can influence participation and bias outcomes, researchers and Ethics Boards need to consider conditions under which studies can proceed without full consent. Despite training, school personnel perform poorly when asked to demonstrate the EpiPen®.

  18. Serious Allergic Reactions (Anaphylaxis)

    Science.gov (United States)

    ... or more of these body systems: skin digestive system respiratory system cardiovascular system For example, someone may feel tightness or closing in the throat (respiratory system) together with a fast heartbeat (cardiovascular system). Here ...

  19. Anaphylaxis: Tips to Remember

    Science.gov (United States)

    ... nuts (such as walnut, cashew, Brazil nut), shellfish, fish, milk, eggs and preservatives. Stinging insects: Insect sting ... way to remain safe, but requires a great deal of education. Specific advice may include: • Food: how ...

  20. Anaphylaxis caused by banana.

    Science.gov (United States)

    Savonius, B; Kanerva, L

    1993-04-01

    An anaphylactic reaction following ingestion of banana occurred in a 32-year-old female cook. The sensitization to banana occurred simultaneously with the development of occupational asthma caused by grain flour. The patient was sensitized to a wide range of airborne and ingestible proteins but not to rubber latex. PMID:8506993

  1. Effect of a cocoa-enriched diet on immune response and anaphylaxis in a food allergy model in Brown Norway rats.

    Science.gov (United States)

    Abril-Gil, Mar; Pérez-Cano, Francisco J; Franch, Àngels; Castell, Margarida

    2016-01-01

    Previous studies have demonstrated that cocoa intake decreased Th2 immune-related antibodies in rats. In consequence, we aimed to study in depth this cocoa action, particularly assessing its effect on a rat model of food allergy (FA) and also on an anaphylactic response. The involvement of the intestinal immune system was analyzed to allow the action mechanisms to be investigated. The role of cocoa flavonoids in the antiallergic properties of cocoa was also established. Brown Norway rats were fed either a reference diet or diets containing conventional cocoa (CC) or nonfermented cocoa (NFC). FA to ovalbumin (OVA) was induced and, later, an anaphylactic response was provoked. As expected, the synthesis of anti-OVA IgE and other Th2-related antibodies was inhibited by CC diet. In addition, the release of mast cell protease II after anaphylaxis was partially prevented by CC, although other variables were not modified. The CC diet also attenuated the increase of some Th2-related cytokines released from mesenteric lymph node and spleen cells, and modulated the intestinal gene expression of molecules involved in allergic response. These results demonstrated the local and systemic influence of CC diet. The effects of the NFC diet were weaker than those of CC, suggesting that cocoa components other than flavonoids play a role in cocoa's action. In conclusion, by acting on intestinal and systemic immune functions, a cocoa-enriched diet in rats exhibited a protective effect against FA and partially against anaphylaxis, making this a food of high interest to the fields of health and immunonutrition. PMID:26601599

  2. Anaphylaxis to IGIV in immunoglobulin-naïve common variable immunodeficiency patient in the absence of IgG anti-IgA antibodies: successful administration of low IgA-containing immunoglobulin

    OpenAIRE

    Gharib, Asal; Caperton, Caroline; Gupta, Sudhir

    2016-01-01

    Although severe reactions to immunoglobulin preparations have been frequently reported, IgE antibodies against IgA are usually not investigated; and occur predominantly in previously sensitized patients. The purpose is to report anaphylaxis to IGIV during initial infusion in a patient with common variable immunodeficiency with absent IgA without prior sensitization and in the absence of detectable IgG anti-IgA antibodies, and positive skin tests for immediate hypersensitivity to four differen...

  3. A rare combination of undiagnosed hypertrophic cardiomyopathy revealed by intraoperative anaphylaxis resulting in acute left ventricular outflow obstruction and cardiac arrest.

    Science.gov (United States)

    Smith, Bradford B; Nickels, Andrew S; Sviggum, Hans P

    2016-06-01

    A 75-year-old female presented for left total hip reimplantation and suffered pulseless electrical activity arrest upon lateral positioning and administering vancomycin. Resuscitation was achieved according to Advanced Cardiac Life Support protocol. Post-event echocardiography showed hypertrophic cardiomyopathy with asymmetrical septal thickening, an under-filled left ventricle, dynamic left ventricular outflow obstruction, and severe mitral regurgitation related to systolic anterior motion of the mitral valve. Laboratory analysis showed a tryptase level of 209 ng/mL. After multispecialty evaluation, it was concluded that the patient's arrest was due to vancomycin anaphylaxis in the setting of previously undiagnosed hypertrophic cardiomyopathy leading to acute left ventricular outflow tract obstruction. After medical optimization of the patient's cardiomyopathy and an evaluation of potential intraoperative allergic triggers, the patient underwent a successful hip reimplantation without incident. This case presents a novel combination of events leading to intraoperative cardiac arrest. Rapid identification and an understanding of the cause(s) of cardiac arrest in this setting are critical for effective perioperative care. PMID:27185714

  4. Study on the Immunoreactivity of Triticum monococcum (Einkorn) Wheat in Patients with Wheat-Dependent Exercise-Induced Anaphylaxis for the Production of Hypoallergenic Foods.

    Science.gov (United States)

    Lombardo, Carla; Bolla, Michela; Chignola, Roberto; Senna, Gianenrico; Rossin, Giacomo; Caruso, Beatrice; Tomelleri, Carlo; Cecconi, Daniela; Brandolini, Andrea; Zoccatelli, Gianni

    2015-09-23

    Wheat [Triticum aestivum (T.a.)] ingestion can cause a specific allergic reaction, which is called wheat-dependent exercise-induced anaphylaxis (WDEIA). The major allergen involved is ω-5 gliadin, a gluten protein coded by genes located on the B genome. Our aim was to study the immunoreactivity of proteins in Triticum monococcum (einkorn, T.m.), a diploid ancestral wheat lacking B chromosomes, for possible use in the production of hypoallergenic foods. A total of 14 patients with a clear history of WDEIA and specific immunoglobulin E (IgE) to ω-5 gliadin were enrolled. Skin prick test (SPT) with a commercial wheat extract and an in-house T.a. gluten diagnostic solution tested positive for 43 and 100% of the cases, respectively. No reactivity in patients tested with solutions prepared from four T.m. accessions was observed. The immunoblotting of T.m. gluten proteins performed with the sera of patients showed different IgE-binding profiles with respect to T.a., confirming the absence of ω-5 gliadin. A general lower immunoreactivity of T.m. gluten proteins with scarce cross-reactivity to ω-5 gliadin epitopes was assessed by an enzyme-linked immunosorbent assay (ELISA). Given the absence of reactivity by SPT and the limited cross-reactivity with ω-5 gliadin, T.m. might represent a potential candidate in the production of hypoallergenic bakery products for patients sensitized to ω-5 gliadin. Further analyses need to be carried out regarding its safety. PMID:26332577

  5. [Anaphylaxis due to peach with negative ImmunoCAP result to peach allergens, including rPru p 1, rPru p 3, AND rPru p 4: a report of two cases].

    Science.gov (United States)

    Maeda, Nobuko; Inomata, Naoko; Morita, Akiko; Kirino, Mio; Moriyama, Tatsuya; Ikezawa, Zenro

    2009-02-01

    We report two cases of anaphylactic reactions to peach with negative result of ImmunoCAP to peach. Case 1 is a 35-year-old man, who felt an itch in his oral cavity immediately after ingesting a whole fresh peach. He rapidly developed generalized urticaria, dyspnea, vomiting, and loss of consciousness. He recovered after treatment at a local hospital, thereafter he was referred to our hospital because ImmunoCAP conducted for screening allergens revealed a negative test result to peach and the cause of anaphylaxis remained unclear. He had a history of pollinosis. He reported that he previously felt an itch on his oral cavity after ingesting melon, watermelon, apple, and strawberry. Serum total IgE was 436 IU/ml. CAP-RAST revealed negative results to peach, strawberry and kiwi. Skin prick tests (SPTs) with raw peach pulp, canned peach pulp, strawberry and kiwi were positive. Case 2 is a 30-year-old woman who felt an itch on her oral cavity accompanied by blepharedema, rhinorrhea, generalized urticaria, nausea, abdominal pain and diarrhea after eating peach. She had a history of pollinosis. She reported that she previously developed urticaria after ingesting an apple. Serum total IgE was 85 IU/ml. ImmunoCAP revealed negative results to peach and apple. SPTs with canned yellow peach, strawberry and apple were positive. Consequently, the two patients were diagnosed with anaphylaxis due to peach, and allergic symptoms have never recurred since they avoided ingesting peach. Furthermore, in two patients ImmunoCAP to rPru p 1, rPru p 3, and rPru p 4 were negative. However, in IgE-immunoblotting of peach, serum IgE antibodies of two patients were bound to approximately 10 kDa proteins. Meanwhile, the cross-reactivity between Rosaceae fruits, such as peach, apple, apricot, and plum, has been reported. These results suggest that in patients, who are suspected of having peach anaphylaxis and show a negative ImmunoCAP result to peach, the additional testing, such as SPT with

  6. Anaphylaxis to Insect Venom Allergens

    DEFF Research Database (Denmark)

    Ollert, Markus; Blank, Simon

    2015-01-01

    by a lack of specificity and venom immunotherapy by severe side effects and incomplete protection. In recent years, the knowledge about the molecular composition of Hymenoptera venoms has significantly increased and more and more recombinant venom allergens with advanced characteristics have become......, and to contribute to the understanding of the immunological mechanisms elicited by insect venoms....

  7. Exploration on the selection of positive materials in active systemic anaphylaxis in guinea pigs%豚鼠主动全身过敏试验两种阳性物质选择的探讨

    Institute of Scientific and Technical Information of China (English)

    高梅; 曹冲; 马会; 朱春花

    2015-01-01

    目的:比较两种阳性物质人血白蛋白、卵白蛋白对豚鼠主动全身过敏作用,为过敏性试验提供较好的阳性对照。方法将豚鼠随机分为14组,以人血白蛋白、卵白蛋白(2、10、100 mg/只)、0.9%氯化钠注射液等受试物为对照,研究不同致敏剂量、激发剂量、激发时间等条件下,豚鼠全身主动过敏的反应情况。结果在2~100 mg/只剂量范围内,人血白蛋白、卵白蛋白豚鼠主动全身过敏反应的发生率为100%。在2~10 mg/只剂量范围内,过敏症状发生程度随致敏剂量、激发剂量的增加而增加,相同剂量的卵白蛋白较人血白蛋白反应程度更强。结论豚鼠主动全身过敏试验,阳性对照推荐使用卵白蛋白,剂量为2 mg/只。%ObjectiveTheaimofthisstudywastoprovideabetterpositivecontrolforallergictestbycomparing the allergic effect of two kinds of positive materials , human albumin and ovalbumin , on active systemic anaphylaxis in guinea pig.Methods Guinea pigs were randomly divided into 14 groups, and were given human albumin , ovalbumin (2, 10, 100 mg/animal), or 0.9%sodium chloride injection as test substances , to assess the symptoms and incidence of systemic allergic responses induced by different sensitizing substances in different challenge doses and different challenge intervals.Results In the range of 2 to 100 mg/animal, the guinea pigs showed a 100%incidence rate of positive allergic reaction to human albumin and ovalbumin , the severity of anaphylactic symptoms was increasing along with the increase of sensitizing doses and challenge doses , and the allergic reaction was more strong induced by the same dose of ovalbumin than human albumin .Conclusions Our findings indicate that in the active systemic anaphylaxis test in guinea pigs , we recommend ovalbumin as the positive control in a dose of 2 mg/animal.

  8. Inhibitory effects of an ellagic acid glucoside, okicamelliaside, on antigen-mediated degranulation in rat basophilic leukemia RBL-2H3 cells and passive cutaneous anaphylaxis reaction in mice.

    Science.gov (United States)

    Kuba-Miyara, Megumi; Agarie, Kengo; Sakima, Rina; Imamura, Shihoko; Tsuha, Kazuyo; Yasumoto, Takeshi; Gima, Shinichi; Matsuzaki, Goro; Ikehara, Tsuyoshi

    2012-04-01

    Degranulation inhibitors in plants are widely used for prevention and treatment of immediate-type allergy. We previously isolated a new ellagic acid glucoside, okicamelliaside (OCS), from Camellia japonica leaves for use as a potent degranulation inhibitor. Crude extracts from leaves also suppressed allergic conjunctivitis in rats. In this study, we evaluated the in vivo effect of OCS using a pure sample and performed in vitro experiments to elucidate the mechanism underlying the extraordinary high potency of OCS and its aglycon. The IC(50) values for degranulation of rat basophilic leukemia cells (RBL-2H3) were 14 nM for OCS and 3 μM for aglycon, indicating that the two compounds were approximately 2 to 3 orders of magnitude more potent than the anti-allergic drugs ketotifen fumarate, DSCG, and tranilast (0.17, 3, and >0.3 mM, respectively). Antigen-induced calcium ion (Ca(2+)) elevation was significantly inhibited by OCS and aglycon at all concentrations tested (p<0.05). Upstream of the Ca(2+) elevation in the principle signaling pathway, phosphorylation of Syk (Tyr525/526) and PLCγ-1 (Tyr783 and Ser1248) were inhibited by OCS and aglycon. In DNA microarray-screening test, OCS inhibited expression of proinflammatory cytokines [interleukin (IL)-4 and IL-13], cytokine-producing signaling factors, and prostaglandin-endoperoxidase 2, indicating that OCS broadly inhibits allergic inflammation. During passive cutaneous anaphylaxis in mice, OCS significantly inhibited vascular hyperpermeability by two administration routes: a single intraperitoneal injection at 10 mg/kg and per os at 5 mg/kg for 7 days (p<0.05). These results suggest the potential for OCS to alleviate symptoms of immediate-type allergy. PMID:22330086

  9. 4-Chlorotetrazolo[1,5-a]quinoxaline inhibits activation of Syk kinase to suppress mast cells in vitro and mast cell-mediated passive cutaneous anaphylaxis in mice

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kui Lea [Center for Drug Development Assistance, National Institute of Food Drug Safety Evaluation (NIFDS), KFDA, Cheongwon-gun (Korea, Republic of); Ko, Na Young; Lee, Jun Ho; Kim, Do Kyun; Kim, Hyuk Soon; Kim, A-Ram; Her, Erk; Kim, Bokyung [Department of Immunology and physiology, College of Medicine, Konkuk University, Chungju (Korea, Republic of); Kim, Hyung Sik [College of Pharmacy, Pusan National University, Busan (Korea, Republic of); Moon, Eun-Yi [Department of Bioscience and Biotechnology, College of Biological Science, Sejong University, Seoul (Korea, Republic of); Kim, Young Mi [College of Pharmacy, Duksung Women' s University, Seoul (Korea, Republic of); Kim, Hang-Rae, E-mail: hangrae2@snu.ac.kr [Department of Anatomy, Seoul National University College of Medicine, Seoul (Korea, Republic of); Choi, Wahn Soo, E-mail: wahnchoi@kku.ac.kr [Department of Immunology and physiology, College of Medicine, Konkuk University, Chungju (Korea, Republic of)

    2011-12-15

    4-Chlorotetrazolo[1,5-a]quinoxaline is a quinoxaline derivative. We aimed to study the effects of 4-chlorotetrazolo[1,5-a]quinoxaline on activation of mast cells in vitro and in mice. 4-Chlorotetrazolo[1,5-a]quinoxaline reversibly inhibited degranulation of mast cells in a dose-dependent manner, and also suppressed the expression and secretion of TNF-{alpha} and IL-4 in mast cells. Mechanistically, 4-chlorotetrazolo[1,5-a]quinoxaline inhibited activating phosphorylation of Syk and LAT, which are crucial for early Fc{epsilon}RI-mediated signaling events, as well as Akt and MAP kinases, which play essential roles in the production of various pro-inflammatory cytokines in mast cells. Notably, although 4-chlorotetrazolo[1,5-a]quinoxaline inhibited the activation of Fyn and Syk, minimal inhibition was observed in mast cells in the case of Lyn. Furthermore, consistent with its in vitro activity, 4-chlorotetrazolo[1,5-a]quinoxaline significantly suppressed mast cell-mediated passive cutaneous anaphylaxis in mice. In summary, the results from this study demonstrate that 4-chlorotetrazolo[1,5-a]quinoxaline shows an inhibitory effect on mast cells in vitro and in vivo, and that this is mediated by inhibiting the activation of Syk in mast cells. Therefore, 4-chlorotetrazolo[1,5-a]quinoxaline could be useful in the treatment of mast cell-mediated allergic diseases. -- Highlights: Black-Right-Pointing-Pointer 4-chlorotetrazolo[1,5-a]quinoxaline is a quinoxaline derivative. Black-Right-Pointing-Pointer The effect of 4-chlorotetrazolo[1,5-a]quinoxaline on mast cells was investigated. Black-Right-Pointing-Pointer 4-chlorotetrazolo[1,5-a]quinoxaline reversibly inhibited Syk activation. Black-Right-Pointing-Pointer 4-chlorotetrazolo[1,5-a]quinoxaline could be useful for IgE-mediated allergy.

  10. [Correlation between pholcodine and perioperative anaphylaxis].

    Science.gov (United States)

    Dumancić, Jelena; Marković, Asja Stipić

    2012-05-01

    A large number of individuals experiencing anaphylactic reaction to neuromuscular blocking agents have not previously been in contact with them. The search for a substance inducing sensitization to muscle relaxants has led Norwegian and Swedish scientists to pholcodine, a cough suppressant, which is widely used in Europe and worldwide. Ammonium ion is an epitope common to pholcodine and neuromuscular blocking agents and it is the basis of their cross-reactivity. Based on the results of published studies that pointed to a connection of the use of pholcodine and perioperative anaphylactic reaction, pholcodine was withdrawn from the Norwegian market and subsequent research revealed a reduction of anaphylactic reactions in that country. In its latest report, the European Medicines Agency made a decision not to withdraw pholcodine mixtures from the market but it urged further research with the aim to clarify the cross-reactivity between pholcodine and neuromuscular blocking agents. PMID:23437637

  11. Cold-induced anaphylaxis - case report

    OpenAIRE

    Gomes, S; Viegas, V.; Pinheiro, A.; Gaspar, A.

    2010-01-01

    Introdução: A urticária ao frio, rara em idade pediátrica, caracteriza-se pela ocorrência de urticária e/ou angioedema após exposição ao frio. Na maioria dos casos é idiopática; causas secundárias incluem crioglobulinémia, défices do complemento, vasculites, neoplasias e doenças infecciosas. Habitualmente é benigna e auto-limitada, no entanto reacções sistémicas potencialmente fatais podem ocorrer. Caso Clínico: Os autores apresentam o caso de um adolescent...

  12. Different risks for NSAID-induced anaphylaxis

    NARCIS (Netherlands)

    van Puijenbroek, Eugène P; Egberts, Antoine C G; Meyboom, Ronald H B; Leufkens, Hubert G M

    2002-01-01

    BACKGROUND: After drugs are marketed, spontaneous reporting systems can provide valuable information regarding the occurrence of suspected adverse drug reactions. The Netherlands Pharmacovigilance Foundation has received a substantial number of anaphylactic reaction reports related to the use of non

  13. Crisis management during anaesthesia: anaphylaxis and allergy

    OpenAIRE

    Currie, M.; Kerridge, R; BACON, A; J. Williamson

    2005-01-01

    Background: Anaphylactic and anaphylactoid reactions during anaesthesia are a major cause for concern for anaesthetists. However, as individual practitioners encounter such events so rarely, the rapidity with which the diagnosis is made and appropriate management instituted varies considerably.

  14. The Anaphylaxis Campaign: Youth Workshop Programme.

    Science.gov (United States)

    Percival, Jennifer

    Almost 10 million people in Britain exhibit symptoms of allergy (Royal College of Physicians and Royal College of Pathologists, 1994). A significant number have severe allergic reactions to foods and substances including: peanuts, tree nuts (almonds, walnuts, hazelnuts and brazil nuts); sesame; milk; eggs; shellfish; fish; fresh fruit; insect venom; latex; and prescribed drugs. The prevalence of peanut allergy in young children has tripled in the UK during the past decade (Grundy et al, 2002). PMID:12747182

  15. Anafilaxia associada à vacina contra sarampo, caxumba e rubéola Anafilaxia asociada a la vacuna contra sarampión, varicela y rubéola Anaphylaxis associated with the vaccine against measles, mumps and rubella

    Directory of Open Access Journals (Sweden)

    Iolanda Maria Novadzki

    2010-04-01

    sensibilización por algún componente residual de la vacuna y posible reacción cruzada con el dextrano.A case-control study was carried out aiming to describe the cases and causes of anaphylaxis associated with the vaccine against measles, mumps and rubella. A total of 22 reported cases in children who showed mucocutaneous manifestations, during the Campanha Nacional de Vacinação (Brazilian Vaccination Campaign, conducted in the city of Curitiba, Southern Brazil, in 2004, were studied. In addition, 66 children, who were next to these cases and did not show a symptomatology after the vaccine was applied, were selected. Serum measurements of antibodies for vaccine antigens and total IgE, specific IgE antibody measurements for several allergens, and skin tests were performed. Vaccine response was adequate, specific IgE measurement and skin tests showed that potential allergens in vaccines and atopy were not associated with anaphylactic reactions. Skin tests with the vaccine and dextran were positive in the cases exclusively, suggesting sensitization to certain residual components of the vaccine and possible cross-reaction with dextran.

  16. 豚鼠过敏抗体的分离纯化及在PCA试验中作用规律的初步研究%Isolation and purification of anaphylactic antibody from guinea pig and preliminary research on its role in passive cutaneous anaphylaxis test (PCA)

    Institute of Scientific and Technical Information of China (English)

    董娜; 陈磊; 徐苗; 邓海清; 苏城; 秦川; 王国治

    2010-01-01

    Objective To establish guinea pig model of type Ⅰ anaphylaxis, isolate the anaphy-lactic antibody(IgE and IgG) preliminarily from sera of sensitized guinea pigs, and investigate its functional characteristics. Methods Animal model was established by sensitizing guinea pigs with OVA and Al(OH)_3, level of antibody was determined by ELISA, IgE and IgG in sera were preliminarily isolated through saturated ammonium sulphate precipitate and affinity chromatograph of Protein A. A continuous passive cutaneous ana-phylaxis test (PCA) was performed by sensitizing guinea pigs individually with IgE and IgG and then challenging at different time , and the variation of blue spots in skin were observed after challenge . Results Concentration of IgE in model group and control group were 719.3750 ng/ml and 2.5250 ng/ml, the optical density of IgG in model group and control group were 0.9921 and 0.0174, the level of two antibodies in model group were significantly higher than that of control group (P<0.05). In 9 d continuous PCA test, the blue spot induced by IgE in skin lasted for 9 days and appeared the largest when challenged at day 5. The diameter of blue spot induced by IgG was the largest when challenged at day 2 and then decreased fast. Con-clusion Anaphylactic antibodies were successfully preliminarily isolated from sera of sensitizing guinea pig, both IgE and IgG play roles in type Ⅰ anaphylaxis of guinea pig, the hypersensitive reaction induced by IgG is fast and short than that induced by IgE, and IgG may become an important surrogate marker in immunotoxic-ity evaluation(type Ⅰ anaphylaxis)of vaccine.%目的 建立豚鼠Ⅰ型过敏反应模型,对致敏血清中过敏抗体(IgE、IgG)进行初步分离纯化,并探讨过敏抗体的作用特点.方法 以卵白蛋白(OVA)和Al(OH)_3作为免疫原制备豚鼠Ⅰ型过敏反应模型,ELISA法检测抗体含量,用饱和硫酸铵沉淀、Protein A柱亲和层析的方法 对致敏血清中IgE、IgG抗体进行初

  17. Uso do azul de metileno no tratamento de choque anafilático durante anestesia: relato de caso Uso del azul de metileno en el tratamiento de choque anafiláctico durante anestesia: relato de caso Methylene blue to treat anaphylaxis during anesthesia: case report

    Directory of Open Access Journals (Sweden)

    Renato Mestriner Stocche

    2004-12-01

    mortalidad entre 3% y 9%. En este caso, se relata el uso del azul de metileno como coadyuvante al tratamiento del choque anafiláctico refractario a la terapéutica tradicional. RELATO DEL CASO: Paciente del sexo masculino, 53 años, sometido a herniorrafia inguinal bajo raquianestesia. Al final del procedimiento, al recibir dipirona (1,5 g, por vía venosa, el paciente inmediatamente presentó broncoespasmo, cianosis, disminución de la SpO2 y de la PS, culminando con parada cardiorrespiratoria. Fue iniciada la reanimación cardiorrespiratoria con masaje cardíaco externo, seguida de IOT e inyección de adrenalina (1 mg, atropina (1 mg, restableciéndose FC de 150 lpm, sin embargo sin pulso palpable. Se administró más 1 mg de adrenalina además de 1 g de hidrocortisona, con restablecimiento de pulso central (8 minutos. A pesar de recibir dopamina (20 µg.kg-1.min-1, el paciente se mantuvo hipotenso (60 mmHg hasta 80 minutos. Se administraron 100 mg de azul de metileno por vía venosa, cuando hubo aumento de la PS para 85 y 105 mmHg, después de la segunda dosis. Se siguió a la disminución de la dosis de dopamina de 20 para 10, 7, 5 y, finalmente, 2 µg.kg-1.min-1. CONCLUSIONES: La anafilaxis tiene como principal mediador la liberación de histamina, que induce la producción de óxido nítrico (NO, con consecuente aumento de guanilato ciclase que promueve vasodilatación arteriolar por aumento del GMP cíclico. El azul de metileno puede ser útil en estas situaciones, pues inhibe la guanilato ciclase y consecuentemente la vasodilatación, lo que resulta en una mejoría hemodinámica.BACKGROUND AND OBJECTIVES: The risk of perioperative anaphylaxis should always be considered. The incidence of anesthetic allergic reactions is controversial, varying from 1/3,000 to 1/20,000, with mortality range between 3 and 9%. This report describes the use of methylene blue as coadjuvant drug to treat anaphylaxis refractory to conventional therapy. CASE REPORT: A 53-year-old male

  18. A case of taurine-containing drink induced anaphylaxis

    OpenAIRE

    Lee, Seung-Eun; Lee, Suh-Young; Jo, Eun-Jung; Kim, Mi-Young; Yang, Min-Suk; Chang, Yoon-Seok; Kim, Sae-Hoon

    2013-01-01

    Taurine is one of most abundant free amino acids in mammalian tissue. It has been used for various health functional foods as a main ingredient in food industry. A 33-year-old female patient repeatedly experienced generalized itching, urticaria, dyspnea and dizziness after drinking taurine-containing drinks. The patient showed positive response to oral challenge tests with taurine-containing drinks. The patient also showed positive response with synthetic taurine but not with natural taurine....

  19. Anaphylaxis to protamine masquerading as an insulin allergy.

    Science.gov (United States)

    Kim, R

    1993-01-01

    This is the case of a 62-year-old man referred for the evaluation of insulin allergy. This patient had reacted to the subcutaneous injection of Novolin 70/30 (Squibb, Princeton, N.J.) and Humulin NPH (Eli Lilly, Indianapolis, Ind.). These reactions were characterized by the immediate onset of diffuse pruritic urticaria and angioedema with progression to hypotension as well as a local reaction. Past history also included anaphylactic shock after intravenous administration of protamine sulfate used for heparin reversal during arterial bypass surgery. Immediate hypersensitivty skin testing to protamine containing (NPH) insulin and protamine sulfate USP were strongly positive, while Lente insulin (Eli Lilly, Indianapolis, Ind.) and controls were negative. RAST tests revealed the titers > 24 ng/ml of protamine specific IgE with 98 percent inhibition and 1163 ng/ml of protamine specific IgG with 29 percent inhibition, while levels of insulin specific antibodies were negligible. Subsequently, the patient was treated with non-protamine containing insulin preparation, Lente insulin, without further incident. This study confirms the diagnosis of Type I hypersensitivity to protamine sulfate masquerading as insulin allergy. PMID:8454092

  20. The radiocontrast molecule in anaphylaxis: a surprising antigen.

    Science.gov (United States)

    Lasser, Elliott C

    2004-01-01

    X-ray contrast media are individually injected into human blood vessels in greater quantities than any other pharmacological substance. Adverse reactions to these substances have heretofore been considered anaphylactoid in nature. Others and we have demonstrated that the mechanisms involved are multifactorial and may involve activation of mast cells and basophils, activation of the complement system, activation of the contact system, and the conversion of L-arginine into nitric oxide. Appropriate pretreatment with corticosteriods will diminish the incidence of reactions. Most recently we have demonstrated that the contrast media function as 'pseudoantigens' (PsA). They can combine with antibodies, but cannot themselves produce antibodies. This property appears to be dependent on aggregation in high concentrations and varies with the individual media. It furthermore appears to be non-specific in relation to antibodies, and suggests that binding occurs to the Fc portion of immunoglobulins. We have now demonstrated that the least toxic of current media demonstrate the best antibody binding and in sufficient concentration can inhibit contrast induced mast cell activation and/or non-contrast antigen induced mast cell activation, apparently due to in vivo pseudoantigen excess. In lesser concentrations and/or lesser binding, the media can trigger mast cell activation. PMID:15025400

  1. Intraoperative Anaphylaxis to Inj Ceftriaxone: Here We Go Again

    Directory of Open Access Journals (Sweden)

    Amit G Bhagwat

    2008-01-01

    Full Text Available Anaphylactic reactions to intraoperative antibiotics are rare events and reactions after a negative intradermal skin testing are even rarer. We are reporting a case of grade V anaphylactic reaction to ceftriaxone, which occurred inspite of a negative skin testing preoperatively. Despite of the treatment along the established guidelines, patient suffered hypoxic brain damage ultimately having a fatal outcome 7 days later. This case highlights the limits of the screening test done preoperatively for antibiotic sensitivity and also the difficulty in resuscitating anaphylactic reac-tions when patient is on B blocker and under spinal anaesthesia.

  2. Anaphylaxis to ethylene oxide - a rare and overlooked phenomenon?

    DEFF Research Database (Denmark)

    Bache, Søren; Petersen, J T; Garvey, L H

    2011-01-01

    Spina bifida patients have been reported to be at increased risk of anaphylactic reactions during general anaesthesia. Following a reaction, latex is often incriminated as spina bifida patients are known to have an increased incidence of latex allergy. Ethylene oxide (EO) has recently been...... suggested to be an alternative cause, but in many cases reported in the literature, it seems that EO has not been considered as a cause. EO is a highly reactive gas widely used to sterilise heat-sensitive medical devices, and traces of EO can be found in many of the same products as latex. We present the...... case of a spina bifida patient with a known latex allergy, where EO was found to be the cause of an anaphylactic reaction during general anaesthesia. In addition, we describe measures taken during preparation of a subsequent general anaesthesia to minimise exposure to EO. Spina bifida patients seem to...

  3. 抑制肿瘤血管新生的复合肽VBP3局部刺激与全身过敏性实验%Security assessment of complex peptide vaccine VBP3 for anti-tumor angiogenesis: analysis of local irritation and systemic anaphylaxis

    Institute of Scientific and Technical Information of China (English)

    康艳丽; 王宏; 向军俭; 王盼盼; 吕卫东; 邓宁

    2011-01-01

    AIM: To evaluate the security of an anti - tumor angiogenesis complex peptide vaccine VBP3.METHODS : Three rabbits were tested for local irritation by local subcutaneous injection of the vac:cine with a self comparison method on the left/right sides of the same body.The test of systemic anaphylaxis was performed in 28 guinea pigs, in which the animals were divided into 4 groups : normal saline ( NS ) group, bovine serum albumin ( BSA ) group, low - dose vaccine group and high - dose vaccine group.The other 4 guinea pigs, 2 received BSA and 2 received vaccine at a high dose, were activated directly without sensitization.RESULTS : No irritable and allergic reaction was observed in the test of all rabbits with local suhcutaneous injection and most of the guinea pigs with systemic anaphylactic test.Only one guinea pig with slightly allergic response was found and spontaneously recovered soon.CONCLUSION : The complex peptide vacc:ine VBP3 for anti - tumor angiogenesis is safe under the experimental conditions.%目的:评价抑制肿瘤血管新生的复合肽VBP3的安全性.方法:同体左右侧自身对比法对3 只家兔进行皮下注射的局部刺激实验.28 只豚鼠随机分为4组:无菌生理盐水(PS)阴性对照组6只,牛血清白蛋白(BSA)阳性对照组6只,复合肽VBP3 低剂量组6只,复合肽VBP3高剂量组6只,进行全身过敏实验;剩余4只豚鼠,牛血清白蛋白阳性对照组和复合肽VBP3 高剂量组各2只,不经致敏直接心脏激发.结果:抑制肿瘤血管新生的复合肽VBP3 对家兔皮下注射的局部刺激反应轻微;豚鼠实验仅复合肽VBP3高剂量组1只豚鼠出现弱阳性过敏反应,且很快缓解,其余豚鼠未见过敏症状.结论:抑制肿瘤血管新生的复合肽VBP3在本实验条件下安全.

  4. Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell Severe cutaneous adverse reactions to drugs - relevant aspects to diagnosis and treatment - Part I: Anaphylaxis and anaphylactoid reactions, erythroderma and the clinical spectrum of Stevens-Johnson syndrome & toxic epidermal necrolysis (Lyell´s disease

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo Criado

    2004-08-01

    Full Text Available As reações cutâneas graves adversas a droga (RCGAD são as que geralmente necessitam de internação hospitalar, por vezes em unidade de terapia intensiva ou de queimados, com observação minuciosa dos sinais vitais e da função de órgãos internos. O objetivo é descrever essas reações, facilitando seu reconhecimento e tratamento. Fazem parte desse grupo a anafilaxia, a síndrome de Stevens-Johnson (SSJ, a necrólise epidérmica tóxica (NET e, dependendo do envolvimento sistêmico, as eritrodermias. Neste artigo, são abordados as características clínicas e o tratamento de algumas reações adversas a droga: anafilaxia, as eritrodermias, a síndrome de Stevens-Johnson (SSJ e a necrólise epidérmica tóxica (NET.Severe Cutaneous Adverse Reactions to drugs (SCARD generally require hospitalization, and at times in the intensive therapy or burn care unit for observation of the vital signs and the viscera function. The aim of this study is to describe these reactions in order to facilitate recognition and treatment. This group of drug reactions includes anaphylaxis, Stevens-Johnson syndrome (SJS, toxic epidermal necrolysis (TEN and, depending on the systemic involvement, erythroderma. In this article we approach the characteristics and treatment of some adverse reactions to drugs: anaphylaxis, erythroderma, Stevens-Johnson syndrome (SJS and toxic epidermal necrolysis (TEN.

  5. Reação anafilática durante transplante renal intervivos em criança alérgica ao látex: relato de caso Reacción anafiláctica durante transplante renal intervivos en niño alérgico al látex: relato de caso Anaphylaxis during renal transplantation of live donor graft in a child with latex allergy: case report

    Directory of Open Access Journals (Sweden)

    Glória Maria Braga Potério

    2009-04-01

    OBJECTIVES: Latex allergy is becoming increasingly more frequent, affecting patients and health care professionals. The objective of this report was to present the case of a child with allergy to latex, who developed anaphylaxis during anesthesia for renal transplantation, and emphasize some of the multidisciplinary conducts used to decrease the risk of anaphylactic shock after graft reperfusion. CASE REPORT: A male child, 5 years and 10 months old, P3 by the ASA classification, with a history of allergy to latex diagnosed after contact with balloons and confirmed by Rast test specific for latex and Prick test, underwent renal transplantation of a live donor graft for end-stage renal disease secondary to urologic malformation. The protocols for patients with Latex Allergy adopted by the Anesthesiology and Nursing Departments of the Hospital das Clínicas da UNICAMP were observed to avoid exposure of the child to latex. They started the day before the surgery by cleaning the operating rooms and substituting of all medical-hospital products by latex-free material. The equipment and materials used during the procedure were latex-free according to a technical report provided by the manufacturers. The surgery was done under general anesthesia and controlled mechanical ventilation. At the end of the surgery, the patient required blood transfusion, which was administered by a pressurizer; he developed cutaneous rash and the blood transfusion was discontinued, hydrocortisone was administered, and the infusion of crystalloids was increased. The child had an immediate and satisfactory response to the treatment. CONCLUSIONS: Latex allergy has become a public health problem and the knowledge of specific therapeutic conducts allows immediate treatment and decreases patient risks.

  6. EAACI Food Allergy and Anaphylaxis Guidelines. Protecting consumers with food allergies

    DEFF Research Database (Denmark)

    Muraro, A; Hoffmann-Sommergruber, K; Holzhauser, T;

    2014-01-01

    set up reliable food safety management plans for some foods. However further work is required to include a wider variety of foods and to understand the impact of the food matrix as well as additional factors which affect the progression and severity of symptoms as a function of dose. Major concerns......Individuals suffering from IgE-mediated food allergy usually have to practice life-long food allergen avoidance. This document aims to provide an overview of recent evidence-based recommendations for allergen risk assessment and management in the food industry and discusses unmet needs and...... expectations of the food allergic consumer in that context. There is a general duty of care on the food industry and obligations in European Union legislation to reduce and manage the presence of allergens alongside other food hazards. Current evidence enables quantification of allergen reference doses used to...

  7. Food-Dependent Exercise-Induced Anaphylaxis - Kasuistik med hydrolyseret valleprotein

    DEFF Research Database (Denmark)

    Junker Christensen, Morten

    2013-01-01

    , gluten, hydrolyseret hvedeprotein, vandkastanje, samt bønnespirer. HR-test er positiv for rå og kogt valle-proteinhydrolysat samt kogt og rå komælk, men følsomheden for valle-hydrolysat er 100 x større end for komælk. HR-test for Profylac og Nutramigen er begge negative. Der findes negativ IgE mod...

  8. A Novel Model of IgE-Mediated Passive Pulmonary Anaphylaxis in Rats

    OpenAIRE

    Eva Wex; Eva Thaler; Sylvia Blum; David Lamb

    2014-01-01

    Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a ...

  9. T cells expressing chimeric antigen receptors can cause anaphylaxis in humans

    OpenAIRE

    Maus, Marcela V.; Haas, Andrew R; Beatty, Gregory L.; Albelda, Steven M.; Levine, Bruce L.; Liu, Xiaojun; Zhao, Yangbing; Kalos, Michael; June, Carl H.

    2013-01-01

    T cells can be redirected to overcome tolerance to cancer by engineering with integrating vectors to express a chimeric antigen receptor (CAR). In preclinical models, we have previously demonstrated that transfection of T cells with messenger RNA (mRNA) coding for a CAR is an alternative strategy that has antitumor efficacy and the potential to evaluate the on-target off-tumor toxicity of new CAR targets safely due to transient mRNA CAR expression. Here, we report the safety observed in four ...

  10. Anaphylaxis to subcutaneous neutral protamine Hagedorn insulin with simultaneous sensitization to protamine and insulin.

    Science.gov (United States)

    Blanco, C; Castillo, R; Quiralte, J; Delgado, J; García, I; de Pablos, P; Carrillo, T

    1996-06-01

    We report an insulin-treated diabetic patient who suffered, in a 2-month period, three severe anaphylactic reactions immediately after self-administered subcutaneous injections of neutral protamine Hagedorn (NPH) human recombinant-DNA insulin. These reactions consisted of local and systemic symptoms, including dyspnea and hypotension. A simultaneous sensitization to human insulin and to protamine was demonstrated, both by skin tests and by the determination of serum specific IgE. Suspecting protamine allergy, we performed a test dose to human lente insulin with perfect tolerance. After a 1-year follow-up with lente-insulin treatment, no reactions have occurred, despite treatment interruptions. Therefore, protamine IgE-mediated allergy probably caused our patient's reactions. In conclusion, protamine sensitization should be ruled out in any patient with a history of reactions to subcutaneous protamine-containing insulins, even if insulin sensitization is present. PMID:8837667

  11. Antagonism of peptidoleukotrienes and inhibition of systemic anaphylaxis by RG 12525 in guinea pigs

    International Nuclear Information System (INIS)

    RG 12525 was determined to be a specific, competitive and orally effective antagonist of the peptidoleukotrienes, LTC4, LTD4 and LTE4, in several assays utilizing guinea pigs. In vitro, RG 12525 competitively inhibited 3H-LTD4 binding to lung membranes and competitively antagonized the spasmogenic activity of LTC4, LTD4 and LTE4 on lung strips with > 8000 fold selectivity. In vivo, RG 12525 orally inhibited LTD4 induced wheal formation LTD4 induced bronchoconstriction and anaphylactic death and antigen induced bronchoconstriction. RG 12525 represents a significant improvement in receptor affinity and oral efficacy and thus, is a valuable pharmacological tool to evaluate peptidoleukotrienes in allergic diseases

  12. Anaphylaxis due to spontaneous rupture of primary isolated splenic hydatid cyst

    OpenAIRE

    Ozkan, Fuat; Yesilkaya, Yakup; Peker, Onur; Yuksel, Murvet

    2013-01-01

    Echinococcosis is a helminthic zoonosis mainly caused by Echinococcus granulosus and commonly encountered in endemic areas. The liver and lung are the most frequently involved organs. A primary isolated hydatid cyst of spleen is an extremely rare disease even in endemic areas. Anaphylactic reaction is a known complication of cystic hydatid disease, a parasitic infestation caused by the larval/cyst stage of E. granulosus that usually occurs after trauma or during interventions. To the best of ...

  13. Bronchial, alveolar, and vascular-induced anaphylaxis and irritant-induced cardiovascular and pulmonary responses.

    OpenAIRE

    Yeates, D B; Mussatto, D J; Hameister, W M; Daza, A.; Chandra, T; Wong, L B

    2001-01-01

    We examine the respiratory, bronchomotor, cardiac, and vascular responses to histamine and ragweed allergen delivered to the bronchi or alveoli compartments and the potential role of sensory nerves and reflexes mediating the histamine-induced responses. The masses of aerosols deposited in the bronchi and alveoli were quantitated using radioaerosol techniques. Activation of sensory nerves and/or histamine-induced mediator release were characterized by depositing nedocromil sodium aerosol prior...

  14. Near fatal intra-operative anaphylaxis to chlorhexidine—is it time to change practice?

    OpenAIRE

    R. A. Khan; Kazi, T; O'Donohoe, B

    2011-01-01

    The authors report a case of a near fatal anaphylactic reaction to chlorhexidine. Increasingly adverse reactions are being reported with the use of chlorhexidine. Serious reactions are related to use on mucous membranes and acceptable alternatives are readily available. Therefore, the fundamental question that must be asked is: is it time to withdraw chlorhexidine preparations used for mucous membranes?

  15. HYDATID CYST LIVER EXCISION: THE TWIN PROBLEMS OF ANAPHYLAXIS AND HYPERNATREMIA

    OpenAIRE

    Anand Rampure Vittal; Vijay Narayanan; Santhosh C

    2015-01-01

    Hydatid cyst infestation is most commonly encountered in liver. Though several procedures have been described in the treatment of hepatic echinococcal cysts ranging from simple puncture to liver resection , radical surgery ( T otal pericystectomy or partial hepatectomy) is indicated for liver cyst. Prevention of spillage into the peritoneal cavity and wound edges by injecting a scolicidal agent into the unopened cyst and walling off the operative field with sponges ...

  16. Prime and boost aerosol exposure via fog machine or shisha smoke followed by cinnamon hypersensitivity and anaphylaxis to spiced food

    OpenAIRE

    Jensen-Jarolim, Erika; Roth-Walter, Franziska; Leitner, Erich; Buchleitner, Stefan; Vogelsang, Harald; Kinaciyan, Tamar

    2016-01-01

    Background Cinnamon aldehyde (alias cinnamaldehyde) is widely used in food, textile or cosmetic industry. It is mostly associated with contact allergy, but immediate type allergies have been reported. The present study was triggered by a case of anaphylactic events to cinnamon in food and upon skin prick test. We investigated a possible correlation of exposure to a disco fog machine and/or shisha consumption with immediate type hypersensitivity to cinnamon aldehyde in the patient and healthy ...

  17. Analysis of the burden of treatment in patients receiving an EpiPen for yellow jacket anaphylaxis

    NARCIS (Netherlands)

    Elberink, Joanne N. G. Oude; van der Heide, S.; Guyatt, Gordon H.; Dubois, Anthony E. J.

    2006-01-01

    Background: Venom immunotherapy (VIT) is a treatment with established efficacy for the prevention of repeated anaphylactic reactions in patients with Hymenoptera allergy, which also allows patients to discontinue carrying an EpiPen. Despite their merits, both treatments can have negative aspects pot

  18. 硫酸氢氯吡格雷致过敏反应%Anaphylaxis induced by clopidogrel hydrogen sulfate

    Institute of Scientific and Technical Information of China (English)

    章靓; 王婷; 郭晓芳; 乔建峰

    2014-01-01

    A 78-year-old female patient with myocardial infarction received oral aspirin 100 mg once daily and clopidogrel hydrogen sulfate 75 mg once daily. She developed pruritus and erythema on her abdomen and both lower extremities in the next morning. The clopidogrel hydrogen sulfate was discontinued and she was treated with loratadine 10 mg once daily. Her pruritus had improved and erythema had subsided after 1 hours. On day 1,the patient self-administered clopidogrel hydrogen sulfate 75 mg. She presented with anaphylactoid symptoms again and loratadine was continued. Four days later,the patient underwent coronary angiography and percutaneous coronary intervention. She received dual antiplatelet therapy with oral ticagrelor 90 mg twice daily and aspirin 100 mg once daily after surgery. The patient had no discomfort at 6 months follow-up.%1例78岁女性患者因心肌梗死给予阿司匹林100 mg,1次/d口服;硫酸氢氯吡格雷75 mg,1次/d口服。次日晨,患者腹部及双下肢出现瘙痒、红斑。停用硫酸氢氯吡格雷,予氯雷他定10 mg,1次/d口服。1 h后瘙痒缓解、红斑消退。第1天,患者自行服用硫酸氢氯吡格雷75 mg,过敏症状再现,继续服用氯雷他定。4d后,患者行冠状动脉造影﹢经皮冠状动脉介入治疗。术后采用替格瑞洛(90 mg、1次/d口服)联合阿司匹林(100 mg,1次/d口服)抗血小板治疗,随访6个月无不适症状。

  19. School Food Allergy and Anaphylaxis Management for the Pediatrician--Extending the Medical Home with Critical Collaborations.

    Science.gov (United States)

    Pistiner, Michael; Devore, Cynthia DiLaura; Schoessler, Sally

    2015-12-01

    Community pediatricians, working in consultation with allergists, create a medical home that is the central focus of care for the child with life-threatening food allergies. They participate in coordinating mutual and critical collaborations within schools that support families and children. They can provide leadership and guidance to both families and schools to safeguard children and adolescents, thereby extending the medical home goals into the school setting. PMID:26456441

  20. Quality assurance ofallergen-specific immunotherapy during a national outbreak of anaphylaxis: results of a continuous sentinel event surveillance system

    DEFF Research Database (Denmark)

    Madsen, F; Frølund, L; Christensen, M;

    2009-01-01

    BACKGROUND AND OBJECTIVE: Subcutaneous allergen-specific immunotherapy (SCIT) is an effective treatment for patients with allergic asthma and rhinitis. SCIT may be performed in many different ways and good safety profiles have been published. Other studies, however, have reported high frequencies...... of severe adverse events (SAEs) but without identifying the causes. After an increase in SCIT-related SAEs in Denmark between 2003 and 2004, strict performance regulations were imposed by the authorities. Because safety data from national databases were not available, we implemented a surveillance...... injection was calculated at < 1.3 per 10 000 injections. DISCUSSION: Our results confirm the good safety profile of SCIT. We applied a sentinel SCIT surveillance system that may offer a means of guaranteeing safety by providing online feedback to all participating clinics when SAEs occur in order to explore...

  1. [A CASE OF ANAPHYLAXIS IN THE PEDIATRIC PATIENT WITH MILK ALLERGY DUE TO TRACES OF MILK PROTEIN IN THE LACTOSE USED AS AN EXCIPIENT OF INAVIR INHALATION].

    Science.gov (United States)

    Morikawa, Miki; Kanemitsu, Yoshitomi; Tsukamoto, Hiroki; Morikawa, Akimasa; Tomioka, Yoshihisa

    2016-05-01

    The patient was a 6-year-old female with milk allergy and persistent asthma. She experienced anaphylactic reactions just after the inhalation of Inavir (Laninamivir Octanoate Hydrate) to treat flu infection. A skin-prick test showed positive reactions for Inavir inhaler powder and lactose used as an excipient but negative for Laninamivir. Same results were obtained in a drug-stimulated basophil activation test. The lactose excipient in Inavir inhaler powder was supposed to contain milk proteins, which caused anaphylactic reactions. To test this possibility, we examined the contamination of allergic milk proteins in the lactose excipient and found the smear band by silver staining, which was identified as β-lactoglobulin (β-LG) by Western blotting using specific monoclonal antibody and patient's sera. The β-LG in Inavir was supposed to be glycosylated with lactose because the molecular weight was slightly higher than β-LG standard reference as seen in mobility. In fact, the incubation with lactose in vitro tended to increase molecular weight. Following these results, we herein report that the trace amounts of β-LG contaminated in the lactose excipient of Inavir could cause immediate allergic reactions. The risk that the lactose-containing dry powder inhalers cause allergic reactions for patients with cow's milk allergy need to be reminded. In particular, the use for flu patients should be paid careful attention because of increased airway hypersensitivity in those patients. PMID:27193929

  2. Delayed Anaphylaxis with Methimazole: Nicolau Syndrome After Oxytocin Intramuscular Administration Anastrazole-Induced Autoimmune Hepatitis Amoxicillin- and Cephalexin-Induced Eosinophilic Colitis Docetaxel-Induced Supravenous Erythematous Eruption.

    Science.gov (United States)

    Mancano, Michael A

    2016-07-01

    The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices (ISMP) in cooperation with the FDA's MedWatch program and Temple University School of Pharmacy. ISMP is an FDA MedWatch partner. PMID:27559184

  3. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger; Krøigaard, Mogens; Belhage, Bo; Husum, Bent; Poulsen, Lars K

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to...... investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis....

  4. 大鼠被动皮肤过敏试验检测方法的探讨%The Discussion about the Methods of Rat's Passive Cutaneous Anaphylaxis Test Detection

    Institute of Scientific and Technical Information of China (English)

    张宏; 甘雨; 乔敏; 李显华; 管仲莹; 邹德俊; 李国信

    2011-01-01

    采用ELISA方法,用酶标仪定量检测大鼠血清中的IgE和组胺,用全自动血细胞分析仪定量检测嗜酸性粒细胞,并与传统的蓝斑吸收度的实验方法进行比较.试验结果表明此方法灵敏快速,结果准确可靠,适于多组份中药过敏原的检测.%Apply the enzyme linked immunosorbent assay ( ELISA) on detecting the content of serum IgE and ergamine of rats by microplate reader, use the automatic cytoanalyze to quantitatively detect the eosinophile granulocyte count. The comparison between the results tested by new methods and traditonal method-locus caeruleus absorbability demonstrates that the methods applied are more sensitive, effective, reliable, and suitable for multi-group detection of chinese medicine anaphylactogen.

  5. Observation on the effect of fluorine protective paint on tooth feeling anaphylaxis%应用氟保护漆治疗牙本质过敏症220例疗效观察

    Institute of Scientific and Technical Information of China (English)

    顾蓓蓓; 李静

    2010-01-01

    目的 评价氟保护漆和氟化钠甘油对牙本质过敏症的治疗效果.方法 选择2006年10月至2008年10月沈阳市妇幼保健所口腔科收治的牙本质过敏症患者220例(388颗惠牙),按就诊顺序随机分为试验组(208颗患牙)和对照组(180颗患牙).试验组:用氟保护漆脱敏治疗;对照组:用75%氟化钠甘油脱敏治疗.结果 1个疗程后试验组和对照组总有效率分别为91.34%和61.11%,3个月后分别为88.94%和45.00%,差异均有统计学意义(P<0.01).结论 氟保护漆是一种较理想的脱敏药物.

  6. 中药防敏润肌唇膏对皮肤刺激性和致敏性研究%Skin irritation and allergy test of the Anti-anaphylaxis Herbal Lipstick

    Institute of Scientific and Technical Information of China (English)

    宋西卫; 夏庆梅; 武昊昀; 刘志东

    2010-01-01

    [目的]考察中药防敏润肌唇膏对皮肤的刺激及致敏作用,并进行安全性评价.[方法]用皮肤刺激及致敏反应评分表评价中药防敏润肌唇膏对皮肤的刺激、致敏反应.[结果]中药防敏润肌唇膏对家兔正常皮肤及破损皮肤的平均刺激分值均<0.50分,即家兔单次及多次性涂用此唇膏后完整皮肤及破损皮肤的涂药部位均未见异常改变.在致敏性实验中,中药防敏润肌唇膏对豚鼠未见致敏作用,而阳性药2,4-二硝基氯苯见有极强致敏性.[结论]中药防敏润肌唇膏对家兔皮肤无刺激性,对豚鼠无致敏性,是一种安全性较好的外用制剂.

  7. [Not Available].

    Science.gov (United States)

    Gülen, Theo; Björkander, Janne

    2016-01-01

    Bee and wasp stings can cause allergic reactions. Although the local reactions are more frequent, anaphylaxis due to insect stings can be potentially fatal. Rapid recognition of anaphylaxis is therefore critical and reactions should immediately be treated with i.m. adrenaline. Patients having experienced anaphylaxis should be referred to an allergist for diagnostic evaluation and possible venom-immunotherapy (VIT). The clinical history is essential in diagnosis of venom allergy as the test results are not always reliable. Diagnostic testing with venom components might be beneficial in appropriate patients. The analysis of serum tryptase from the acute episode can be crucial. Mastocytosis is associated in about 8 percent of patients with severe anaphylaxis from insect stings and should be considered in the differential diagnosis. VIT is indicated for patients with a history of anaphylaxis and is effective in preventing future anaphylaxis from Hymenoptera stings. PMID:27505851

  8. Drug allergies

    Science.gov (United States)

    Allergic reaction - drug (medication); Drug hypersensitivity; Medication hypersensitivity ... vomiting to life-threatening anaphylaxis . A true drug allergy is caused by a series of chemical steps ...

  9. The Role of Lumbar Sympathetic Nerves in Regulation of Blood Flow to Skeletal Muscle during Anaphylactic Hypotension in Anesthetized Rats.

    Directory of Open Access Journals (Sweden)

    Jie Song

    Full Text Available During hypovolemic shock, skeletal muscle blood flow could be redistributed to vital organs via vasoconstriction in part evoked by activation of the innervating sympathetic nerve activity. However, it is not well known whether this mechanism operates during anaphylactic shock. We determined the femoral artery blood flow (FBF and lumbar sympathetic nerve activity (LSNA mainly regulating the hindquater muscle blood flow during anaphylactic hypotension in anesthetized rats. Anesthetized Sprague-Dawley rats were randomly allocated to the following groups (n = 7/group: (1 non-sensitized, (2 anaphylaxis, (3 anaphylaxis-lumbar sympathectomy (LS and (4 anaphylaxis-sinoaortic denervation (SAD groups. Anaphylaxis was induced by an intravenous injection of the ovalbumin antigen to the sensitized rats. The systemic arterial pressure (SAP, heart rate (HR, central venous pressure (CVP, FBF and LSNA were continuously measured. In the anaphylaxis group, LSNA and HR increased, while SAP and FBF decreased after antigen injection. In the anaphylaxis-SAD group, LSNA did not significantly change during the early phase, but the responses of SAP and FBF were similar to those in the anaphylaxis group. In the anaphylaxis-LS group, both FBF and SAP decreased similarly to the anaphylaxis group during anaphylactic hypotension. These results indicated that LSNA increased via baroreceptor reflex, but this sympathoexcitation or LS did not affect antigen-induced decreases in FBF or SAP. Lumbar sympathetic nerves are not involved in regulation of the blood flow to the hindlimb or systemic blood pressure during anaphylactic hypotension in anesthetized rats.

  10. Virtual Allergist

    Science.gov (United States)

    ... Possible Issues: Conditions related to swollen throat: Anaphylaxis Food allergy Stinging insect reactions Lungs/chest Step Two Select A Symptom: ... to shortness of breath: Anaphylaxis Asthma Drug reactions Food allergy Stinging insect reactions Trouble breathing Step Three Possible Issues: Conditions ...

  11. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger;

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to inve...

  12. Ethical Principles as a Guide in Implementing Policies for the Management of Food Allergies in Schools

    Science.gov (United States)

    Behrmann, Jason

    2010-01-01

    Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to…

  13. 基于RBL-2H3细胞模型的Ⅰ型过敏反应和类过敏反应研究%Study progress of type Ⅰ anaphylaxis reaction and anaphylactoid reaction on the basis of RBL-2H3 cell models

    Institute of Scientific and Technical Information of China (English)

    赵吟; 李钦; 张信岳

    2010-01-01

    Ⅰ型速发型过敏是常见的药物不良反应,长期受到人们的广泛重视和研究.类过敏反应自20世纪80年代在造影剂和麻醉剂的使用中发现以来,其发生频率不断提高,尤其随着中药注射剂的广泛使用而越来越受到重视.但其确切机理还尚未得到阐明.RBL-2H3细胞是一类表面舍有丰富的IgE受体鼠嗜碱性淋巴细胞,在研究过敏反应方面有重要作用.本文就如何以RBL-2H3细胞构建这两类过敏反应的体外细胞模型及如何检测其效应分子进行简单阐述,同时介绍这两类反应机制的研究进展.

  14. 儿童严重过敏反应的处理:欧洲变态反应学及临床免疫学会指南%The Management of Anaphylaxis in Childhood:Position Paper of the European Academy of Allergology and Clinical Immunology

    Institute of Scientific and Technical Information of China (English)

    A.Muraro; 青曼丽; G.Roberts; A.Clark; P.A.Eigenmann; S.Halken; G.Lack; A.Moneret-Vautrin; B.Niggemann; F.Ranc

    2009-01-01

    严重过敏反应在儿科急诊越来越多见,但因尚无一致定义,至今难以诊断。很多欧洲国家没有专门针对严重过敏反应的指南。本文由欧洲变态反应学及临床免疫学会(European Academy of Allergology and Clinical Immunology,EAACI)儿童严重过敏反应工作组提供.旨在依据当前有限的资料为儿童严重过敏反应制定一个实用的指南。目前公认,无论在医院还是社区。肌肉注射肾上腺素均是严重过敏反应的一线用药,且一旦诊断就应该使用。

  15. Feeding Tubes

    Science.gov (United States)

    ... The smaller line (longer in length) is then threaded down into the jejunum where the formula (and/ ... Cyclic Vomiting Syndrome Association FAACT - Food Allergy & Anaphylaxis Connection Team FARE- Food Allergy R esearch and Education ...

  16. Asthma and Allergy Foundation of America

    Science.gov (United States)

    ... Allergy Symptoms Anaphylaxis / Severe Allergic Reaction Eye Allergies Rhinitis Sinusitis Skin Allergies Eczema Contact Dermatitis Hives Swelling ... Partners Media Donate Subscribe Learn how to better control asthma and allergies, and live a life without ...

  17. Food Allergy

    Science.gov (United States)

    Food allergy is an abnormal response to a food triggered by your body's immune system. In adults, the foods ... a severe reaction called anaphylaxis. Symptoms of food allergy include Itching or swelling in your mouth Vomiting, ...

  18. What Is a Pediatric Allergist / Immunologist?

    Science.gov (United States)

    ... usually harmless. Pet dander, pollen, dust, mold spores, insect stings, food, and medications are examples of such things. This ... atopic dermatitis) Hives (urticaria, welts) Severe reactions to foods, insect stings, and medications (anaphylaxis) Immune disorders that lead ...

  19. Anafylaktisk shock efter intradermal injektion af steroidpræparat

    DEFF Research Database (Denmark)

    Meyer, Martin Willy; Zachariae, Claus Otto Carl; Garvey, Lene Heise

    2015-01-01

    Anaphylactic shock after intradermal injection of corticosteroid Carboxymethylcellulose (CMC) is a derivative of cellulose found in many food products, pharmaceuticals and cosmetics. Allergy to carboxymethylcellulose in parenteral corticosteroid preparations leading to anaphylaxis is rare, but has...

  20. Food Allergies

    Science.gov (United States)

    ... a skin test. A doctor or nurse will scratch the skin (usually on the forearm or back) ... Allergic Reactions (Anaphylaxis) Celiac Disease Egg Allergy Allergy Testing Contact Us Print Resources Send to a friend ...

  1. Food Allergy

    Science.gov (United States)

    Food allergy is an abnormal response to a food triggered by your body's immune system. In adults, the ... cause a severe reaction called anaphylaxis. Symptoms of food allergy include Itching or swelling in your mouth Vomiting, ...

  2. Asthma and Food Allergies

    Science.gov (United States)

    ... Español Text Size Email Print Share Asthma and Food Allergies Page Content Article Body A family history of ... child may develop asthma . Children with asthma and food allergies are at increased risk for anaphylaxis, a severe ...

  3. Hymenoptera Allergy and Mast Cell Activation Syndromes.

    Science.gov (United States)

    Bonadonna, Patrizia; Bonifacio, Massimiliano; Lombardo, Carla; Zanotti, Roberta

    2016-01-01

    Mast cell activation syndrome (MCAS) can be diagnosed in patients with recurrent, severe symptoms from mast cell (MC)-derived mediators, which are transiently increased in serum and are attenuated by mediator-targeting drugs. When KIT-mutated, clonal MC are detected in these patients, a diagnosis of primary MCAS can be made. Severe systemic reactions to hymenoptera venom (HV) represent the most common form of anaphylaxis in patients with mastocytosis. Patients with primary MCAS and HV anaphylaxis are predominantly males and do not have skin lesions in the majority of cases, and anaphylaxis is characterized by hypotension and syncope in the absence of urticaria and angioedema. A normal value of tryptase (≤11.4 ng/ml) in these patients does not exclude a diagnosis of mastocytosis. Patients with primary MCAS and HV anaphylaxis have to undergo lifelong venom immunotherapy, in order to prevent further potentially fatal severe reactions. PMID:26714690

  4. Pholcodine consumption and immunoglobulin E-sensitization in atopics from Australia, Korea, and Japan

    OpenAIRE

    Katelaris, Constance H.; Kurosawa, Motohiro; Moon, Hee-Bom; Borres, Magnus; Florvaag, Erik; Johansson, Stig Gunnar Olof

    2014-01-01

    Background Accumulating data indicates that pholcodine (PHO)-consuming countries have higher sero-prevalences of immunoglobulin E (IgE)-antibodies to PHO and suxamethonium (SUX) and increased frequencies of IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBAs) than nonconsuming. Withdrawing PHO-containing cough syrups resulted in a significant decrease of cases with anaphylaxis in Scandinavia. Nevertheless, the European Medicines Agency in 2011 advised to continue the unrestricted...

  5. Anaphyllaxis management: Current concepts

    OpenAIRE

    Mali, Shrikant; Jambure, Rajesh

    2012-01-01

    Anaphylactic shock is medical emergency characterized by circulatory collapse resulted from severe acute allergic reactions, namely anaphylaxis and anaphylactoid reaction. Anaphylaxis is an acute, systemic, IgE-mediated, and immediate hypersensitivity reaction caused by the release of mediators by mast cells and basophils after exposure to antigens. The pathophysiology involves activated mast cells and basophils releasing preformed, granule-associated mediators, and newly formed lipid mediato...

  6. Atopic diseases: Risk factor in developing adverse reaction to intravenous N-Acetylcysteine

    OpenAIRE

    F Gheshlaghi; Eizadi-Mood, N.

    2006-01-01

    Background: N-acetylcysteine (NAC) is the choice treatment for acetaminophen overdose. The main side effect of intravenous NAC therapy is anaphylaxis or anaphylactoid reactions. We investigated the prevalence of anaphylactoid or anaphylaxis reactions to IV-NAC therapy in acetaminophen poisoned patients with atopic disease. Methods: A case series antrograde and descriptive–analytic study was done on acetaminophen poisoned patients who treated with IV-NAC from September 2003 to September 2...

  7. KIT D816V mutation burden does not correlate to clinical manifestations of indolent systemic mastocytosis

    DEFF Research Database (Denmark)

    Broesby-Olsen, Sigurd; Kielsgaard Kristensen, Thomas; Vestergaard, Hanne; Brixen, Kim; Møller, Michael Boe; Bindslev-Jensen, Carsten

    2013-01-01

    Clinical manifestations of indolent systemic mastocytosis (ISM) comprise mediator-related symptoms, anaphylaxis, and osteoporosis. A new sensitive method for KIT D816V mutation detection allows quantification of the level of mutation-positive cells.......Clinical manifestations of indolent systemic mastocytosis (ISM) comprise mediator-related symptoms, anaphylaxis, and osteoporosis. A new sensitive method for KIT D816V mutation detection allows quantification of the level of mutation-positive cells....

  8. A case study of apple seed and grape allergy with sensitisation to nonspecific lipid transfer protein.

    Science.gov (United States)

    Murad, Ari; Katelaris, Constance H; Baumgart, Karl

    2016-04-01

    Lipid transfer proteins can be an important cause of allergy given their stability and high degree of protein sequence homology. We describe the case of a child who developed two separate episodes of anaphylaxis after consuming apple seed and grape, with evidence that nonspecific lipid transfer proteins may have been responsible for these reactions. Lipid transfer protein allergy should be considered when anaphylaxis is inconsistent, such as in patients who can tolerate fruit pulp but react to fresh whole fruit juices. PMID:27141487

  9. A case study of apple seed and grape allergy with sensitisation to nonspecific lipid transfer protein

    Science.gov (United States)

    Katelaris, Constance H; Baumgart, Karl

    2016-01-01

    Lipid transfer proteins can be an important cause of allergy given their stability and high degree of protein sequence homology. We describe the case of a child who developed two separate episodes of anaphylaxis after consuming apple seed and grape, with evidence that nonspecific lipid transfer proteins may have been responsible for these reactions. Lipid transfer protein allergy should be considered when anaphylaxis is inconsistent, such as in patients who can tolerate fruit pulp but react to fresh whole fruit juices. PMID:27141487

  10. Clinical development methodology for infusion-related reactions with monoclonal antibodies.

    Science.gov (United States)

    Doessegger, Lucette; Banholzer, Maria Longauer

    2015-07-01

    Infusion-related reactions (IRRs) are common with monoclonal antibodies (mAbs) and timely related to drug administration and have been reported as anaphylaxis, anaphylactoid reactions and cytokine release syndrome, among other terms used. We address risk management measures for individual patients and for the study and propose a consistent reporting approach in an attempt to allow cross-molecule comparisons. Once the symptoms of IRR have resolved, the mAb may be restarted. Rechallenge should not be done for suspected IgE-mediated anaphylaxis and Grade 4 IRRs. Management of IRRs for subsequent patients includes administration of premedication, which, however, does not prevent IgE-mediated anaphylaxis. Reporting approach: (1) Report as IRRs, reactions occurring during or within 24 h after an infusion. Negative skin Prick test and absent or undetectable allergen-specific IgE levels have high negative predictive value for an IgE-mediated allergic reaction. If IgE-mediated anaphylaxis is suspected based on medical history and/or laboratory test results, the reaction should be reported as suspected (IgE mediated) anaphylaxis. (2) Collect signs and symptoms with grades to allow characterization of IRRs. IRRs pathogenesis is of scientific interest and has impact on drug development. Animal toxicology studies are neither predictive of severe IRRs nor of anaphylaxis in human. Preclinical tests should be further developed to identify patients at risk for severe IRRs, for complement activation-related pseudoallergy and for IgE-mediated anaphylaxis. The proposed approach should help standardizing data collection and analysis of IRRs in an attempt to enable comparisons across molecules. PMID:26246897

  11. Clindamycin-induced hypersensitivity reaction.

    Science.gov (United States)

    Bulloch, Marilyn N; Baccas, Jonathan T; Arnold, Scott

    2016-06-01

    Drug-induced anaphylaxis is an unpredictable adverse reaction. Although it may occur with any medication, antibiotics induce more cases of anaphylaxis than any other medication class with most cases being induced by β-lactam antibiotics. Clindamycin is an antibiotic with good gram-positive and anaerobe coverage which is often used in patients with β-lactam allergies. We report the case of a 46-year-old female who experienced anaphylaxis after a dose of intravenous (IV) clindamycin. Following treatment with methylprednisolone, epinephrine, diphenhydramine, and albuterol, the patient stabilized. The patient's score on the Naranjo's algorithm was 8 (probable); a score of 9 (definite) limited only by absence of drug re-challenge. To our knowledge, this is the first report of a clindamycin-induced anaphylaxis where the patient was not exposed to any other agent that may have triggered the response, the first case in the United States, and only the third documented case in the literature. Clinicians should be aware of the potential for drug-induced anaphylaxis in all medications. PMID:26216470

  12. Evaluation of the antigenicity of hydrolyzed cow's milk protein formulas using the mouse basophil activation test.

    Science.gov (United States)

    Iwamoto, Hiroshi; Matsubara, Takeshi; Nakazato, Yuki; Namba, Kazuyoshi; Takeda, Yasuhiro

    2016-02-01

    Hypoallergenic infant formulas are widely used for infants with cow's milk allergy. The aim of this study was to assess the utility of the mouse basophil activation test (BAT) in the evaluation of residual antigenicity in these formulas. Whole blood samples derived from β-lactoglobulin- or casein-immunized mice were incubated with one of the following formulas: conventional, partially hydrolyzed, or extensively hydrolyzed. Basophilic activation was analyzed by flow cytometry using an IgE-dependent activation marker CD200R1 and an IgG-dependent activation marker CD200R3. Systemic anaphylaxis was induced by i.v. injection of milk formula and results were compared. Conventional formula induced pronounced changes in CD200R1 and CD200R3 expression on basophils, whereas extensively hydrolyzed formulas did not elicit any changes in these markers. Similarly, challenge with conventional formula induced anaphylaxis, whereas extensively hydrolyzed formulas did not induce anaphylaxis. Although the partially hydrolyzed formula also induced basophilic activation and systemic anaphylaxis, the magnitude of these effects was smaller than that observed with the conventional formula. Compared to CD200R1, the observed trend in CD200R3 expression resembled the results obtained from systemic anaphylaxis test more closely. These findings show that mouse BAT, in particular using CD200R3, is highly useful for the evaluation of antigenicity of milk formulas. PMID:26626100

  13. Clinical presentations of food allergy.

    Science.gov (United States)

    Mansoor, Darlene K; Sharma, Hemant P

    2011-04-01

    Food allergies are immune-mediated responses to food proteins. Because of differences in the underlying immunologic mechanisms, there are varying clinical presentations of food allergy. This article discusses the manifestations of IgE-mediated disorders, including urticaria and angioedema, rhinoconjunctivitis, asthma, gastrointestinal anaphylaxis, generalized anaphylaxis, food-dependent exercise-induced anaphylaxis, and oral allergy syndrome. It also reviews the presentations of mixed IgE- and cell-mediated disorders, including atopic dermatitis and eosinophilic gastrointestinal disorders. Finally, the manifestations of cell-mediated food allergies are discussed, including dietary protein-induced proctitis and proctocolitis, food protein-induced enterocolitis syndrome, celiac disease, and food-induced pulmonary hemosiderosis. PMID:21453804

  14. Allergy to Chlorhexidine.

    Science.gov (United States)

    Pemberton, Michael N

    2016-04-01

    Chlorhexidine is an effective antiseptic which is widely used in dentistry. Over recent years, it has also been used in other healthcare products as well as in cosmetics. Anaphylaxis to chlorhexidine has been increasingly reported throughout the world, including two incidents in the UK where chlorhexidine-containing mouthwash had been used to wash tooth sockets following recent tooth extraction. Chlorhexidine is under-recognized as a cause of anaphylaxis and dentists should be aware of its potential for serious adverse effects. Dentists need to consider whether the washing out of a tooth socket with chlorhexidine solution should be avoided in the treatment of established dry socket. On current evidence the potential risks of using chlorhexidine as irrigation solution for treating an established dry socket appears to outweigh any known benefit. CPD/Clinical Relevance: Chlorhexidine has the potential to cause anaphylaxis in the dental surgery. PMID:27439274

  15. Mast cell stabilizing and antiallergic activity of Abrus precatorius in the management of asthma

    Institute of Scientific and Technical Information of China (English)

    DJ Taur; RY Patil

    2011-01-01

    Objective: To investigate effects of ethanol extract of Abrus precatorius leaves (EAPL) on egg albumin induced mast cell degranulation in mice and passive cutaneous anaphylaxis in rats.Methods: In present study ethanol extract of Abrus precatorius leaves (EAPL) at doses of 100, 125, 150 mg/kg i.p were evaluated for preliminary phytochemical screening, acute toxicity studies and egg albumin induced mast cell degranulation in mice and passive cutaneous anaphylaxis in rats.Results: The results of present investigation showed that the LD 50 of EAPL is more than 1300 mg/kg. EAPL (100-150 mg/kg, i.p.) significantly protect egg albumin induced degranulation of mast cell and inhibit area of leakage of dye in passive cutaneous anaphylaxis. Phytochemical studies observed presence of saponin, alkaloids, flavonoids, and glycosides. Conclusions: In conclusion EAPL possesses anti asthmatic potential.

  16. Impact of CD40 ligand, B cells, and mast cells in peanut-induced anaphylactic responses.

    Science.gov (United States)

    Sun, Jiangfeng; Arias, Katherine; Alvarez, David; Fattouh, Ramzi; Walker, Tina; Goncharova, Susanna; Kim, Bobae; Waserman, Susan; Reed, Jennifer; Coyle, Anthony J; Jordana, Manel

    2007-11-15

    The effector immune mechanisms underlying peanut-induced anaphylaxis remain to be fully elucidated. We investigated the relative contribution of Igs, mast cells (MCs), and FcepsilonRI in the elicitation of anaphylaxis in a murine model. Assessment of peanut hypersensitivity reactions was performed clinically and biologically. Our data show that wild-type (WT; C57BL/6 strain) mice consistently developed severe anaphylaxis (median clinical score: 3.5/5), an approximately 8 degrees C drop in core body temperature, and significantly increased plasma levels of histamine and leukotrienes. CD40 ligand- and B cell-deficient mice presented evidence of allergic sensitization as demonstrated by production of Th2-associated cytokines by splenocytes and a late-phase inflammatory response that were both indistinguishable to those detected in WT mice. However, CD40 ligand- and B cell-deficient mice did not exhibit any evidence of anaphylaxis. Our data also show that MC-deficient (Kit(W)/Kit(W-v)) mice did not suffer, unlike their littermate controls, anaphylactic reactions despite the fact that serum levels of peanut-specific Igs were similarly elevated. Finally, FcepsilonRI-deficient mice experienced anaphylactic responses although to a significantly lesser degree than those observed in WT mice. Thus, these data demonstrate that the presence of peanut-specific Abs along with functional MCs comprise a necessary and sufficient condition for the elicitation of peanut-induced anaphylaxis. That the absence of FcepsilonRI prevented the development of anaphylaxis only partially insinuates the contribution of an IgE-independent pathway, and suggests that strategies to impair MC degranulation may be necessary to improve the efficacy of anti-IgE therapy. PMID:17982059

  17. Large-scale survey of adverse reactions to canine non-rabies combined vaccines in Japan.

    Science.gov (United States)

    Miyaji, Kazuki; Suzuki, Aki; Shimakura, Hidekatsu; Takase, Yukari; Kiuchi, Akio; Fujimura, Masato; Kurita, Goro; Tsujimoto, Hajime; Sakaguchi, Masahiro

    2012-01-15

    Canine non-rabies combined vaccines are widely used to protect animals from infectious agents, and also play an important role in public health. We performed a large-scale survey to investigate vaccine-associated adverse events (VAAEs), including anaphylaxis, in Japan by distributing questionnaires on VAAEs to veterinary hospitals from April 1, 2006 through May 31, 2007. Valid responses were obtained for 57,300 vaccinated dogs at 573 animal hospitals; we obtained VAAEs information for last 100 vaccinated dogs in each veterinary hospital. We found that of the 57,300, 359 dogs showed VAAEs. Of the 359 dogs, death was observed in 1, anaphylaxis in 41, dermatological signs in 244, gastrointestinal signs in 160, and other signs in 106. Onset of VAAEs was mostly observed within 12h after vaccination (n=299, 83.3%). In this study, anaphylaxis events occurred within 60 min after vaccination, and about half of these events occurred within 5 min (n=19, 46.3%). Furthermore, where anaphylaxis was reported, additional information to support the diagnosis was obtained by reinvestigation. Our resurvey of dogs with anaphylaxis yielded responses on 31 dogs; 27 of these demonstrated collapse (87.1%), 24 demonstrated cyanosis (77.4%), and both signs occurred in 22 (71.0%). Higher rates of animal VAAEs, anaphylaxis, and death were found in Japan than in other countries. Further investigations, including survey studies, will be necessary to elucidate the interaction between death and vaccination and the risk factors for VAAEs, and thus develop safer vaccines. Moreover, it may also be necessary to continually update the data of VAAEs. PMID:22264736

  18. CD32a antibodies induce thrombocytopenia and type II hypersensitivity reactions in FCGR2A mice.

    Science.gov (United States)

    Meyer, Todd; Robles-Carrillo, Liza; Davila, Monica; Brodie, Meghan; Desai, Hina; Rivera-Amaya, Mildred; Francis, John L; Amirkhosravi, Ali

    2015-11-01

    The CD32a immunoglobulin G (IgG) receptor (Fcγ receptor IIa) is a potential therapeutic target for diseases in which IgG immune complexes (ICs) mediate inflammation, such as heparin-induced thrombocytopenia, rheumatoid arthritis, and systemic lupus erythematosus. Monoclonal antibodies (mAbs) are a promising strategy for treating such diseases. However, IV.3, perhaps the best characterized CD32a-blocking mAb, was recently shown to induce anaphylaxis in immunocompromised "3KO" mice. This anaphylactic reaction required a human CD32a transgene because mice lack an equivalent of this gene. The finding that IV.3 induces anaphylaxis in CD32a-transgenic mice was surprising because IV.3 had long been thought to lack the intrinsic capacity to trigger cellular activation via CD32a. Such an anaphylactic reaction would also limit potential therapeutic applications of IV.3. In the present study, we examine the molecular mechanisms by which IV.3 induces anaphylaxis. We now report that IV.3 induces anaphylaxis in immunocompetent CD32a-transgenic "FCGR2A" mice, along with the novel finding that IV.3 and 2 other well-characterized CD32a-blocking mAbs, AT-10 and MDE-8, also induce severe thrombocytopenia in FCGR2A mice. Using recombinant variants of these same mAbs, we show that IgG "Fc" effector function is necessary for the induction of anaphylaxis and thrombocytopenia in FCGR2A mice. Variants of these mAbs lacking the capacity to activate mouse IgG receptors not only failed to induce anaphylaxis or thrombocytopenia, but also very potently protected FCGR2A mice from near lethal doses of IgG ICs. Our findings show that effector-deficient IV.3, AT-10, and MDE-8 are promising candidates for developing therapeutic mAbs to treat CD32a-mediated diseases. PMID:26396093

  19. Polyethylene glycols (PEG) and related structures

    DEFF Research Database (Denmark)

    Wenande, Emily; Kroigaard, Mogens; Mosbech, Holger; Garvey, Lene H

    2015-01-01

    We describe hypersensitivity to polyethylene glycols (PEGs), with cross-reactivity to a structural analog, polysorbate 80, in a 69-year-old patient with perioperative anaphylaxis and subsequent, severe anaphylactic reactions to unrelated medical products. PEGs and PEG analogs are prevalent in the...... perioperative setting, contained in a wide range of products seldom suspected of causing hypersensitivity reactions and thus rarely documented in surgical/anesthetic records. We suggest routine testing for PEGs after perioperative anaphylaxis because exposure to these polymers often is significant....... Comprehensive brand name documentation on the anesthetic chart of all product exposures is central to identifying the responsible allergen....

  20. [Anaphylactic shock after intradermal injection of corticosteroid].

    Science.gov (United States)

    Meyer, Martin Willy; Zachariae, Claus; Garvey, Lene Heise

    2015-01-19

    Carboxymethylcellulose (CMC) is a derivative of cellulose found in many food products, pharmaceuticals and cosmetics. Allergy to CMC in parenteral corticosteroid preparations leading to anaphylaxis is rare, but has previously been reported. We report a case of a 52-year-old woman with prurigo nodularis of Hyde, who reacted with anaphylaxis after intradermal injection of Kenalog 40 mg/ml. Allergy testing showed a positive skin prick test for CMC and the patient was advised to avoid future parenteral exposure to CMC. This case highlights the need to examine excipients in severe cases of drug allergy. PMID:25613209

  1. Rhabdomyolysis due to Multiple Wasp Stings

    Directory of Open Access Journals (Sweden)

    K. Ito

    2012-01-01

    Full Text Available Wasp sting is a relatively common arthropod assault, but is sometimes fatal because of anaphylaxis. Rhabdomyolysis is a serious condition, with destruction of striated muscles, and can be induced by various causes such as drugs, heart attacks, CRASH syndrome, and viper bites. Mass envenomation by multiple wasp stings can also cause rhabdomyolysis followed by acute renal failure, although it is extremely rare. We herein report a case who had an anaphylaxis-like reaction and rhabdomyolysis due to multiple wasp stings.

  2. Type I allergic hypersensitivity reactions due to ethylene oxide sterilised leucocyte filters in patients with thalassaemia: report of four cases.

    Science.gov (United States)

    Belen, Burcu; Polat, Meltem

    2015-01-01

    Ethylene oxide (EO) is a highly reactive gas used in sterilisation of heat sensitive medical devices, such as infusion sets, cannulae, intubation materials, ventriculoperitoneal shunts, dialysis catheters and stents. Allergic reactions due to EO have been reported in haemodialysis patients, patients undergoing extracorporeal photopheresis and donors of plasmapheresis. Clinical manifestations vary considerably and generally do not allow differentiation between IgE-mediated anaphylaxis and anaphylactoid reactions. We report four patients with thalassaemia who experienced anaphylaxis during transfusion due to ethylene oxide sterilised leucocyte filters. The aim of this report is to highlight the fact that frequently transfused patients can have allergic reactions due to EO particles left in leucocyte filters. PMID:25725028

  3. Anaphylactoid reaction to corticosteroid: case report and review of the literature.

    Science.gov (United States)

    Peller, J S; Bardana, E J

    1985-04-01

    It has been suggested that corticosteroids can cause allergic reactions including anaphylaxis. Thirty-five patients have been reported to have anaphylaxis-like reactions following exposure to hydrocortisone in topical and parenteral preparations. We describe a further case of a nonatopic woman who developed urticaria during intravenous infusion of hydrocortisone. A review of the literature reveals that IgE-mediated immediate hypersensitivity has not been definitely proven in any case. We conclude that the clinical manifestations occasionally experienced after receiving hydrocortisone are most likely pseudoallergic reactions. PMID:3985425

  4. Anafylaksi

    DEFF Research Database (Denmark)

    Malling, Hans-Jørgen; Hansen, Kirsten Skamstrup; Garvey, Lene Heise

    2014-01-01

    Anaphylaxis is a potentially life-threatening systemic allergic reaction involving several organ systems. Recognition of the reaction leading to prompt treatment is essential for a good outcome. The lifesaving treatment is intramuscular injection of adrenaline (0.3-0.5 mg for adults and children...

  5. Fighting Allergies at School

    Science.gov (United States)

    Taylor, Kelley R.

    2008-01-01

    In the last decade, the number of children diagnosed with food allergies has increased significantly--to an estimated 3 million affected in the United States alone (Food Allergy and Anaphylaxis Network, n.d.). As that number increases, so do the articles, legislation, and policies that are designed to address how to best deal with peanut allergies…

  6. National pholcodine consumption and prevalence of IgE-sensitization: a multicentre study

    DEFF Research Database (Denmark)

    Johansson, S G O; Florvaag, E; Oman, H;

    2010-01-01

    The aim of this study was to test, on a multinational level, the pholcodine (PHO) hypothesis, i.e. that the consumption of PHO-containing cough mixtures could cause higher prevalence of IgE antibodies to PHO, morphine (MOR) and suxamethonium (SUX). As a consequence the risk of anaphylaxis to...

  7. Occupational eczema and asthma in a hairdresser caused by hair-bleaching products

    DEFF Research Database (Denmark)

    Hougaard, Majken G; Menné, Torkil; Søsted, Heidi

    2012-01-01

    Occupational allergic contact eczema and asthma caused by bleaching agents is seen in hairdressers. Bleaching agents contain persulfate salts, which are known to induce immediate reactions such as rhinitis, asthma, contact urticaria, and anaphylaxis. The immunologic mechanism is not, however, ful...

  8. Epidemiology, Diagnosis, and Treatment of Hymenoptera Venom Allergy in Mastocytosis Patients

    NARCIS (Netherlands)

    Niedoszytko, Marek; Bonadonna, Patrizia; Oude Elberink, Joanne N. G.; Golden, David B. K.

    2014-01-01

    Hymenoptera venom allergy is a typical IgE-mediated reaction caused by sensitization to 1 or more allergens of the venom, and accounts for 1.5% to 34% of all cases of anaphylaxis. Patients suffering from mastocytosis are more susceptible to the anaphylactic reactions to an insect sting. This article

  9. Sensitization to lupine flour : is it clinically relevant?

    NARCIS (Netherlands)

    de Jong, N. W.; van Maaren, M. S.; Vlieg-Boersta, B. J.; Dubois, A. E. J.; de Groot, H.; van Wijk, R. Gerth

    2010-01-01

    Background Lupinus angustifolius (blue lupine) is used for human and animal consumption. Currently, the lupine content in bread varies from 0% to 10% and from 0.5% to 3% in pastry. Although lupine flour is present in many products, anaphylaxis on lupine flour is rarely seen. Objective The aim of our

  10. Lungeødem efter kontrastindgift som led i koronarangiografi

    DEFF Research Database (Denmark)

    Plambech, Morten; Garvey, Lene Heise

    2012-01-01

    Adverse reactions to radiographic contrast media are relatively rare and occur with a frequency of 0.02-0.04%. We describe a case of isolated pulmonary oedema after computed tomography of the coronary arteries in a 51 year-old man. Initially anaphylaxis was suspected, but due to the clinical...

  11. An Extraordinary Case Associated with an Allergic Reaction to Clopidogrel: Coronary Artery Spasm or Kounis Syndrome?

    Science.gov (United States)

    Liping, Zhang; Bin, Hui; Qiming, Feng

    2015-11-01

    Kounis syndrome is the concurrence of acute coronary syndrome with allergic reactions, such as anaphylaxis or anaphylactoid reactions. Here, we describe a unique case: CASs (coronary artery spasms) with both non-hypersensitivity and hypersensitivity aetiology (associated with clopidogrel hypersensitivity) were observed in a 61 year-old patient. Herein, the mechanism and clinical implications of this association are discussed. PMID:26138623

  12. Anaphylactoid reactions to paracetamol

    OpenAIRE

    Ayonrinde, O.; Saker, B.

    2000-01-01

    The toxic effects of paracetamol in overdose quantities are well recognised but the occurrence of anaphylactoid reactions to paracetamol is infrequently identified by consumers and health care professionals. Nevertheless adverse reactions to this drug, even in therapeutic doses, can have fatal or near fatal consequences. A case of an anaphylactoid reaction to paracetamol is described.


Keywords: paracetamol; anaphylaxis; allergy; hypersensitivity

  13. Centipede Envenomation: Bringing the Pain to Hawai‘i and Pacific Islands

    OpenAIRE

    Fenderson, Joshua L

    2014-01-01

    Scolopendra subspinipes is the only clinically significant centipede found in Hawai‘i. Envenomation typically leads to extreme localized pain, erythema, induration, and tissue necrosis and possible lymphedema or lymphangitis. Mortality is uncommon and results from secondary infection or anaphylaxis. Management is supportive and includes wound care, pain control, and treatment with topical or oral antihistamines and anti-inflammatory medications.

  14. Anti-snake venom: use and adverse reaction in a snake bite study clinic in Bangladesh

    Directory of Open Access Journals (Sweden)

    MR Amin

    2008-01-01

    Full Text Available Snakebites can present local or systemic envenomation, while neurotoxicity and respiratory paralysis are the main cause of death. The mainstay of management is anti-snake venom (ASV, which is highly effective, but liable to cause severe adverse reactions including anaphylaxis. The types of adverse reaction to polyvalent anti-snake venom have not been previously studied in Bangladesh. In this prospective observational study carried out between 1999 and 2001, in the Snake Bite Study Clinic of Chittagong Medical College Hospital, 35 neurotoxic-snake-bite patients who had received polyvalent anti-snake venom were included while the ones sensitized to different antitoxins and suffering from atopy were excluded. The common neurotoxic features were ptosis (100%, external ophthalmoplegia (94.2%, dysphagia (77.1%, dysphonia (68.5% and broken neck sign (80%. The percentage of anti-snake venom reaction cases was 88.57%; pyrogenic reaction was 80.64%; and anaphylaxis was 64.51%. The common features of anaphylaxis were urticaria (80%; vomiting and wheezing (40%; and angioedema (10%. The anti-snake venom reaction was treated mainly with adrenaline for anaphylaxis and paracetamol suppository in pyrogenic reactions. The average recovery time was 4.5 hours. Due to the danger of reactions the anti-snake venom should not be withheld from a snakebite victim when indicated and appropriate guidelines should be followed for its administration.

  15. LACK OF REPRODUCIBILITY OF A SINGLE NEGATIVE STING CHALLENGE RESPONSE IN THE ASSESSMENT OF ANAPHYLACTIC RISK IN PATIENTS WITH SUSPECTED YELLOW JACKET HYPERSENSITIVITY

    NARCIS (Netherlands)

    FRANKEN, HH; DUBOIS, AEJ; MINKEMA, HJ; VANDERHEIDE, S; DEMONCHY, JGR

    1994-01-01

    To investigate the reproducibility of a single negative response to sting challenge with a living insect, we rechallenged a group of 61 patients who showed no clinical response to a first sting challenge. All patients had previously had symptoms suggestive of anaphylaxis after a yellow jacket field

  16. MMR vaccination of children with egg allergy is safe

    DEFF Research Database (Denmark)

    Andersen, Dorthe Vestergård; Jørgensen, Inger Merete

    2013-01-01

    Measles, mumps and rubella (MMR) vaccination is part of the Danish Childhood Vaccination Programme. It is known that children may react with anaphylaxis to MMR vaccines containing traces of egg protein. In Denmark, national clinical guidelines recommend that children with egg allergy be referred to...

  17. Socio-Cultural Matrix of Raising a Child with Food Allergies: Experiences of a Migrant Mother

    Science.gov (United States)

    Sanagavarapu, Prathyusha

    2004-01-01

    Children with life-threatening food allergies are increasing in number in Australia. A variety of foods such as dairy milk, peanut and tree nuts, fish and egg can cause severe allergic reactions in some children. The foods that cause allergies could trigger severe breathing difficulties (anaphylaxis) for these children and, if not treated…

  18. Preparing School Personnel to Assist Students with Life-Threatening Food Allergies.

    Science.gov (United States)

    Hay, Genevieve H.; And Others

    1994-01-01

    Knowledge of and preparation for life-threatening food allergies will enable school personnel to better respond to students who have severe allergic reactions. Given the high incidence of food-related anaphylaxis in public places, teachers and school personnel should be aware of and prepared to handle severe food allergy reactions. (SM)

  19. Disease-specific health-related quality of life instruments for IgE-mediated food allergy

    NARCIS (Netherlands)

    Salvilla, S. A.; Dubois, A. E. J.; Flokstra-de Blok, Bertine; Panesar, S. S.; Worth, A.; Patel, S.; Muraro, A.; Halken, S.; Hoffmann-Sommergruber, K.; DunnGalvin, A.; Hourihane, J. O'B.; Regent, L.; de Jong, N. W.; Roberts, G.; Sheikh, A.

    2014-01-01

    This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are

  20. Systematic review on cashew nut allergy

    NARCIS (Netherlands)

    van der Valk, J. P. M.; Dubois, A. E. J.; van Wijk, R. Gerth; Wichers, H. J.; de Jong, N. W.

    2014-01-01

    Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognitio

  1. Generating a Natural Porcine Model of Gastrointestinal Food Allergy to Peanut

    Science.gov (United States)

    The peanut (Arachis hypogaea) is an extremely potent allergen and is one of the most life-threatening food sensitivities known. Peanuts cause the majority of food-related anaphylaxis in children, adolescents, and adults. There is no good animal model currently in place to study peanut allergies. Exp...

  2. Managing the Student with Severe Food Allergies

    Science.gov (United States)

    Robinson, Joanne M.; Ficca, Michelle

    2012-01-01

    School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting.…

  3. Anaphylactic shock after intradermal injection of corticosteroid

    DEFF Research Database (Denmark)

    Meyer, Martin Willy; Zachariae, Claus; Garvey, Lene Heise

    2015-01-01

    Carboxymethylcellulose (CMC) is a derivative of cellulose found in many food products, pharmaceuticals and cosmetics. Allergy to CMC in parenteral corticosteroid preparations leading to anaphylaxis is rare, but has previously been reported. We report a case of a 52-year-old woman with prurigo...

  4. Giant Asian honeybee stings induced acute myocarditis: a case report

    Directory of Open Access Journals (Sweden)

    NP Dinamithra

    2013-10-01

    Full Text Available Hymenopterid stings and subsequent allergic reactions including fatal anaphylaxis are a common indication for emergency department visits worldwide. Less commonly, multiple wasp stings can result in multi-system involvement ranging from intravascular hemolysis, rhabdomyolysis, acute renal failure, cardiac involvement, hepatic dysfunction and occasionally thrombocytopenia and coagulopathy. Here we report one case of multiple Giant Asian honey bee stings induced myocarditis.

  5. Assay of mast cell mediators

    DEFF Research Database (Denmark)

    Rådinger, Madeleine; Jensen, Bettina M; Swindle, Emily;

    2015-01-01

    Mediator release from activated mast cells is a major initiator of the symptomology associated with allergic disorders such as anaphylaxis and asthma. Thus, methods to monitor the generation and release of such mediators have widespread applicability in studies designed to understand the processe...

  6. Adverse Reaction to Omalizumab in Patients with Chronic Urticaria: Flare Up or Ineffectiveness?

    Science.gov (United States)

    Ertaş, Ragıp; Özyurt, Kemal; Yıldız, Sinem; Ulaş, Yılmaz; Turasan, Abdullah; Avcı, Atıl

    2016-02-01

    Omalizumab is a recombinant humanized anti-Ig E monoclonal antibody used as the third line treatment of chronic spontaneous urticaria (CSU). We report four patients with severe antihistamine-resistant CSU, who developed angioedema, anaphylaxis and/or flare up of urticaria at different times following omalizumab therapy. PMID:26996116

  7. Evidence questioning cromolyn’s effectiveness and selectivity as a “mast cell stabilizer” in mice

    Science.gov (United States)

    Oka, Tatsuya; Kalesnikoff, Janet; Starkl, Philipp; Tsai, Mindy; Galli, Stephen J.

    2013-01-01

    Cromolyn, widely characterized as a “mast cell stabilizer”, has been used in mice to investigate the biological roles of mast cells in vivo. However, it is not clear to what extent cromolyn can either limit the function of mouse mast cells or influence biological processes in mice independently of effects on mast cells. We confirmed that cromolyn (at 10 mg/kg in vivo or 10 – 100 μM in vitro) can inhibit IgE-dependent mast cell activation in rats in vivo (measuring Evans blue extravasation in passive cutaneous anaphylaxis and increases in plasma histamine in passive systemic anaphylaxis) and in vitro (measuring peritoneal mast cell β-hexosaminidase release and prostaglandin D2 synthesis). However, under the conditions tested, cromolyn did not inhibit those mast cell-dependent responses in mice. In mice, cromolyn also failed to inhibit the ear swelling or leukocyte infiltration at sites of passive cutaneous anaphylaxis. Nor did cromolyn inhibit IgE-independent degranulation of mouse peritoneal mast cells induced by various stimulators in vitro. At 100 mg/kg, a concentration ten times higher than that which inhibited passive systemic anaphylaxis in rats, cromolyn significantly inhibited the increases in plasma concentrations of mouse mast cell protease-1 (but not of histamine) during passive systemic anaphylaxis, but had no effect on the reduction in body temperature in this setting. Moreover, this concentration of cromolyn (100 mg/kg) also inhibited LPS-induced TNF production in genetically mast cell-deficient C57BL/6-KitW-sh/W-sh mice in vivo. These results question cromolyn’s effectiveness and selectivity as an inhibitor of mast cell activation and mediator release in the mouse. PMID:22906983

  8. Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation.

    Directory of Open Access Journals (Sweden)

    Shelley F Stone

    Full Text Available BACKGROUND: Snake bite is one of the most neglected public health issues in poor rural communities worldwide. In addition to the clinical effects of envenoming, treatment with antivenom frequently causes serious adverse reactions, including hypersensitivity reactions (including anaphylaxis and pyrogenic reactions. We aimed to investigate the immune responses to Sri Lankan snake envenoming (predominantly by Russell's viper and antivenom treatment. METHODOLOGY/PRINCIPAL FINDINGS: Plasma concentrations of Interleukin (IL-6, IL-10, tumor necrosis factor α (TNFα, soluble TNF receptor I (sTNFRI, anaphylatoxins (C3a, C4a, C5a; markers of complement activation, mast cell tryptase (MCT, and histamine were measured in 120 Sri Lankan snakebite victims, both before and after treatment with antivenom. Immune mediator concentrations were correlated with envenoming features and the severity of antivenom-induced reactions including anaphylaxis. Envenoming was associated with complement activation and increased cytokine concentrations prior to antivenom administration, which correlated with non-specific systemic symptoms of envenoming but not with coagulopathy or neurotoxicity. Typical hypersensitivity reactions to antivenom occurred in 77/120 patients (64%, satisfying criteria for a diagnosis of anaphylaxis in 57/120 (48%. Pyrogenic reactions were observed in 32/120 patients (27%. All patients had further elevations in cytokine concentrations, but not complement activation, after the administration of antivenom, whether a reaction was noted to occur or not. Patients with anaphylaxis had significantly elevated concentrations of MCT and histamine. CONCLUSIONS/SIGNIFICANCE: We have demonstrated that Sri Lankan snake envenoming is characterized by significant complement activation and release of inflammatory mediators. Antivenom treatment further enhances the release of inflammatory mediators in all patients, with anaphylactic reactions characterised by high

  9. Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell) Severe cutaneous adverse reactions to drugs - relevant aspects to diagnosis and treatment - Part I: Anaphylaxis and anaphylactoid reactions, erythroderma and the clinical spectrum of Stevens-Johnson syndrome & toxic epidermal necrolysis (Lyell´s disease)

    OpenAIRE

    Paulo Ricardo Criado; Roberta Fachini Jardim Criado; Cidia Vasconcellos; Rodrigo de Oliveira Ramos; Andréia Christina Gonçalves

    2004-01-01

    As reações cutâneas graves adversas a droga (RCGAD) são as que geralmente necessitam de internação hospitalar, por vezes em unidade de terapia intensiva ou de queimados, com observação minuciosa dos sinais vitais e da função de órgãos internos. O objetivo é descrever essas reações, facilitando seu reconhecimento e tratamento. Fazem parte desse grupo a anafilaxia, a síndrome de Stevens-Johnson (SSJ), a necrólise epidérmica tóxica (NET) e, dependendo do envolvimento sistêmico, as eritrodermias....

  10. Rare case of stress cardiomyopathy due to intramuscular epinephrine administration.

    Science.gov (United States)

    Nazir, Salik; Melnick, Stephen; Lohani, Saroj; Lloyd, Benjamin

    2016-01-01

    We report a case of a 37-year-old woman who presented to our hospital with retrosternal chest pain following intramuscular administration of epinephrine due to presumed anaphylaxis. On arrival, she was found to have ST segment depression in the anterolateral leads on ECG and elevated cardiac troponins. She was diagnosed with stress cardiomyopathy based on left ventricle dysfunction and angiographically normal coronary arteries on cardiac catheterisation. To the best of our knowledge, this is the third reported case of takotsubo cardiomyopathy following appropriately dosed intramuscular administration of epinephrine for anaphylaxis. This case highlights the importance of considering stress cardiomyopathy in patients presenting with chest pain syndrome following systemic administration of epinephrine. PMID:27268785

  11. F-fucoidan from Saccharina japonica is a novel inducer of galectin-9 and exhibits anti-allergic activity.

    Science.gov (United States)

    Tanino, Yuka; Hashimoto, Takashi; Ojima, Takao; Mizuno, Masashi

    2016-07-01

    Fucoidan is a sulfated polysaccharide from brown sea algae. In the present study, it was demonstrated that oral administration of F-fucoidan from Saccharina japonica possessed anti-allergic effects using the passive cutaneous anaphylaxis reaction, but not by intraperitoneal administration. The inhibitory mechanism was dependent on galectin-9, which belongs to a soluble lectin family that recognizes β-galactoside and prevents IgE binding to mast cells. The anti-allergy properties of F-fucoidan were cancelled by an intravenous dose of anti-galectin-9 antibody or lactose, which bind competitively with galectin-9 before the passive cutaneous anaphylaxis reaction. F-fucoidan increased the expression level of galectin-9 mRNA in intestinal epithelial cells and serum galectin-9 levels. Oral treatment with F-fucoidan suppressed allergic symptoms through the induction of galectin-9. This is the first report that F-fucoidan can induce the secretion of galectin-9. PMID:27499575

  12. Anaphylactic shock and cardiac arrest caused by thiamine infusion.

    Science.gov (United States)

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald; Jensen, Svend Eggert

    2013-01-01

    Parenteral thiamine has a very high safety profile. The most common adverse effect is local irritation; however, anaphylactic or anaphylactoid reactions may occur, mostly related to intravenous administration. We describe a 44-year-old man, a chronic alcoholic, who was admitted with alcohol intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations. He was discharged in good health after 14 days. This case report emphasises both the importance of recognising the symptoms of anaphylaxis and the fact that facilities for treating anaphylaxis and cardiopulmonary resuscitation should be available when thiamine or for that matter, any drug is given in-hospital. PMID:23853017

  13. Management of hypersensitivity reactions to anti-D immunoglobulin preparations.

    Science.gov (United States)

    Rutkowski, K; Nasser, S M

    2014-11-01

    RhD immunoglobulin G (anti-D) administered to pregnant Rh(-) women prevents Rh isoimmunization. Its use has significantly reduced the incidence of haemolytic disease of the foetus and newborn previously responsible for one death in every 2200 births. In pregnancy, acute drug-induced hypersensitivity reactions including anaphylaxis can have serious deleterious effects on the mother and foetus/neonate. Women can be erroneously labelled as drug allergic as the investigation of hypersensitivity reactions in pregnancy is complex and drug challenges are usually contraindicated. We present three cases of suspected anti-D hypersensitivity clinically presenting as anaphylaxis and delayed transfusion-related reaction. We also propose a new algorithm for the investigations of such reaction. It relies on detailed history, cautious interpretation of skin tests, foetal Rh genotyping from maternal blood and, in some cases, anti-D challenges. This is not to deprive women of anti-D which might put their future pregnancies at risk. PMID:25066207

  14. Chlorhexidine impregnated central venous catheter inducing an anaphylatic shock in the intensive care unit.

    Science.gov (United States)

    Khoo, A; Oziemski, P

    2011-10-01

    Chlorhexidine, a bisbiguanide, is widely used as an antiseptic agent in medical practice as it has the greatest residual antimicrobial activity. Central venous catheters coated extraluminally with chlorhexidine have been made to reduce extraluminal contamination. By using both the chlorhexidine-alchohol skin preparation and antimicrobial-coated catheters during vascular cannulation, it can reduce catheter related bloodstream significantly [1]. The reduction in infection rate is especially vital in critically ill patients who require long-term vascular access. Adverse reactions to chlorhexidine are rare and uncommon, and have been under-recognised as a cause of anaphylaxis. There are several reports of allergic reactions following exposure to chlorhexidine. We report of a case of anaphylaxis shock requiring cardiopulmonary resuscitation during the placement of a chlorhexidine impregnated central venous catheters. PMID:21036666

  15. Acute allergic angioedema of upper lip.

    Science.gov (United States)

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  16. Japanese Guideline for Food Allergy 2014

    Directory of Open Access Journals (Sweden)

    Atsuo Urisu

    2014-01-01

    The therapy for food allergies includes treatment of and prophylactic measures against hypersensitivity such as anaphylaxis. A fundamental prophylactic measure is the elimination diet. However, elimination diets should be used only if necessary because of the patient-related burden. For this purpose, it is very important that causative foods be accurately identified. There are a number of means available to identify causative foods, including the history taking, a skin prick test, detection of antigen-specific IgE antibodies in the blood, the basophil histamine release test, the elimination diet test, and the oral challenge test, etc. Of these, the oral challenge test is the most reliable. However, it should be conducted under the supervision of experienced physicians because it may cause adverse reactions, such as anaphylaxis.

  17. [Development of allergic reactivity to Artemesia pollen during combined sensitization to pollen and microbes].

    Science.gov (United States)

    Ermekova, R K

    1978-08-01

    Some regularities of formation of hypersensitivity of the immediate type to the pollen of Artemisia absinthium were studied under conditions of combined hypersensitivity to pollen and Brucella abortus 19-BA vaccine strain; the latter was administered 3, 12, and 28 days after the pollen. The degree of specific allergic reconstruction to the pollen was studied by passive skin anaphylaxis after Ovary, indirect degranulation of mast cells of healthy rats, and by general anaphylaxis in response to intravenous injection of the Artemisia absinthium pollen water-salt extract. Early formation of allergy to the pollen was observed in the groups of animals with combined hypersensitivity to the pollen and brucellae. The degree of allergic reactivity to the pollen allergen was more expressed in the groups with combined allergy than in those with pure pollen hypersensitivity at all the stages of this experiment. PMID:99195

  18. Acute allergic angioedema of upper lip

    Science.gov (United States)

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  19. Acute allergic angioedema of upper lip

    Directory of Open Access Journals (Sweden)

    Kavitha Mahendran

    2016-01-01

    Full Text Available Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures.

  20. Two galactose-α-1,3-galactose carrying peptidases from pork kidney mediate anaphylactogenic responses in delayed meat allergy

    DEFF Research Database (Denmark)

    Hilger, Christiane; Fischer, Jörg; Swiontek, Kyra;

    2016-01-01

    BACKGROUND: Serum IgE-antibodies directed at galactose-α-1,3-galactose (α-Gal) are associated with a novel form of delayed anaphylaxis occuring upon consumption of red meat or innards. Pork kidney is known as the most potent trigger of this syndrome, but the culprit allergens have not yet been...... resistent to heat denaturation. Pork kidney extract, isolated ACE I and AP-N were able to activate patient basophils and elicit positive responses in skin prick tests. CONCLUSION: Two cell-membrane proteins carrying α-Gal epitopes were identified in pork kidney. For the first time, isolated meat proteins...... were shown to induce basophil activation in patients with delayed anaphylaxis to red meat providing further confirmation for the clinical relevance of these α-Gal-carrying proteins. This article is protected by copyright. All rights reserved....

  1. Benzopyrones. 14. Synthesis and antiallergic properties of some N-tetrazolylcarboxamides and related compounds.

    Science.gov (United States)

    Ellis, G P; Becket, G J; Shaw, D; Wilson, H K; Vardey, C J; Skidmore, I F

    1978-11-01

    A series of chromones containing an acidic group has been synthesized and screened for the ability to inhibit passive cutaneous anaphylaxis and the release of histamine from mast cells of the rat. Many of the chromones contain the N-(5-tetrazolyl)carboxamido group, a novel source of acidity. Others contain a carboxyl, C-(5-tetrazolyl), 5-(4H)-oxotetrazolinyl, or N-(5-tetrazolyl)sulfonamido function. The compounds were compared with cromolyn sodium (sodium cromoglycate) and many were found to be powerful inhibitors of anaphylaxis. The most potent was 7-methoxy-4-oxo-N-(5-tetrazolyl)-4H-1-benzopyran-2-carboxamide (15). Structure-activity relationships among the chromones and also some related compounds are discussed. PMID:82617

  2. How safe is your curry? Food allergy awareness of restaurant staff

    OpenAIRE

    Common , Lucy A R; Corrigan, Christopher J.; Smith, Helen; Bailey, Sam; Harris, Scott; Holloway, Judith A.

    2013-01-01

    Background: Incidents of severe and fatal anaphylaxis to accidentally ingested food allergens are increasing. Individuals are more likely to encounter difficulties when eating away from home. In restaurants, front-of-house and kitchen staff may be called upon to provide information about ingredients or ensure certain food allergens are excluded from dishes. Following a series of reactions related to the accidental ingestion of peanuts in curries we assessed food allergy awareness and allergen...

  3. Indigenous enteric eosinophils control DCs to initiate a primary Th2 immune response in vivo

    OpenAIRE

    Chu, Derek K.; Jimenez-Saiz, Rodrigo; Verschoor, Christopher P.; Walker, Tina D; Goncharova, Susanna; Llop-Guevara, Alba; Shen, Pamela; Gordon, Melissa E.; Barra, Nicole G; Bassett, Jennifer D.; Kong, Joshua; Fattouh, Ramzi; McCoy, Kathy D.; Bowdish, Dawn M.; Erjefält, Jonas

    2014-01-01

    Eosinophils natively inhabit the small intestine, but a functional role for them there has remained elusive. Here, we show that eosinophil-deficient mice were protected from induction of Th2-mediated peanut food allergy and anaphylaxis, and Th2 priming was restored by reconstitution with il4(+/+) or il4(-/-) eosinophils. Eosinophils controlled CD103(+) dendritic cell (DC) activation and migration from the intestine to draining lymph nodes, events necessary for Th2 priming. Eosinophil activati...

  4. Immunopathological modifications in the rectal mucosa from an animal model of food allergy Modificaciones inmunopatológicas de la mucosa rectal en un modelo animal de alergia alimentaria

    OpenAIRE

    Vinuesa, M.; N. Bassan; S. Roma; Pérez, F.

    2005-01-01

    Aim: the aim is to determine immunopathological modifications in rectal mucosa from rabbit after local challenge in sensitized animals with ovalbumin (OVA). Experimental design: thirty rabbits divided into three groups: G1: normal, G2: subcutaneously OVA sensitized, G3: sensitized, locally OVA challenged and sampled 4 hours after challenge. Specific anti-OVA IgE levels were evaluated by passive cutaneous anaphylaxis test (PCA). In each group 200 high microscopical power fields (HPF) were coun...

  5. Uncommon Locations and Presentations of Hydatid Cyst

    OpenAIRE

    Sachar, S; Goyal, S; Sangwan, S.

    2014-01-01

    Background: Hydatid disease (HD) is an ancient disease and even was known to Hippocrates. This disease involves all human parts and most common affected organs are liver and lungs. Incidence of unusual site is about 8-10%. The clinical picture depends upon the involved organs, its effects on adjacent structures, complications due to secondary infection, rupture, and anaphylaxis caused by hydatid cysts. Aim: The aim of this study was to find out incidence of unusual location of hydatid cyst in...

  6. Lithium-Associated Thyromegaly: An Unusual Cause of Airway Obstruction

    OpenAIRE

    Ashish Verma; Siddharth Wartak; Mark Tidswell

    2012-01-01

    Acute upper airway obstruction is a medical emergency and can be caused by many serious conditions such as a foreign body occluding the airway, intrinsic swelling (as in anaphylaxis), or extrinsic compression. Thyromegaly has rarely been reported as a source of airway compromise. We present a patient whose thyromegaly is presumed to have been induced by lithium and was massive enough to cause severe airway compromise.

  7. Severe reactions to foods in childhood : clinical perspectives, epidemiology and risk management

    OpenAIRE

    Vetander, Mirja

    2014-01-01

    Food allergy is a public health issue, particularly among children, and seems to be increasing worldwide. Allergic reactions to foods vary in terms of symptoms and severity. Anaphylaxis, the most severe allergic reaction, can be fatal. Food allergy has significant negative impact in the daily lives of allergic children and their families. The overall aim of this thesis was to gain knowledge about severe reactions to foods among Swedish children with regard to epidemiology, clinical per...

  8. 418 Frequency of Food Hypersensitivity Mediated by IGG in Patients Received in a Venezuelan Laboratory During 2011

    OpenAIRE

    Lic, Cristina Najm; Benarroch, Lorena; Camacho, Natacha; Figueroa, Daniela; Guzmán, Jhonarly; Perdomo, Angel; García, Nirsen; Silva, Noel A.

    2012-01-01

    Background Foods could cause adverse reactions, which manifested with similar symptoms that could complicate the diagnosis, that is, gastrointestinal disease, rashes, edema, eczema, asthma, anaphylaxis, others; these reactions may be mediated or not by immunological processes. In the past years there were many research studies related with different types of immunological reactions, like for example those mediated by IgG, which are characterized with delayed and insidious manifestations. Thes...

  9. Immunopathology of giardiasis: the role of lymphocytes in intestinal epithelial injury and malfunction

    OpenAIRE

    AG Buret

    2005-01-01

    T lymphocyte-mediated pathogenesis is common to a variety of enteropathies, including giardiasis, cryptosporidiosis, bacterial enteritis, celiac's disease, food anaphylaxis, and Crohn's disease. In giardiasis as well as in these other disorders, a diffuse loss of microvillous brush border, combined or not with villus atrophy, is responsible for disaccharidase insufficiencies and malabsorption of electrolytes, nutrients, and water, which ultimately cause diarrheal symptoms. Other mucosal chang...

  10. Anaphylactic reaction to intravenous diclofenac

    Directory of Open Access Journals (Sweden)

    Ranju Singh

    2011-01-01

    Full Text Available Diclofenac sodium is a non-steroidal anti-inflammatory drug widely used as an opioid sparing agent for postoperative analgesia. Anaphylaxis due to intravenous diclofenac sodium is very rare. We report a case of anaphylactic reaction to IV diclofenac sodium, occurring postoperatively in a 25-year-old primigravida, the clinical features of which mimicked pulmonary embolism. The rarity, clinical importance and the diagnostic dilemma associated prompted us to report this case.

  11. Systemic mastocytosis--a systematic review

    DEFF Research Database (Denmark)

    Andersen, Christen Lykkegaard; Kristensen, Thomas Kielsgaard; Severinsen, Marianne Tang;

    2012-01-01

    The mast cell lives a hidden life, but it is implicated in several physiological reactions. Its ability to react to different stimuli impacts a variety of conditions such as asthma, atopic dermatitis, urticaria and anaphylaxis. It is not until recent decades that the evolution of the cell has bee...... described and its fascinating biology has only recently been depicted. We here give a review of systemic mastocytosis in regards to cell biology, diagnostic approaches and clinical practice....

  12. 非イオン性ヨード造影剤によるアレルギー様症状の有害事象に及ぼす水分摂取の影響

    OpenAIRE

    元井, 玲子; 矢野, 育子; 尾崎, 淳子; 鋒山, 香苗; 山本, 崇; 深津, 祥央; 石塚, 良子; 松村, 由美; 谷口, 正洋; 東村, 享治; 松原, 和夫

    2015-01-01

    The use of iodine contrast agents occasionally causes serious allergic symptoms including anaphylaxis. At Kyoto University Hospital to prevent nephropathy we began recommending water intake before and after administration of iodine contrast agents in September 2012. In the present study we investigated the effect of water intake on the incidence of allergy-like events after the use of non-ionic iodine contrast agents. We extracted the occurrence of allergy-like events from the incident report...

  13. Food allergy in Asia: how does it compare?

    OpenAIRE

    Lee, Alison Joanne; Thalayasingam, Meera; Lee, Bee Wah

    2013-01-01

    Asia is a populous and diverse region and potentially an important source of information on food allergy. This review aims to summarize the current literature on food allergy from this region, comparing it with western populations. A PubMed search using strategies "Food allergy AND Asia", "Food anaphylaxis AND Asia", and "Food allergy AND each Asian country" was made. Overall, 53 articles, published between 2005 and 2012, mainly written in English were reviewed. The overall prevalence of food...

  14. Food Allergy--Lessons from Asia

    OpenAIRE

    Lee, Bee Wah; Shek, Lynette Pei-Chi; Gerez, Irvin Francis A; Soh, Shu E.; Van Bever, Hugo P

    2008-01-01

    Objective This is a review on published data available on food allergy in East Asia and a discussion on the insights that it offers. Methods PubMed searches were made for terms food allergy and anaphylaxis, in combination with Asia. Results There is a paucity of population-based prevalence studies on food allergy in Asia. Certain unique food allergens, such as buckwheat, chestnuts, chickpeas, bird's nest, and royal jelly, which are consumed extensively by certain Asian populations have result...

  15. Perforated hydatid cyst into peritoneum presented with urticaria

    OpenAIRE

    Turgut Piskin; Cengiz Ara; Abuzer Dirican; Dincer Ozgor; Bulent Unal; Sezai Yılmaz

    2010-01-01

    Hydatid cyst of liver is generally asymptomatic unlessleading to complications. Spontaneously or trauma inducedperforation of cyst into peritoneum is one of thatcomplications. Rupture into the abdominal cavity maycause mild to fatal complications like abdominal pain, urticaria,anaphylaxis and sudden death. We present, herein,a case with abdominal pain and urticaria due to spontaneouslyhydatid cyst rupture into peritoneum. A 32 year-oldwoman admitted to the emergency room with abdominalpain an...

  16. Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report

    OpenAIRE

    Badik, Jennifer; Chen, Jimmy; Letvak, Kira; So, Tsz-Yin

    2016-01-01

    Allergy to human insulin or its analogs is rare, but it is still a significant issue in current diabetes care. Allergic reactions can range from localized injection site reactions to generalized anaphylaxis, and they can be caused by excipients or the insulin molecules themselves. We presented a case of a 14-year-old male patient with generalized allergic reactions to insulin glargine and insulin detemir. The patient was successfully managed by being switched to a continuous subcutaneous insu...

  17. Epidemiology and risk factors for drug allergy

    OpenAIRE

    Thong, Bernard Y-H; Tan, Teck-Choon

    2011-01-01

    The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular...

  18. Anaphylactoid Reactions to Tolmetin After Interrupted Dosage

    OpenAIRE

    Bretza, Joseph A.; Novey, Harold S.

    1985-01-01

    Seven patients had anaphylactoid reactions after ingesting tolmetin sodium. In each case the reaction followed readministration of the drug after an interrupted period of at least three days and within 90 minutes of taking a single 400-mg capsule. None of the patients had had prior anaphylaxis and none were judged atopic. Skin tests to an extract of the drug (0.02 mg) were uniformly negative, whereas a higher concentration produced a nonspecific irritant reaction. In vitro tests in one patien...

  19. Anaphylactic and anaphylactoid reactions during the perioperative period

    OpenAIRE

    Lagopoulos, V; Gigi, E

    2011-01-01

    Anaphylactic reactions in the peri-operative period are often serious and potentially life-threatening conditions, involving multiple organ systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils. Anaphylaxis is an immune mediated type I allergic reaction following the massive release of mediators from mast cells and basophils as a response to an allergen. Anaphylactoid reactions are defined as those reactions that p...

  20. Clinical development methodology for infusion-related reactions with monoclonal antibodies

    OpenAIRE

    Doessegger, Lucette; Banholzer, Maria Longauer

    2015-01-01

    Infusion-related reactions (IRRs) are common with monoclonal antibodies (mAbs) and timely related to drug administration and have been reported as anaphylaxis, anaphylactoid reactions and cytokine release syndrome, among other terms used. We address risk management measures for individual patients and for the study and propose a consistent reporting approach in an attempt to allow cross-molecule comparisons. Once the symptoms of IRR have resolved, the mAb may be restarted. Rechallenge should ...

  1. Anaphylactic reaction to intraurethral chlorhexidine: sensitisation following previous repeated uneventful administration

    OpenAIRE

    Dyer, JE; Nafie, S; MELLON, JK; Khan, MA

    2013-01-01

    Instillagel® (CliniMed, High Wycombe, UK) is commonly used in urethral catheterisation and to facilitate the passage of instruments into the bladder in urological practice. Its active ingredients include 0.25% chlorhexidine, 2% lidocaine, 0.06% methyl hydroxybenzoate and 0.025% propyl hydroxybenzoate. We discuss the case of an 84-year-old man who received intraurethral Instillagel® prior to laser ablation of a recurrent transitional cell carcinoma of the bladder, resulting in anaphylaxis. Sub...

  2. Systemic Immediate Hypersensitive Reactions after Treatment with Sweet Bee Venom: A Case Report

    OpenAIRE

    NaYoung Jo; JeongDu Roh

    2015-01-01

    Objectives: A previous study showed that bee venom (BV) could cause anaphylaxis or other hypersensitivity reactions. Although hypersensitivity reactions due to sweet bee venom (SBV) have been reported, SBV has been reported to be associated with significantly reduced sensitization compared to BV. Although no systemic immediate hypersensitive response accompanied by abnormal vital signs has been reported with respect to SBV, we report a systemic immediate hypersensitive response that we experi...

  3. Regulatory T cells Enhance Mast Cell Production of IL-6 via Surface-bound TGFβ1

    OpenAIRE

    Ganeshan, Kirthana; Bryce, Paul J.

    2011-01-01

    Mast cell degranulation is a hallmark of allergic reactions but mast cells can also produce many cytokines that modulate immunity. Recently, CD25+ regulatory T cells (Tregs) have been shown to inhibit mast cell degranulation and anaphylaxis but their influence on cytokine production remained unknown. Here, we show that, rather than inhibit, Tregs actually enhance mast cell production of IL-6. We demonstrate that, while inhibition of degranulation was OX40/OX40L dependent, enhancement of IL-6 ...

  4. TRALI - A Less Commonly Known Complication of Transfusion

    OpenAIRE

    Pradeep Bhatia; Tulsiani, K. L.

    2008-01-01

    Transfusion Related Acute Lung Injury (TRALI) has been recently recognized as one of the serious risks associated with transfusion, presenting as respiratory distress during or after transfusion of blood products. The symptoms can be confused with other transfusion-related events such as anaphylaxis, haemolysis, or circulatory overload, or with non-transfusion-related co-morbidities such as cardiac failure. TRALI varies in severity, and mortality is not uncommon. TRALI is now the leading caus...

  5. Current understanding of allergic transfusion reactions: incidence, pathogenesis, laboratory tests, prevention and treatment

    OpenAIRE

    Hirayama, Fumiya

    2012-01-01

    Non-haemolytic transfusion reactions are the most common type of transfusion reaction and include transfusion-related acute lung injury, transfusion-associated circulatory overload, allergic reactions, febrile reactions, post-transfusion purpura and graft-versus- host disease. Although life-threatening anaphylaxis occurs rarely, allergic reactions occur most frequently. If possible, even mild transfusion reactions should be avoided because they add to patients' existing suffering. During the ...

  6. Adverse drug reactions to ibuprofen: a case report

    OpenAIRE

    Khobragade Yadneshwar; Khobragade Sujata

    2016-01-01

    Ibuprofen is a commonly used drug available by prescription and over the counter for treatment of fever, joint pain, headache, migraine, inflammatory states. It is available in combination with paracetamol and various other drugs. Side effects associated with aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) are rash, gastrointestinal ulcers, hepatic toxicity, Steven Johnson syndrome, respiratory skin rashes, acute exacerbation of asthma and anaphylaxis. We have reported here sever...

  7. Angioneurotic Edema Associated with Haloperidol

    OpenAIRE

    Samrina Kahlon; Cathy Lee; Roger Chirurgi; Getaw Worku Hassen

    2012-01-01

    Background. Angioneurotic edema is a life-threatening medical emergency that requires urgent diagnosis and treatment. Haloperidol is in the butyrophenone class of antipsychotic medications. Acute anaphylaxis to Haloperidol is very rare and no cases have been reported in literature. Objective. To report the association of life-threatening angioneurotic edema with intramuscular Haloperidol. Case Report. We present a case of an adult with no known allergies in whom angioneurotic edema with tongu...

  8. Pulmonary hydatid cyst rupture in childhood: Presentation diagnosis and treatment strategies

    OpenAIRE

    Özdemir, Tunç; Arıkan, Ahmet

    2013-01-01

    Aim: Rupture of pulmonary hydatid cyst is rare yet very serious complication The patients may be presented with cough and hydroptysis or may be presented with anaphylaxis and suffocation Pediatric patients with ruptured pulmonary hydatid cyst were evaluated retrospectively surgical and medical options yielding to treatment are discussed Material and Method: Between January 1999 and June 2012 a total of 956 patients with hydatid cyst had undergone surgical treatment One hundred and ten...

  9. The Most Common Cow's Milk Allergenic Proteins with Respect to Allergic Symptoms in Iranian Patients.

    Science.gov (United States)

    Shokouhi Shoormasti, Raheleh; Fazlollahi, Mohammad Reza; Barzegar, Saeedeh; Teymourpour, Pegah; Yazdanyar, Zahra; Lebaschi, Zahra; Nourizadeh, Maryam; Tazesh, Behnaz; Movahedi, Masoud; Kashani, Homa; Pourpak, Zahra; Moin, Mostafa

    2016-04-01

    Cow's milk allergy (CMA) is an immunological response to cow's milk proteins such as casein, α-lactalbumin and β lactoglobulin. The aim of this study was to determine the most common cow's milk allergenic proteins in patients with CMA and identify the most effective proteins in different allergic symptoms. Eighty seven patients (≤18 years) with allergy to cow's milk from 2006 to 2013 entered this study. They had a positive history of allergic reactions to cow's milk and a positive specific IgE test to whole cow's milk. The patients' symptoms were divided into four groups. Serum specific IgEs against four different main proteins of cow's milk were measured using RIDA Allergy Screen. Among 87 patients, 53 (60.5%) were male and the median age was 2.5 years. The frequency of respiratory, skin, gastrointestinal symptoms, and anaphylaxis were 63.3%, 55.7%, 20.3%, and 13.4%, respectively. Specific IgEs to total cow's milk protein (n=75, 89.3%), and the main Cow's Milk Proteins including α-lactalbumin (n=65, 77.4%), casein (n=64, 75.3%), β-lactoglobulin (n=52, 62.7%), and bovine serum albumin (n=35, 44.9%) were detected. Specific IgE tests to β-lactoglobulin were positive in 90% of the patients with anaphylaxis. Moreover, significant relationship was found between specific IgE to β-lactoglobulin and anaphylaxis (p=0.04). Although it is presumed that α-lactalbumin and casein are the most common allergenic proteins of cow's milk, in this study there is a significant relationship between the anaphylaxis and the presence of β-lactoglobulin-specific IgE. Therefore, more precautions are recommended due to possible anaphylactic reactions in patients with a positive test history for β-lactoglobulin specific IgE. PMID:27090370

  10. Block Copolymer/DNA Vaccination Induces a Strong Allergen-Specific Local Response in a Mouse Model of House Dust Mite Asthma

    OpenAIRE

    Rolland-Debord, Camille; Lair, David; Roussey-Bihouée, Tiphaine; Hassoun, Dorian; Evrard, Justine; Cheminant, Marie-Aude; Chesné, Julie; Braza, Faouzi; Mahay, Guillaume; Portero, Vincent; Sagan, Christine; Pitard, Bruno; Magnan, Antoine

    2014-01-01

    Background Allergic asthma is caused by abnormal immunoreactivity against allergens such as house dust mites among which Dermatophagoides farinae (Der f) is a common species. Currently, immunotherapy is based on allergen administration, which has variable effect from patient to patient and may cause serious side effects, principally the sustained risk of anaphylaxis. DNA vaccination is a promising approach by triggering a specific immune response with reduced allergenicity. Objective The aim ...

  11. Acute kidney injury and rhabdomyolysis due to multiple wasp stings

    OpenAIRE

    Hemachandar Radhakrishnan

    2014-01-01

    In most patients, wasp stings cause local reactions and rarely anaphylaxis. Acute kidney injury and rhabdomyolysis are unusual complications of wasp stings. We report a case of acute kidney injury and rhabdomyolysis secondary to multiple wasp stings. A 55-year-old farmer developed multi organ dysfunction with acute kidney injury and rhabdomyolysis 3 days after he had sustained multiple wasp stings. The etiology of acute kidney injury is probably both rhabdomyolysis and acute tubular necrosis....

  12. Bioequivalence evaluation of epinephrine autoinjectors with attention to rapid delivery

    OpenAIRE

    Sclar DA

    2013-01-01

    David Alexander Sclar Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, USA Abstract: Timely and proper injection of epinephrine is critical to prevent serious consequences relating to anaphylaxis. In a recent bioavailability study comparing epinephrine delivery from the Auvi-Q™ and EpiPen® epinephrine autoinjectors, the Auvi-Q failed to meet the bioequivalence threshold when using partial area under the curve (AUC) analyses based on zero to ...

  13. Bioequivalence evaluation of epinephrine autoinjectors with attention to rapid delivery

    OpenAIRE

    Sclar, David

    2013-01-01

    David Alexander Sclar Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, USA Abstract: Timely and proper injection of epinephrine is critical to prevent serious consequences relating to anaphylaxis. In a recent bioavailability study comparing epinephrine delivery from the Auvi-Q™ and EpiPen® epinephrine autoinjectors, the Auvi-Q failed to meet the bioequivalence threshold when using partial area under the curve (AUC) analyses based on...

  14. Wirksamkeit und Verträglichkeit des H1-Antihistaminikums und PAF-Antagonisten Rupatadin bei der Behandlung der Mastozytose

    OpenAIRE

    Förtsch, Andrea

    2014-01-01

    The vast majority of adult patients with mastocytosis suffers from cutaneous or indolent systemic mastocytosis, which are characterized by symptoms resulting from mast cell mediator release, including pruritus, flushing, diarrhoea and abdominal pain, up to severe and life-threatening anaphylaxis. Therefore, many patients require continuous and on demand medication. Non-sedating antihistamines (nsAH) are the first line therapeutic strategy to treat mediator-related symptoms of mastocytosis. Ho...

  15. Systemisk mastocytose

    DEFF Research Database (Denmark)

    Andersen, Christen Lykkegaard; Kristensen, Thomas Kielsgaard; Severinsen, Marianne Tang; Møller, Michael Boe; Vestergaard, Hanne Thang; Bergmann, Olav Jonas; Hasselbalch, Hans Carl; Bjerrum, Ole Weis

    2012-01-01

    The mast cell lives a hidden life, but it is implicated in several physiological reactions. Its ability to react to different stimuli impacts a variety of conditions such as asthma, atopic dermatitis, urticaria and anaphylaxis. It is not until recent decades that the evolution of the cell has bee...... described and its fascinating biology has only recently been depicted. We here give a review of systemic mastocytosis in regards to cell biology, diagnostic approaches and clinical practice....

  16. Anaphylactic reaction to platelet transfusion as the initial symptom of an undiagnosed systemic mastocytosis: a case report and review of the literature

    OpenAIRE

    Blieden, Clifford R.; Campuzano-Zuluaga, German; Moul, Adrienne; Chapman, Jennifer R.; Cioffi-Lavina, Maureen; Offiong F Ikpatt; Byrne, Gerald E.; Vega, Francisco

    2014-01-01

    Introduction The association between anaphylactic reactions and systemic mastocytosis is well documented. However, platelet transfusion has not previously been reported as a potential elicitor of anaphylaxis in the context of systemic mastocytosis. Case presentation We describe the clinicopathological findings of a 59-year-old Latin American man who presented to the emergency room with fatigue, leukocytosis, thrombocytopenia and mild hepatosplenomegaly. He developed two separate, temporally a...

  17. Mastocytosis

    OpenAIRE

    Brockow, Knut; Metcalfe, Dean D.

    2010-01-01

    It is known that patients with mastocytosis have an increased risk of anaphylaxis. This also appears to be the case with patients with evidence of a clonal mast cell disorder resulting in the monoclonal mast cell activation syndrome (MMAS) who do not express the full mastocytosis phenotype. Most patients with mastocytosis are recognized by their characteristic skin lesions. An increased level of baseline serum mast cell tryptase is also an indicator for a possible clonal mast cell disorder in...

  18. Stingray injury.

    OpenAIRE

    Evans, R.J.; Davies, R S

    1996-01-01

    A case of stingray injury is reported. Local symptoms and signs include intense pain, oedema around the wound, erythema and petechiae. Systemic symptoms and signs include nausea and vomiting, muscle cramps, diaphoresis, syncope, headache, muscle fasciculations, and cardiac arrhythmias. Treatment aims to reverse local and systemic effects of the venom, alleviate pain, and prevent infection. Antitetanus prophylaxis is important. Treatment for anaphylaxis may be necessary.

  19. The Safety of Yellow Fever Vaccine 17D or 17DD in Children, Pregnant Women, HIV+ Individuals, and Older Persons: Systematic Review

    OpenAIRE

    Thomas, Roger E.; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler

    2012-01-01

    Yellow fever vaccine provides long-lasting immunity. Rare serious adverse events after vaccination include neurologic or viscerotropic syndromes or anaphylaxis. We conducted a systematic review of adverse events associated with yellow fever vaccination in vulnerable populations. Nine electronic bibliographic databases and reference lists of included articles were searched. Electronic databases identified 2,415 abstracts for review, and 32 abstracts were included in this review. We identified ...

  20. Bedbugs and Infectious Diseases

    OpenAIRE

    Delaunay, Pascal; Blanc, Véronique; Del Giudice, Pascal; Levy-Bencheton, Anna; Chosidow, Olivier; Marty, Pierre; Brouqui, Philippe

    2011-01-01

    Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occ...

  1. ALIMENTARY ALLERGY AND HYPERSENSIVITY TO SOYA BEAN PROTEINS

    OpenAIRE

    V. B. Gervazieva; V. V. Sveranovskaya

    2014-01-01

    Abstract. In connection with the increasing number of allergic diseases in Russia and in the world, the exogenic factor responsible for the development of food allergy in children have been discussed. The main types of alimentary allergens have been determined; their biochemical features, as well as aggravation of the food allergy clinical symptoms to the extent of anaphylaxis, have been reported. With the development of genetic engineering food products, the special attention has been paid t...

  2. RhoA and ROCK mediate histamine-induced vascular leakage and anaphylactic shock

    OpenAIRE

    Mikelis, Constantinos M.; Simaan, May; Ando, Koji; Fukuhara, Shigetomo; Sakurai, Atsuko; Amornphimoltham, Panomwat; Masedunskas, Andrius; Weigert, Roberto; Chavakis, Triantafyllos; Adams, Ralf; Offermanns, Stefan; Mochizuki, Naoki; Zheng, Yi; Gutkind, J. Silvio

    2015-01-01

    Histamine-induced vascular leakage is an integral component of many highly prevalent human diseases, including allergies, asthma, and anaphylaxis. Yet, how histamine induces the disruption of the endothelial barrier is not well defined. By using genetically modified animal models, pharmacologic inhibitors, and a synthetic biology approach, here we show that the small GTPase RhoA mediates histamine-induced vascular leakage. Histamine causes the rapid formation of focal adherens junctions, disr...

  3. New Perspectives for Use of Native and Engineered Recombinant Food Proteins in Treatment of Food Allergy

    OpenAIRE

    Nowak-Wegrzyn, Anna

    2007-01-01

    Food allergy is a serious medical problem without definitive treatment at this time. Intense research focuses on severe peanut allergy. Recombinant peanut major allergens engineered to lose IgE binding capacity mixed with E coli showed great promise in a murine model of peanut anaphylaxis. Rectal vaccine containing E.coli expressing engineered recombinant major peanut allergens Ara h 1, 2, 3 is in preparation for first human clinical trials. Oral desensitization and sublingual immunotherapy w...

  4. Food allergy:definitions, prevalence, diagnosis and therapy

    OpenAIRE

    van Ree, Ronald; Poulsen, Lars K.; Wong, Gary WK; Ballmer-Weber, Barbara K; Gao, Zhongshan; Jia, Xudong

    2015-01-01

    Food allergy is phenotypically an extremely heterogeneous group of diseases affecting multiple organs, sometimes in an isolated way, sometimes simultaneously, with the severity of reactions ranging from mild and local to full-blown anaphylaxis. Mechanistically, it is defined as a Th2-driven immune disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions. The sites of sensitization and symptoms do not necessarily overlap. Food allergy, which is the th...

  5. Bienen-/Wespengiftallergie: Wirksamkeit und Sicherheit einer Immuntherapie mit 100 µg Gift über 3 bis 5 Jahre

    OpenAIRE

    Hofmann, Bernd

    2011-01-01

    Die Bienen-/Wespengiftallergie ist auf der einen Seite eine potentiell lebensbedrohliche IgE-vermittelte Allergiekrankheit, in Deutschland neben den Nahrungsmittelallergien die häufigste Ursache für eine tödlich verlaufende Anaphylaxie. Auf der anderen Seite steht mit der Bienen-/Wespengift-spezifischen Immuntherapie (SIT) gerade für diese Allergie seit Jahrzehnten eine hochwirksame kausale Therapie zur Verfügung. Placebokontrollierte Studien mit unbehandelten Patienten sind daher aus ethisch...

  6. Chlorhexidine urticaria: A rare occurrence with a common mouthwash

    OpenAIRE

    Sharma Anamika; Chopra Harneet

    2009-01-01

    Chlorhexidine is a widely used antiseptic and disinfectant in medical and nonmedical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. The prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. This case report presents a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by skin prick test.

  7. Update on the Management of Antibiotic Allergy

    OpenAIRE

    Thong, Bernard Yu-Hor

    2010-01-01

    Drug allergy to antibiotics may occur in the form of immediate or non-immediate (delayed) hypersensitivity reactions. Immediate reactions are usually IgE-mediated whereas non-immediate hypersensitivity reactions are usually non-IgE or T-cell mediated. The clinical manifestations of antibiotic allergy may be cutaneous, organ-specific (e.g., blood dyscracias, hepatitis, interstitial nephritis), systemic (e.g., anaphylaxis, drug induced hypersensitivity syndrome) or various combinations of these...

  8. Phacolytic glaucoma-its treatment by planned extracapsular cataract extraction with posterior chamber intraocular lens implantation

    OpenAIRE

    Singh Gurdeep; Kaur Jagmeet; Mall Sanjay

    1994-01-01

    Phacolytic glaucoma has traditionally been treated with intracapsular lens extraction to avoid any anaphylaxis. Various mechanisms have been described for the rise of intraocular pressure in these cases. The present study was undertaken to evaluate the response of extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation (PC IOL) in five cases of phacolytic glaucoma that occurred between March 1989 and August 1990. A planned extracapsular cataract extractio...

  9. Anti-anaphylactic and anti-inflammatory activities of a bioactive alkaloid from the root bark of Plumeria acutifolia Poir

    Institute of Scientific and Technical Information of China (English)

    A Vijayalakshmi; V Ravichandiran; Malarkodi Velraj; S Hemalatha; G Sudharani; S Jayakumari

    2011-01-01

    Objective: To investigate the anti-anaphylactic, anti-inflammatory and membrane stabilizing properties of plumerianine (compound 1) isolated from the root bark of Plumeria acutifolia Poir. Methods: The anti-anaphylactic activity of compound 1 (10, 25 and 50 mg/kg) was studied by using models such as passive cutaneous anaphylaxis, passive paw anaphylaxis and its anti-inflammatory activity against carrageenin induced paw edema and cotton pellet granuloma in albino rats was also investigated using ketotifen and indomethacin as reference drugs. Results: A dose-dependent beneficial effect was observed on leakage of evans blue dye in skin challenged with antigen and on paw anaphylaxis induced by antiserum. The compound 1 also exhibited significant (P<0.01) inhibition of rat paw edema and granuloma tissue formation, including significant protection of RBC against the haemolytic effect of hypotonic solution, an indication of membrane-stabilizing activity. Conclusions: Anti-anaphylactic activity of compound 1 may be possibly due to inhibition of the release of various inflammatory mediators. Anti-inflammatory activity of compound may be related to the inhibition of the early phase and late phase of inflammatory events.

  10. Experimental study of antigenicity test of Sweet Bee Venom in Guinea Pigs

    Directory of Open Access Journals (Sweden)

    Byung Jun Cho

    2011-12-01

    Full Text Available Objectives: This study was performed to examine the antigenic potential of pure melittin (Sweet Bee Venom - SBV extracted from the bee venom by utilizing protein isolation method of gel filtration. Methods: All experiments were conducted at Biotoxtech (Chungwon, Korea, authorized a non-clinical studies institution, under the regulations of Good Laboratory Practice (GLP. Antigenic potential of SBV was examined by active systemic anaphylaxis (ASA and passive cutaneous anaphylaxis (PCA in guinea pigs. SBV was subcutaneously administered at 0.07 and 0.28㎎/㎏and also as a suspension with adjuvant (Freund's complete adjuvant: FCA. Ovalbumin (OVA as a suspension with adjuvant was used to induce positive control response (5㎎/㎖- FCA. Results: 1. In the ASA test, experimental groups showed some symptoms of anaphylaxis like piloerection, hyperpnea and staggering gait. 2. In the PCA test, low dosage group did not show any antibody responses, whereas high dosage group showed positive responses. 3. In the weight measurement and clinical observation, experimental groups didn't show any significant changes compared with control group. 4. In the autopsy of body, the abnormalities of lung were detected in the corpse. This means that the cause of death may induced anaphylactic shock. Conclusions: Above findings suggested that SBV had antigenic potential in guinea pig. Further studies on the subject should be conducted to yield more concrete evidences.

  11. Exploring Low-Income Families’ Financial Barriers to Food Allergy Management and Treatment

    Directory of Open Access Journals (Sweden)

    Leia M. Minaker

    2014-01-01

    Full Text Available Objectives. Low-income families may face financial barriers to management and treatment of chronic illnesses. No studies have explored how low-income individuals and families with anaphylactic food allergies cope with financial barriers to anaphylaxis management and/or treatment. This study explores qualitatively assessed direct, indirect, and intangible costs of anaphylaxis management and treatment faced by low-income families. Methods. In-depth, semistructured interviews with 23 participants were conducted to gain insight into income-related barriers to managing and treating anaphylactic food allergies. Results. Perceived direct costs included the cost of allergen-free foods and allergy medication and costs incurred as a result of misinformation about social support programs. Perceived indirect costs included those associated with lack of continuity of health care. Perceived intangible costs included the stress related to the difficulty of obtaining allergen-free foods at the food bank and feeling unsafe at discount grocery stores. These perceived costs represented barriers that were perceived as especially salient for the working poor, immigrants, youth living in poverty, and food bank users. Discussion. Low-income families report significant financial barriers to food allergy management and anaphylaxis preparedness. Clinicians, advocacy groups, and EAI manufacturers all have a role to play in ensuring equitable access to medication for low-income individuals with allergies.

  12. The more allergens an atopic patient is exposed to, the easier and quicker anaphylactic shock and Kounis syndrome appear: Clinical and therapeutic paradoxes.

    Science.gov (United States)

    Kounis, N G; Mazarakis, A; Almpanis, G; Gkouias, K; Kounis, G N; Tsigkas, G

    2014-07-01

    Kounis syndrome is a condition that combines allergic, hypersensitivity, anaphylactic or anaphylactoid reactions with acute coronary syndromes including vasospastic angina, acute myocardial infarction and stent thrombosis. This syndrome is a ubiquitous disease affecting patients of any age, involving numerous and continuously increasing causes, with broadening clinical manifestations and covering a wide spectrum of mast cell activation disorders. Drugs, environmental exposures and various conditions are the main offenders. Clinical and therapeutic paradoxes concerning Kounis syndrome therapy, pathophysiology, clinical course and causality have been encountered during its clinical course. Drugs that counteract allergy, such as H2-antihistamines, can induce allergy and Kounis syndrome. The more drugs an atopic patient is exposed to, the easier and quicker anaphylaxis and Kounis syndrome can occur. Every anesthetized patient is under the risk of multiple drugs and substances that can induce anaphylactic reaction and Kounis syndrome. The heart and the coronary arteries seem to be the primary target in severe anaphylaxis manifesting as Kounis syndrome. Commercially available adrenaline saves lives in anaphylaxis but it contains as preservative sodium metabisulfite and should be avoided in the sulfite allergic patients. Thus, careful patient past history and consideration for drug side effects and allergy should be taken into account before use. The decision to prescribe a drug where there is a history of previous adverse reactions requires careful assessment of the risks and potential benefits. PMID:25097390

  13. Can we identify patients at risk of life-threatening allergic reactions to food?

    Science.gov (United States)

    Turner, P J; Baumert, J L; Beyer, K; Boyle, R J; Chan, C-H; Clark, A T; Crevel, R W R; DunnGalvin, A; Fernández-Rivas, M; Gowland, M H; Grabenhenrich, L; Hardy, S; Houben, G F; O'B Hourihane, J; Muraro, A; Poulsen, L K; Pyrz, K; Remington, B C; Schnadt, S; van Ree, R; Venter, C; Worm, M; Mills, E N C; Roberts, G; Ballmer-Weber, B K

    2016-09-01

    Anaphylaxis has been defined as a 'severe, life-threatening generalized or systemic hypersensitivity reaction'. However, data indicate that the vast majority of food-triggered anaphylactic reactions are not life-threatening. Nonetheless, severe life-threatening reactions do occur and are unpredictable. We discuss the concepts surrounding perceptions of severe, life-threatening allergic reactions to food by different stakeholders, with particular reference to the inclusion of clinical severity as a factor in allergy and allergen risk management. We review the evidence regarding factors that might be used to identify those at most risk of severe allergic reactions to food, and the consequences of misinformation in this regard. For example, a significant proportion of food-allergic children also have asthma, yet almost none will experience a fatal food-allergic reaction; asthma is not, in itself, a strong predictor for fatal anaphylaxis. The relationship between dose of allergen exposure and symptom severity is unclear. While dose appears to be a risk factor in at least a subgroup of patients, studies report that individuals with prior anaphylaxis do not have a lower eliciting dose than those reporting previous mild reactions. It is therefore important to consider severity and sensitivity as separate factors, as a highly sensitive individual will not necessarily experience severe symptoms during an allergic reaction. We identify the knowledge gaps that need to be addressed to improve our ability to better identify those most at risk of severe food-induced allergic reactions. PMID:27138061

  14. Tyrosol Suppresses Allergic Inflammation by Inhibiting the Activation of Phosphoinositide 3-Kinase in Mast Cells.

    Directory of Open Access Journals (Sweden)

    In-Gyu Je

    Full Text Available Allergic diseases such as atopic dermatitis, rhinitis, asthma, and anaphylaxis are attractive research areas. Tyrosol (2-(4-hydroxyphenylethanol is a polyphenolic compound with diverse biological activities. In this study, we investigated whether tyrosol has anti-allergic inflammatory effects. Ovalbumin-induced active systemic anaphylaxis and immunoglobulin E-mediated passive cutaneous anaphylaxis models were used for the immediate-type allergic responses. Oral administration of tyrosol reduced the allergic symptoms of hypothermia and pigmentation in both animal models. Mast cells that secrete allergic mediators are key regulators on allergic inflammation. Tyrosol dose-dependently decreased mast cell degranulation and expression of inflammatory cytokines. Intracellular calcium levels and activation of inhibitor of κB kinase (IKK regulate cytokine expression and degranulation. Tyrosol blocked calcium influx and phosphorylation of the IKK complex. To define the molecular target for tyrosol, various signaling proteins involved in mast cell activation such as Lyn, Syk, phosphoinositide 3-kinase (PI3K, and Akt were examined. Our results showed that PI3K could be a molecular target for tyrosol in mast cells. Taken together, these findings indicated that tyrosol has anti-allergic inflammatory effects by inhibiting the degranulation of mast cells and expression of inflammatory cytokines; these effects are mediated via PI3K. Therefore, we expect tyrosol become a potential therapeutic candidate for allergic inflammatory disorders.

  15. Wilderness Medical Society practice guidelines for the use of epinephrine in outdoor education and wilderness settings: 2014 update.

    Science.gov (United States)

    Gaudio, Flavio G; Lemery, Jay; Johnson, David E

    2014-12-01

    The Epinephrine Roundtable took place on July 27, 2008, during the 25th Annual Meeting of the Wilderness Medical Society (WMS) in Snowmass, CO. The WMS convened this roundtable to explore areas of consensus and uncertainty in the field treatment of anaphylaxis. Panelists were selected on the basis of their relevant academic or professional experience. There is a paucity of data that address the treatment of anaphylaxis in the wilderness. Anaphylaxis is a rare disease, with a sudden onset and drastic course that does not lend itself to study in randomized, controlled trials. Therefore, the panel endorsed the following position based on the limited available evidence and review of published articles, as well as expert consensus. The position represents the consensus of the panelists and is endorsed by the WMS. In 2014, the authors reviewed relevant articles published since the Epinephrine Roundtable. The following is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2010;21(4):185-187. PMID:25498258

  16. Inhibitory effect of 1,2,4,5-tetramethoxybenzene on mast cell-mediated allergic inflammation through suppression of IκB kinase complex

    International Nuclear Information System (INIS)

    As the importance of allergic disorders such as atopic dermatitis and allergic asthma, research on potential drug candidates becomes more necessary. Mast cells play an important role as initiators of allergic responses through the release of histamine; therefore, they should be the target of pharmaceutical development for the management of allergic inflammation. In our previous study, anti-allergic effect of extracts of Amomum xanthioides was demonstrated. To further investigate improved candidates, 1,2,4,5-tetramethoxybenzene (TMB) was isolated from methanol extracts of A. xanthioides. TMB dose-dependently attenuated the degranulation of mast cells without cytotoxicity by inhibiting calcium influx. TMB decreased the expression of pro-inflammatory cytokines such as tumor necrosis factor-α and interleukin (IL)-4 at both the transcriptional and translational levels. Increased expression of these cytokines was caused by translocation of nuclear factor-κB into the nucleus, and it was hindered by suppressing activation of IκB kinase complex. To confirm the effect of TMB in vivo, the ovalbumin (OVA)-induced active systemic anaphylaxis (ASA) and IgE-mediated passive cutaneous anaphylaxis (PCA) models were used. In the ASA model, hypothermia was decreased by oral administration of TMB, which attenuated serum histamine, OVA-specific IgE, and IL-4 levels. Increased pigmentation of Evans blue was reduced by TMB in a dose-dependent manner in the PCA model. Our results suggest that TMB is a possible therapeutic candidate for allergic inflammatory diseases that acts through the inhibition of mast cell degranulation and expression of pro-inflammatory cytokines. - Highlights: • TMB reduced the degranulation of mast cells. • TMB inhibited the production of pro-inflammatory cytokines. • TMB suppressed both active and passive anaphylaxis. • Anti-allergic inflammatory effects of TMB might be due to the blocking IKK complex. • TMB might be a candidate for the treatment of

  17. Inhibitory effect of 1,2,4,5-tetramethoxybenzene on mast cell-mediated allergic inflammation through suppression of IκB kinase complex

    Energy Technology Data Exchange (ETDEWEB)

    Je, In-Gyu [Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu 700-422 (Korea, Republic of); Choi, Hyun Gyu [College of Pharmacy, Yeungnam University, Gyeongsan 712-749 (Korea, Republic of); Kim, Hui-Hun; Lee, Soyoung; Choi, Jin Kyeong [Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu 700-422 (Korea, Republic of); Kim, Sung-Wan; Kim, Duk-Sil [Department of Thoracic and Cardiovascular Surgery, CHA Gumi Medical Center, CHA University, Gumi 730-040 (Korea, Republic of); Kwon, Taeg Kyu [Department of Immunology, School of Medicine, Keimyung University, Daegu 704-701 (Korea, Republic of); Shin, Tae-Yong [College of Pharmacy, Woosuk University, Jeonju 565-701 (Korea, Republic of); Park, Pil-Hoon [College of Pharmacy, Yeungnam University, Gyeongsan 712-749 (Korea, Republic of); Khang, Dongwoo, E-mail: dkhang@gachon.ac.kr [Department of Molecular Medicine, School of Medicine, Gachon University, Incheon 406-840 (Korea, Republic of); Kim, Sang-Hyun, E-mail: shkim72@knu.ac.kr [Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu 700-422 (Korea, Republic of)

    2015-09-01

    As the importance of allergic disorders such as atopic dermatitis and allergic asthma, research on potential drug candidates becomes more necessary. Mast cells play an important role as initiators of allergic responses through the release of histamine; therefore, they should be the target of pharmaceutical development for the management of allergic inflammation. In our previous study, anti-allergic effect of extracts of Amomum xanthioides was demonstrated. To further investigate improved candidates, 1,2,4,5-tetramethoxybenzene (TMB) was isolated from methanol extracts of A. xanthioides. TMB dose-dependently attenuated the degranulation of mast cells without cytotoxicity by inhibiting calcium influx. TMB decreased the expression of pro-inflammatory cytokines such as tumor necrosis factor-α and interleukin (IL)-4 at both the transcriptional and translational levels. Increased expression of these cytokines was caused by translocation of nuclear factor-κB into the nucleus, and it was hindered by suppressing activation of IκB kinase complex. To confirm the effect of TMB in vivo, the ovalbumin (OVA)-induced active systemic anaphylaxis (ASA) and IgE-mediated passive cutaneous anaphylaxis (PCA) models were used. In the ASA model, hypothermia was decreased by oral administration of TMB, which attenuated serum histamine, OVA-specific IgE, and IL-4 levels. Increased pigmentation of Evans blue was reduced by TMB in a dose-dependent manner in the PCA model. Our results suggest that TMB is a possible therapeutic candidate for allergic inflammatory diseases that acts through the inhibition of mast cell degranulation and expression of pro-inflammatory cytokines. - Highlights: • TMB reduced the degranulation of mast cells. • TMB inhibited the production of pro-inflammatory cytokines. • TMB suppressed both active and passive anaphylaxis. • Anti-allergic inflammatory effects of TMB might be due to the blocking IKK complex. • TMB might be a candidate for the treatment of

  18. [Academician Vladas Lasas -- distinguished Lithuanian scientist, organizer and educator].

    Science.gov (United States)

    Padegimas, Bernardas; Abraitis, Romualdas

    2002-01-01

    The material of this publication is dedicated to the memory of Professor Vladas Lasas, honored scientist of Lithuania, member of Lithuanian Academy of Sciences and corresponding member of the Academy of Medicine of the USSR. V. Lasas was born on January 13th, 1892, on a farmstead in Rokiskis region, Lithuania. He died on January 2nd, 1966 in Kaunas. V. Lasas studied medicine at the Faculty of Medicine of Tartu (Dorpat) University and graduated from it in 1918. In 1921 he was invited to deliver lectures on physiology at the newly organized Higher Courses in Kaunas. During 1920-1924 he attended higher educational establishments of Prague, Berlin, Lausanne and Paris. In 1924 V. Lasas worked on probation in Lausanne under supervision of famous scientist M. Arthus, the founder of experimental allergy--anaphylaxis, in the field of experimental anaphylaxis, desensibilization, enteral sensibilization and resorption of native albumins, transfer of allergic state from mother to fetus, the role of interoceptors and biologically active substances in the formation and development of anaphylaxis. Over 40 scientific papers were published and 12 doctoral these were maintained, dealing with these problems. From 1924 to 1940 and from 1944 to 1946 V. Lasas acted as dean of the Faculty of Medicine at Kaunas University. During this period he displayed great organizational talent, and on his initiative three basic clinical buildings were built for the Faculty of Medicine. In 1946 V. Lasas was elected as academician and appointed as secretary-in-charge of natural mathematical and applied science of the Academy of Sciences of Lithuania. V. Lasas was the founder and longstanding chairman of the Lithuanian Physiological Society. Alone and with coauthors he has published 16 original textbooks. The list of his bibliography accounts to 229 publications. PMID:12474745

  19. Blockade of peanut allergy with a novel Ara h 2–Fcγ fusion protein in mice

    Science.gov (United States)

    Liu, Yu; Sun, Yongtao; Chang, Lee-Jah; Li, Newton; Li, Huabin; Yu, Yanni; Bryce, Paul J.; Grammer, Leslie C.; Schleimer, Robert P.; Zhu, Daocheng

    2013-01-01

    Background Conventional immunotherapy for peanut allergy using crude peanut extracts is not recommended because of the unacceptably high risk of anaphylaxis. Allergen-specific immunotherapy is not currently undertaken for peanut allergy. Objectives The objective of this study was to develop a novel peanut-human fusion protein to block peanut-induced anaphylaxis. Methods We genetically designed and expressed a novel plant-human fusion protein composed of the major peanut allergen Ara h 2 and human IgG Fcγ1. We tested the Ara h 2–Fcγ fusion protein (AHG2)’s function in purified human basophils. Transgenic mice expressing human FcεRIα and a murine peanut allergy model were used. Results AHG2 inhibited histamine release induced by whole peanut extract (WPE) from basophils of patients with peanut allergy, whereas the fusion protein itself did not induce mediator release. AHG2 inhibited the WPE-induced, peanut-specific, IgE-mediated passive cutaneous anaphylaxis in hFcεRIα transgenic mice. AHG2 also significantly inhibited acute anaphylactic reactivity, including the prototypical decrease in body temperature in WPE-sensitized mice challenged with crude peanut extract. Histologic evaluation of the airways showed that AHG2 decreased peanut-induced inflammation, whereas the fusion protein itself did not induce airway inflammation in peanut-sensitized mice. AHG2 did not exert an inhibitory effect in mice lacking FcγRII. Conclusion AHG2 inhibited peanut-specific IgE-mediated allergic reactions in vitro and in vivo. Linking specific peanut allergen to Fcγ can provide a new approach for the allergen immunotherapy of peanut allergy. PMID:23199607

  20. Omalizumab, an anti-immunoglobulin E antibody: state of the art

    Directory of Open Access Journals (Sweden)

    Incorvaia C

    2014-02-01

    Full Text Available Cristoforo Incorvaia,1 Marina Mauro,2 Marina Russello,2 Chiara Formigoni,3 Gian Galeazzo Riario-Sforza,1 Erminia Ridolo41Allergy/Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento Hospital, Milan, Italy; 2Allergy Unit, 3Scientific Library, Sant'Anna Hospital, Como, Italy; 4Department of Clinical and Experimental Medicine, University of Parma, Parma, ItalyAbstract: A large number of trials show that the anti-immunoglobulin (Ig E antibody omalizumab is very effective in patients with severe allergic asthma. This is acknowledged in consensus documents. The drug also has a good safety profile and a pharmacoeconomic advantage due to a reduction in the number of hospitalizations for asthma attacks. In recent years, some studies have shown that omalizumab is effective also in nonallergic asthma. Effects on the complex signaling mechanisms leading to activation of effector cells and to mediator release may account for this outcome. Indeed, omalizumab has been reported to be effective in a number of IgE-mediated and non-IgE-mediated disorders. Concerning the former, clinical efficacy has been observed in rhinitis, allergic bronchopulmonary aspergillosis, latex allergy, atopic dermatitis, allergic urticaria, and anaphylaxis. In addition, omalizumab has been demonstrated to be able to prevent systemic reactions to allergen immunotherapy, thus enabling completion of treatment in patients who otherwise would have to stop it. Concerning non-IgE-mediated disorders, omalizumab has been reported to be effective in nasal polyposis, autoimmune urticaria, chronic idiopathic urticaria, physical urticaria, idiopathic angioedema, and mastocytosis. Current indications for treatment with omalizumab are confined to severe allergic asthma. Consequently, any other prescription can only be off-label. However, it is reasonable to expect that the use of omalizumab will be approved for particularly important indications, such as anaphylaxis, in the near future

  1. The forgotten successes and sacrifices of Charles Kellaway, director of the Walter and Eliza Hall Institute, 1923-1944.

    Science.gov (United States)

    Hobbins, Peter G; Winkel, Kenneth D

    Charles Halliley Kellaway (1889-1952) was one of the first Australians to make a full-time career of medical research. He built his scientific reputation on studies of snake venoms and anaphylaxis. Under Kellaway's directorship, the Walter and Eliza Hall Institute gained worldwide acclaim, and he played a critical role in its success between the world wars. His administrative and financial strategies in the era before the National Health and Medical Research Council (NHMRC) helped local medical research weather the Depression and gain a strong foothold by World War II. PMID:18072902

  2. Life-threatening ACE inhibitor-induced angio-oedema successfully treated with icatibant

    DEFF Research Database (Denmark)

    Ostenfeld, Sarah; Bygum, Anette; Rasmussen, Eva Rye

    2015-01-01

    We present a case of a 75-year-old woman treated with an ACE inhibitor, who presented with angio-oedema of the tongue and had difficulty speaking. No symptoms of anaphylaxis or urticaria were present. The patient was treated intravenously with antihistamine and glucocorticoid in combination....... Although the angio-oedema was potentially life threatening, the patient avoided intubation and mechanical ventilation. ACE inhibitor-induced angio-oedema is most likely caused by an accumulation of bradykinin and substance P. Consequently, a bradykinin receptor antagonist is the rational treatment...

  3. THE FACTS ABOUT PENICILLIN ALLERGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    Sanjib Bhattacharya

    2010-03-01

    Full Text Available Hypersensitivity reactions are the major problem in the use of penicillins. Truepenicillin allergy is rare with the estimated frequency of anaphylaxis at 1-5 per 10 000cases of penicillin therapy. Hypersensitivity is however, its most important adversereaction resulting in nausea, vomiting, pruritus, urticaria, wheezing, laryngeal oedemaand ultimately, cardiovascular collapse. Identification of patients who erroneously carryß-lactam allergy leads to improved utilization of antibiotics and slows the spread ofmultiple drug-resistant bacteria. Cross-reactivity between penicillin and second and thirdgeneration cephalosporin is low and may be lower than the cross-reactivity betweenpenicillin and unrelated antibiotics.

  4. The facts about penicillin allergy: A review

    Directory of Open Access Journals (Sweden)

    Sanjib Bhattacharya

    2010-01-01

    Full Text Available Hypersensitivity reactions are the major problem in the use of penicillins. True penicillin allergy is rare with the estimated frequency of anaphylaxis at 1-5 per 10 000 cases of penicillin therapy. Hypersensitivity is however, its most important adverse reaction resulting in nausea, vomiting, pruritus, urticaria, wheezing, laryngeal oedema and ultimately, cardiovascular collapse. Identification of patients who erroneously carry β-lactam allergy leads to improved utilization of antibiotics and slows the spread of multiple drug-resistant bacteria. Cross-reactivity between penicillin and second and third generation cephalosporin is low and may be lower than the cross-reactivity between penicillin and unrelated antibiotics.

  5. Retrosternal Mass: An Interesting Allergic Reaction to Intravenous Thrombolytic Therapy for Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Masoud Mehrpour

    2013-07-01

    Full Text Available Stroke is an important cause of disability and death worldwide, with the majority of strokes occurring in older people. Thrombolysis with recombinant tissue plasminogen activator (r-TPA is the approved treatment for acute ischemic stroke. A major concern of physicians, who treat acute ischemic stroke with recombinant tissue plasminogen activator (r-TPA, is the risk of intracerebral hemorrhage. However, other adverse reactions, including anaphylaxis and angioedema, can also occur. Here we report an interesting soft tissue reaction to intravenous r-TPA in an 80 year-old male who was treated for acute ischemic stroke.

  6. Retrosternal mass: An interesting allergic reaction to intravenous thrombolytic therapy for acute ischemic stroke.

    Science.gov (United States)

    Mehrpour, Masoud; Motamed, Mohammad Reza; Aghaei, Mahboubeh; Badi, Zahra

    2013-01-01

    Stroke is an important cause of disability and death worldwide, with the majority of strokes occurring in older people. Thrombolysis with recombinant tissue plasminogen activator (r-TPA) is the approved treatment for acute ischemic stroke. A major concern of physicians, who treat acute ischemic stroke with recombinant tissue plasminogen activator (r-TPA,) is the risk of intracerebral hemorrhage. However, other adverse reactions, including anaphylaxis and angioedema, can also occur. Here we report an interesting soft tissue reaction to intravenous r-TPA in an 80 year-old male who was treated for acute ischemic stroke. PMID:24250917

  7. Interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms in persistent IgE-mediated cow's milk allergy

    OpenAIRE

    Cristina Miuki Abe Jacob; Antonio Carlos Pastorino; Thelma Suely Okay; Ana Paula BM Castro; Gushken, Andrea Keiko F.; Letícia Aki Watanabe; Vanessa CZ Frucchi; Léa Campos Oliveira

    2013-01-01

    OBJECTIVES: The aim of this cross-sectional study was to evaluate whether interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms were associated with persistent IgE-mediated cow's milk allergy in 50 Brazilian children. The diagnostic criteria were anaphylaxis triggered by cow's milk or a positive double-blind, placebo-controlled food challenge. Tolerance was defined as the absence of a clinical response to a double-blind, placebo-controlled food challenge or cow's ...

  8. Allergy to goat/sheep’s milk with good tolerance to cow’s milk but not to cow’s milk cheese: identification of 1-105 peptide from κ-casein as the molecular basis of reactivity toward cow’s milk cheese for two patients

    OpenAIRE

    Beaumesnil, Marion; Denery-Papini, Sandra; Drouet, Martine; Gaudin, Jean-Charles

    2013-01-01

    In Europe, a new population of patients developing anaphylaxis to goat’s/sheep’s milk associated to tolerance to cow’s milk has recently appeared. Nevertheless, among these patients, some show allergic reactions to cow’s milk cheeses but these reactions are less severe than those directed against goat’s/sheep’s milk. The objective of the study was to the molecular determinants of the reactivity of this category of patients toward goat’s/sheep’s milk and cow’s milk cheese. Western blots with e...

  9. Baked Milk and Egg Diets for Milk and Egg Allergy Management.

    Science.gov (United States)

    Leonard, Stephanie A; Nowak-Węgrzyn, Anna H

    2016-02-01

    In baked form, cow's milk and egg are less allergenic and are tolerated by most milk- and egg-allergic children. Not only may including baked milk and egg in the diets of children who are tolerant improve nutrition and promote more social inclusion but there is also evidence that inclusion may accelerate the resolution of unheated milk and egg allergy. Further research is needed on biomarkers that can predict baked milk or egg reactivity; however, data suggest casein- and ovomucoid-specific immunoglobulin E levels may be useful. Physician-supervised introduction of baked milk and egg is recommended because anaphylaxis has occurred. PMID:26617232

  10. Liver hepatotoxicity associated with pantoprazole: a rare case report.

    Science.gov (United States)

    Aslan, Mehmet; Celik, Yilmaz; Karadas, Sevdegul; Olmez, Sehmus; Cifci, Adem

    2014-06-01

    Hepatotoxicity may occasionally develop over the course of treatment with proton pump inhibitors (PPIs). Although skin reactions, interstitial nephritis, pancytopenia, anaphylaxis, and generalized edema have been reported to be associated with PPIs, hepatotoxicity associated with oral pantoprazole is very rare. In this report, we present a case of hepatotoxicity in a 35-year-old man who received pantoprazole (40 mg/day) for acute gastritis. One week after discontinuation of pantoprazole, his liver function began to improve, and the patient gradually fully recovered. Although this toxicity occurs only infrequently, pantoprazole should be considered as a rare hepatotoxic agent in the literature. PMID:24652021

  11. Food allergies.

    LENUS (Irish Health Repository)

    O'Leary, Paula F G

    2012-02-03

    Adverse reactions to foods are commonly implicated in the causation of ill health. However, foreign antigens, including food proteins and commensal microbes encountered in the gastrointestinal tract, are usually well tolerated. True food allergies, implying immune-mediated adverse responses to food antigens, do exist, however, and are especially common in infants and young children. Allergic reactions to food manifest clinically in a variety of presentations involving the gastrointestinal, cutaneous, and respiratory systems and in generalized reactions such as anaphylaxis. Both IgE-mediated and non-IgE-mediated immune mechanisms are recognized. Important advances in the clinical features underlying specific food hypersensitivity disorders are reviewed.

  12. Cardiac arrest in intensive care unit: Case report and future recommendations

    Directory of Open Access Journals (Sweden)

    Mohammad A

    2010-01-01

    Full Text Available Initiation of hemofiltration in a patient in septic shock can cause hemodynamic compromise potentially leading to cardiac arrest. We propose that the standard ′4Hs and 4Ts′ approach to the differential diagnosis of a cardiac arrest should be supplemented in critically ill patients with anaphylaxis and human and technical errors involving drug administration (the 5 th H and T. To illustrate the point, we report a case where norepinephrine infused through a central venous catheter (CVC was being removed by the central venovenous hemofiltration (CVVH catheter causing the hemodynamic instability. CVVH has this potential of interfering with the systemic availability of drugs infused via a closely located CVC.

  13. Fatal anaphylactoid reaction associated with heparin-induced thrombocytopenia.

    Science.gov (United States)

    Singla, Atul; Amini, Mohammad R; Alpert, Martin A; Gornik, Heather L

    2013-06-01

    Acute systemic (anaphylaxis and anaphylactoid) reactions have been well described in patients with heparin-induced thrombocytopenia (HIT). Both necrotizing and non-necrotizing skin lesions at heparin injection sites have been reported and may occur in 10-20% of patients with HIT. We report herein a patient treated with subcutaneous enoxaparin sodium who developed non-necrotizing erythematous skin lesions at enoxaparin sodium injection sites. A subsequent intravenous bolus of unfractionated heparin produced a fatal anaphylactoid reaction. This suggests that caution should be exercised in the administration of intravenous heparin to patients with non-necrotizing erythematous skin lesions at prior heparin injection sites. PMID:23579400

  14. Inhibition of Immunoglobulin E signals during allergen ingestion leads to reversal of established food allergy and induction of regulatory T cells

    OpenAIRE

    Burton, Oliver T.; Noval-Rivas, Magali; Zhou, Joseph S.; Logsdon, Stephanie L.; Darling, Alanna R.; Koleoglou, Kyle J.; Roers, Axel; Houshyar, Hani; Crackower, Michael A.; Chatila, Talal A; Oettgen, Hans C.

    2014-01-01

    Immunoglobulin E (IgE) antibodies are known for triggering immediate hypersensitivity reactions such as food anaphylaxis. In this study, we tested whether they might additionally function to amplify nascent antibody and T helper 2 (Th2) cell-mediated responses to ingested proteins and if blocking IgE would modify sensitization. Using mice harboring a disinhibited form of the IL-4 receptor, we developed an adjuvant-free model of peanut allergy. Mast cells and IgE were required for induction of...

  15. TRALI - A Less Commonly Known Complication of Transfusion

    Directory of Open Access Journals (Sweden)

    Pradeep Bhatia

    2008-01-01

    Full Text Available Transfusion Related Acute Lung Injury (TRALI has been recently recognized as one of the serious risks associated with transfusion, presenting as respiratory distress during or after transfusion of blood products. The symptoms can be confused with other transfusion-related events such as anaphylaxis, haemolysis, or circulatory overload, or with non-transfusion-related co-morbidities such as cardiac failure. TRALI varies in severity, and mortality is not uncommon. TRALI is now the leading cause of transfusion-associated mortality, even though it is probably still under-diagnosed and under-reported due to lack of awareness of its entity.

  16. Trichinella pseudospiralis larvae express natural killer (NK) cell-associated asialo-GM1 antigen and stimulate pulmonary NK activity.

    OpenAIRE

    Niederkorn, J. Y.; Stewart, G L; Ghazizadeh, S; Mayhew, E.; Ross, J; Fischer, B.

    1988-01-01

    Natural killer (NK) cell function was evaluated in mice infected with either Trichinella pseudospiralis or T. spiralis larvae. T. pseudospiralis-infected mice consistently demonstrated augmented pulmonary NK cell-mediated clearance of YAC-1 tumor cells in vivo but failed to display enhanced splenic NK cell-mediated lysis of the same tumor cells in vitro. Attempts to alter NK cell function in vivo by the injection of anti-asialo-GM1 antibody resulted in anaphylaxis and death of the hosts infec...

  17. Variation in examination and treatment offers to patients with allergic diseases in general practice

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Jarbøl, Dorte Ejg; Munck, Anders Peter

    2010-01-01

    general practice to patients with allergic diseases, and to evaluate guideline compliance with respect to anaphylaxis emergency treatment kits. DESIGN: A questionnaire-based survey among general practitioners (GPs) about examination and treatment procedures offered in the surgery to patients with allergic...... recommendations for preparedness for anaphylactic shock in connection with allergy vaccine therapy were not fully implemented. CONCLUSION: General practice is substantially involved in the examination and treatment of patients with allergic diseases. There is room for further involvement of staff members and...

  18. Treatments for food allergy: how close are we?

    Science.gov (United States)

    Wang, Julie; Sampson, Hugh A

    2012-12-01

    Food allergy continues to be a challenging health problem, with prevalence continuing to increase and anaphylaxis still an unpredictable possibility. While improvements in diagnosis are more accurately identifying affected individuals, treatment options remain limited. The cornerstone of treatment relies on strict avoidance of the offending allergens and education regarding management of allergic reactions. Despite vigilance in avoidance, accidental ingestions and reactions continue to occur. With recent advances in the understanding of humoral and cellular immune responses in food allergy and mechanisms of tolerance, several therapeutic strategies for food allergies are currently being investigated with the hopes of providing a cure or long-term remission from food allergy. PMID:22434517

  19. Food allergy therapy: is a cure within reach?

    Science.gov (United States)

    Nowak-Węgrzyn, Anna; Muraro, Antonella

    2011-04-01

    There is an unmet medical need for an effective food allergy therapy; thus, development of therapeutic interventions for food allergy is a top research priority. The food allergen-nonspecific therapies for food-induced anaphylaxis include monoclonal anti-IgE antibodies and Chinese herbs. The food allergen-specific therapies include oral, sublingual, and epicutaneous immunotherapy with native food allergens and mutated recombinant proteins. Diet containing heated milk and egg may represent an alternative approach to oral immunomodulation. Oral food immunotherapy remains an investigational treatment to be further studied before advancing into clinical practice. PMID:21453816

  20. MMR vaccination of children with egg allergy is safe

    DEFF Research Database (Denmark)

    Andersen, Dorthe Vestergård; Jørgensen, Inger Merete

    2013-01-01

    Measles, mumps and rubella (MMR) vaccination is part of the Danish Childhood Vaccination Programme. It is known that children may react with anaphylaxis to MMR vaccines containing traces of egg protein. In Denmark, national clinical guidelines recommend that children with egg allergy be referred to...... vaccination at a paediatric ward despite changed recommendations in other countries. The purpose of this study was to determine whether children with egg allergy presented with anaphylactic/allergic reactions to MMR vaccination and to discuss whether Danish recommendations should be upheld....

  1. Pharmacological targeting of the KIT growth factor receptor: a therapeutic consideration for mast cell disorders

    DEFF Research Database (Denmark)

    Jensen, Bettina Margrethe; Akin, C; Gilfillan, A M

    2008-01-01

    activated, accumulation of mast cells in tissues results in mastocytosis. Such dysregulated KIT activation is a manifestation of specific activating point mutations within KIT, with the human D816V mutation considered as a hallmark of human systemic mastocytosis. A number of other activating mutations in...... within these tissues, mast cell activation by antigen may also be amplified by SCF. Thus, KIT inhibitors may have potential application in multiple conditions linked to mast cells including systemic mastocytosis, anaphylaxis, and asthma. In this review, we discuss the role of KIT in the context of mast...

  2. BiSpectral Index (BIS monitoring may detect critical hypotension before automated non-invasive blood pressure (NIBP measurement during general anaesthesia; a case report. [v1; ref status: indexed, http://f1000r.es/2oi

    Directory of Open Access Journals (Sweden)

    Matthew M. J. Smith

    2014-01-01

    Full Text Available A patient undergoing general anaesthesia for neurosurgery exhibited an unexpected sudden decrease in the BiSpectral Index (BIS value to near-zero. This prompted the detection of profound hypotension using non-invasive blood pressure (NIBP measurement and expedited urgent assessment and treatment, with the patient making a full recovery. Widely regarded as a ‘depth of anaesthesia’ monitor, this case demonstrates the potential extra clinical benefit BIS may have in the detection of critical incidents such as anaphylaxis during general anaesthesia.

  3. Caracterização da hipersensibilidade a luvas de látex em profissionais da odontologia - DOI: 10.4025/actascihealthsci.v29i1.103 Rubber latex gloves hypersensitivities in dental workers - DOI: 10.4025/actascihealthsci.v29i1.103

    Directory of Open Access Journals (Sweden)

    Ana Maria Sell

    2007-12-01

    Full Text Available As reações alérgicas ao látex vêm aumentando em profissionais da saúde e se manifestam como um incômodo local ou sintomatologia sistêmica. Para conhecer a freqüência das manifestações alérgicas nos usuários de luvas de látex foi realizada busca entre os profissionais da odontologia via aplicação de questionários. Foram aplicados 450 questionários e, dentre os respondedores (140, 19% relataram manifestar reações locais ao contato com as luvas de látex e 5% reações sistêmicas a outros produtos de látex. Cerca de 2,5% declararam dermatite de contato e reações sistêmicas (anafiláticas, 1,5% apenas dermatite de contato e 1% sintomas de anafilaxia ao uso das luvas. Vinte por cento dos profissionais atenderam pacientes com alergia ao látex e 29% declararam questionar, durante a anamnese, a respeito de alergia ao látex. As reações alérgicas a luvas de látex foram freqüentes e é objeto de preocupação entre os profissionais da odontologia.Allergic reactions to natural rubber latex have increased in dental practice affecting both the professional and the patients. Allergic reactions may range from skin disease to asthma and anaphylaxis. This study aimed at determining the incidence of latex gloves allergy among dental care workers. 450 allergy questionnaires were used to collect information on latex gloves reactions and 140 dental works answered them. Latex gloves reaction occurred in 19% of them and 5% reported allergic reactions to other latex products. 2.5% reported symptoms suggesting contact dermatitis and anaphylaxis hypersensitivities, 1.5% contact dermatitis, and 1% reported anaphylaxis symptoms when wearing them. 20% of them had patients who presented symptoms suggestive of anaphylaxis hypersensitivity to rubber gloves latex. Our study confirms that rubber latex gloves reactions are frequent among dental care workers, and dentists must be aware of the latex allergy in dental practice.

  4. Caracterização da hipersensibilidade a luvas de látex em profissionais da odontologia = Rubber latex gloves hypersensitivities in dental workers

    Directory of Open Access Journals (Sweden)

    Flávia Sukekava

    2007-01-01

    Full Text Available As reações alérgicas ao látex vêm aumentando em profissionais da saúde e se manifestam como um incômodo local ou sintomatologia sistêmica. Para conhecer a freqüência das manifestações alérgicas nos usuários de luvas de látex foi realizada busca entre os profissionais da odontologia via aplicação de questionários. Foram aplicados 450questionários e, dentre os respondedores (140, 19% relataram manifestar reações locais ao contato com as luvas de látex e 5% reações sistêmicas a outros produtos de látex. Cerca de 2,5% declararam dermatite de contato e reações sistêmicas (anafiláticas, 1,5% apenas dermatite de contato e 1% sintomas de anafilaxia ao uso das luvas. Vinte por cento dos profissionais atenderam pacientes com alergia ao látex e 29% declararam questionar, durante a anamnese, a respeito de alergia ao látex. As reações alérgicas a luvas de látex foram freqüentes e é objeto de preocupação entre os profissionais da odontologia.Allergic reactions to natural rubber latex have increased in dental practice affecting both the professional and the patients. Allergic reactions may range from skin disease to asthma and anaphylaxis. This study aimed at determining the incidence of latex gloves allergy amongdental care workers. 450 allergy questionnaires were used to collect information on latex gloves reactions and 140 dental works answered them. Latex gloves reaction occurred in 19% of them and 5% reported allergic reactions to other latex products. 2.5% reported symptoms suggesting contact dermatitis and anaphylaxis hypersensitivities, 1.5% contact dermatitis, and 1% reported anaphylaxis symptoms when wearing them. 20% of them had patients who presented symptoms suggestive of anaphylaxis hypersensitivity to rubber gloves latex. Our study confirms that rubber latex gloves reactions are frequent among dental care workers, and dentists must be aware of the latex allergy in dental practice.

  5. Severe anaphylactic shock due to ethylene oxide in a patient with myelomeningocele: successful exposure prevention and pretreatment with omalizumab.

    Science.gov (United States)

    Listyo, Adrian; Hofmeier, Kathrin Scherer; Bandschapp, Oliver; Erb, Thomas; Hasler, Carol-Claudius; Bircher, Andreas J

    2014-01-01

    Ethylene oxide (EO) is a highly reactive gas widely used for sterilization of medical devices, for example, plastic materials and ventriculoperitoneal shunts. Allergic reactions to EO are rare and have been observed mainly in patients during hemodialysis and myelomeningocele patients. We describe severe anaphylaxis to EO in a patient with myelomeningocele during general anesthesia. A detailed description is provided about the prevention measures aimed at reducing exposure to EO including a novel approach by resterilization with plasma. Also, pretreatment with omalizumab was implemented for the first time in such a case. With these measures, further surgeries in our patient were uneventful. PMID:25612258

  6. Anthropogenic Climate Change and Allergic Diseases

    Directory of Open Access Journals (Sweden)

    Hueiwang Anna Jeng

    2012-02-01

    Full Text Available Climate change is expected to have an impact on various aspects of health, including mucosal areas involved in allergic inflammatory disorders that include asthma, allergic rhinitis, allergic conjunctivitis and anaphylaxis. The evidence that links climate change to the exacerbation and the development of allergic disease is increasing and appears to be linked to changes in pollen seasons (duration, onset and intensity and changes in allergen content of plants and their pollen as it relates to increased sensitization, allergenicity and exacerbations of allergic airway disease. This has significant implications for air quality and for the global food supply.

  7. Allergenic activity of honey

    OpenAIRE

    Bogdan Kędzia; Elżbieta Hołderna-Kędzia

    2012-01-01

    An allergy to honey is a rare symptom. It usually occurs when people are allergic to food components, pollen and bee venom. Most often an allergy to honey is manifested by disturbances of skin and digestive system. Anaphylaxis is seldom, pollen proteins are more often the cause of an allergy to honey than honeybee ones. In particular cases an allergy can be caused by moulds, yeasts and secretion of sapsucking insects. An allergy to honey is often caused by pollen of floral plants from Composi...

  8. Recent Advances in Biology of Cysteinyl Leukotriene

    Science.gov (United States)

    Ago, Hideo; Miyano, Masashi

    Cysteinyl leukotriene has been known to be a major component of SRS-A (Slow Reacting Substance of Anaphylaxis). Inhibitors affecting on its biosynthesis and antagonists of its G-protein coupled receptor are therapeutic agents for acute inflammatory diseases, such as bronchial asthma and rhinitis. Latest findings in pathobiology of asthma suggest that cysteinyl leukotriene would take a key role in not only acute but also chronic inflammation of asthma. The structure basis of biosynthesis of cysteinyl leukotriene was revealed by crystallographic analysis of human membrane protein leukotriene C4 synthase.

  9. Urticaria and anaphilaxis in a child after inhalation of lentils vapours: a case report and literature review

    OpenAIRE

    Vitaliti Giovanna; Morselli Ignazio; Di Stefano Valeria; Lanzafame Angela; La Rosa Mario; Leonardi Salvatore

    2012-01-01

    Abstract Background Among legumes, lentils seem to be the most common legume implicated in pediatric allergic reactions in the Mediterranean area and India, and usually they start early in life, below 4 years of age. Case report A 22 -month-old child was admitted to our Pediatric Department for anaphylaxis and urticaria. At the age of 9 months she presented a first episode of angioedema and laryngeal obstruction, due to a second assumption of lentils in her diet. At admission we performed rou...

  10. Antibiotic allergy in cystic fibrosis

    OpenAIRE

    Parmar, J.; Nasser, S.

    2005-01-01

    Allergic reactions to antibiotics are more common in cystic fibrosis (CF) than in the general population. This in part is due to the improving survival in adults with CF and the increased use of high dose intravenous antibiotics. While some are immediate anaphylaxis type (IgE mediated) reactions, the majority are late onset and may have non-specific features such as rash and fever. Piperacillin has consistently been found to have the highest rate of reported reactions (30–50%). There is a low...

  11. Purification, crystallization and preliminary X-ray analysis of a deletion mutant of a major buckwheat allergen

    International Nuclear Information System (INIS)

    A 16 kDa buckwheat protein (BWp16) is a major allergen responsible for immediate hypersensitivity reactions including anaphylaxis. An immunologically active mutant of BWp16 was prepared and a three-wavelength MAD data set was collected from a crystal of selenomethionine-labelled mutant protein. A 16 kDa buckwheat protein (BWp16) is a major allergen responsible for immediate hypersensitivity reactions including anaphylaxis. A deletion mutant of BWp16 (rBWp16ΔN) was overproduced and purified and was shown to be immunologically active. A three-wavelength MAD data set was collected from a crystal of selenomethionine-labelled rBWp16ΔN. The crystal belonged to the triclinic space group P1, with unit-cell parameters a = 28.39, b = 31.54, c = 32.20 Å, α = 111.92, β = 108.91, γ = 98.74°. One monomer was expected to be present in the asymmetric unit based on the calculated Matthews coefficient of 1.76 Å3 Da−1

  12. Study on Anti-Allergic Effecst of Ganoderma lucidum Herbal Acupuncture and Ganoderma lucidum Extract

    Directory of Open Access Journals (Sweden)

    Kang Kyung-Hwa

    2007-12-01

    Full Text Available Objectives : We studied on anti-allergic effects of Ganoderma lucidum herbal acupuncture(GHA and Ganoderma lucidum extract(GE. Methods : in vivo, Animals were herbal-acupunctured GHA at both B13s three times for 5 days. Then, we investigated compound 48/80-induced active systemic anaphylatic shock using ICR mice and anti-DNP IgE-induced passive cutaneous anaphylaxis using Sprague Dawley rat. In vitro, we measured cell viability, b-hexosaminidase release, IL-4 and TNF-a from RBL-2H3 cells, and nitric oxide from Raw264.7 cell after treatment of GE of various concentrations. Results : In vivo, GHA pretreatments at both B13s inhibited compound 48/80-induced active systemic anaphylatic shock. Passive cutaneous anaphylaxis were inhibited by GHA10 and OP. In vitro, 0.1 ~ 2% GE treatments were not affect on cell viability and inhibited b-hexosaminidase release, IL-4, TNF-a and nitric oxide. Conclusions : These results suggest that GHA and GE may be beneficial in the inhibition of allergic inflammatory response.

  13. Atypical Anaphylactic Reaction to Patent Blue During Sentinel Lymph Node Biopsy for Breast Cancer

    Science.gov (United States)

    Lanitis, Sophocles; Filippakis, George; Sidhu, Virinder; Mufti, Ragheed AL; Lee, Tak H; Hadjiminas, Dimitri J

    2008-01-01

    INTRODUCTION We present an unusual case of severe anaphylaxis to Patent Blue dye with atypical clinical features during sentinel lymph node biopsy (SLNB). The medical personnel involved with sentinel node biopsies should be alert, and familiar with this unusual entity. We also present current data from the literature. CASE REPORT During a wide local excision for primary breast cancer and SLNB, and early during the operation, the patient became severely tachycardic and hypotensive without any signs of urticaria, rash, oedema, or bronchospasm. Resuscitation required the addition of noradrenaline infusion followed by an overnight admission to the intensive care unit. Raised serum tryptase levels supported the diagnosis of anaphylactic shock while skin tests showed a severe reaction to Patent Blue dye. CONCLUSIONS Severe, life-threatening anaphylaxis to Patent Blue dye may present without obvious previous exposure to the dye and without the cardinal signs of oedema, urticaria and bronchospasm making the diagnosis and management of such cases challenging. Correct diagnosis and identification of the causative factor is important and requires a specific set of laboratory tests that are not commonly requested in every-day medical practice. It is not clear from the literature whether the condition is common enough to justify pre-operative prophylactic or diagnostic measures. PMID:18492403

  14. IgE-mediated food hypersensitivity disorders.

    Science.gov (United States)

    Gotua, M; Lomidze, N; Dolidze, N; Gotua, T

    2008-04-01

    Food allergy has become a serious health concern especially in developed countries in the past two decades. In general population approximately 4-6% of children and 1-3% of adults experience food allergy. The article reviews IgE-mediated food hypersensitivity disorders. Epidemiology, Mechanism, Clinical manifestations, Genetically modified crops (GMOs), Diagnosis, Prevention and Treatment of IgE-mediated food allergies are discussed. The investigations show that over 90% of IgE-mediated food allergies in childhood are caused by: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish and shellfish. Also the causes of food allergy are food additives, genetically modified crops. Risk factors for food-dependent exercise-induced anaphylaxis include asthma and previous allergic reactions to the causative food. Food allergy is one of the most common causes of systematic anaphylaxis and anaphylactoid reactions, with an annual incidence of four cases per million populations and estimated 500 deaths annually. In addition to gastrointestinal symptoms, individuals may experience urticaria, angioedema, atopic dermatitis, oral syndrome, asthma, rhinitis, conjunctivitis, hypotension, shock and cardiac arrhythmias, caused by the massive release of mediators from mast cells and basophiles. Diagnosis of food allergy is based on history, detailed dietary analysis, skin testing, measuring specific IgE in blood serum and challenge tests. Treatment and prevention includes: avoidance diet, application of auto-injectable epinephrine, H1 and H2 antihistamines, corticosteroids, antileukotrienes, prostaglandin synthetase inhibitors, cromolyn sodium, etc. PMID:18487689

  15. Nesting and reproduction of Pachycondyla striata (Formicidae: Ponerinae in urban areas: an ant that offers risk of accidents

    Directory of Open Access Journals (Sweden)

    Stefano Marco Cantone

    2015-07-01

    Full Text Available It was conducted a research, in urban areas, on the nesting habits and reproductive period of Pachycondyla striata, a species of ant that stings painfully. The study was motivated by the frequent reports of accidents in the city of São Paulo. The reports are more common during the reproductive seasons of the species, when the winged females sting the population, since they enter the houses of the people attracted to light. Although anaphylaxis for P. striata has not been reported yet, other close species may cause anaphylaxis, which makes important to understand their biology in order to take management and control measures. Fourteen green areas in the city of São Paulo, Brazil, were monitored in the search for the species and their nests that were found in 64.3% of the areas. The nests are located around the trunk base of the trees, between the roots that protrude from the ground, under the rocks and through the cracks and crevices on the sidewalks. The spatial distribution of the nests is random. The reproductive period of P. striata was monitored from April 2012 to November 2013, through passive collection and laboratory colony. The nuptial flights occur during the cooler and drier months of the year, between July and September.

  16. Disclosing food allergy status in schools: health-related stigma among school children in Ontario.

    Science.gov (United States)

    Dean, Jennifer; Fenton, Nancy E; Shannon, Sara; Elliott, Susan J; Clarke, Ann

    2016-09-01

    In 2006, 3 years after the tragic death of 13-year-old Sabrina Shannon, the Province of Ontario (Canada) passed Sabrina's Law ushering in a new era of focus and concern for severe food allergic children at risk of anaphylaxis. Questions were raised at the time regarding the potential of doing more harm than good with the new legislation. This paper reports the experiences of health-related stigma among food allergic children at risk of anaphylaxis who were required to disclose their health status under this new legislation. In 2008, in-depth interviews were conducted with 20 children and youth and their parents in order to explore the experiences living with a severe food allergy. This particular study explores their experiences of felt and enacted stigma in the school setting as a result of the disclosure process. Interviews were tape recorded with permission and transcribed for subsequent thematic analysis using NVIVO, a qualitative analysis software package. Results indicate that participants were stigmatised as a result of protective school policies under the law, and that created tension between their physical safety and social well-being. Sabrina's Law also led to a cultural shift in awareness of food allergies that resulted in some participants normalising their health status, offering promising directions for the future. PMID:25939442

  17. Perioperative allergy: uncommon agents.

    Science.gov (United States)

    Caimmi, S; Caimmi, D; Cardinale, F; Indinnimeo, L; Crisafulli, G; Peroni, D G; Marseglia, G L

    2011-01-01

    Anesthesia may often be considered as a high-risk procedure and anaphylaxis remains a major cause of concern for anesthetists who routinely administer many potentially allergenic agents. Neuromuscular blocking agents, latex and antibiotics are the substances involved in most of the reported reactions. Besides these three agents, a wide variety of substances may cause an anaphylactic reaction during anesthesia. Basically all the administered drugs or substances may be potential causes of anaphylaxis. Among them, those reported the most in literature include hypnotics, opioids, local anesthetics, colloids, dye, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Iodinated Contrast Media (ICM), antiseptics, aprotinin, ethylene oxyde and formaldehyde, and protamine and heparins. No premedication can effectively prevent an allergic reaction and a systematic preoperative screening is not justified for all patients; nevertheless, an allergy specialist should evaluate those patients with a history of anesthesia-related allergy. Patients must be fully informed of investigation results, and advised to provide a detailed report prior to future anesthesia. PMID:22014927

  18. Anaphylactic shock: Kounis hypersensitivity-associated syndrome seems to be the primary cause

    Directory of Open Access Journals (Sweden)

    Nicholas G Kounis

    2013-01-01

    Full Text Available Experiments have shown that anaphylaxis decreases cardiac output; increases left ventricular end diastolic pressure; induces severe early acute increase in respiratory resistance with pulmonary interstitial edema; and decreases splanchnic, cerebral, and myocardial blood flow more than what would be expected from severe arterial dilation and hypotension. This is attributed to the constrictive action of inflammatory mediators released during anaphylactic shock. Inflammatory mediators such as histamine, neutral proteases, arachidonic acid products, platelet-activating factor (PAF, and a variety of cytokines and chemokines constitute the pathophysiologic basis of Kounis hypersensitivity-associated acute coronary syndrome. Although the mechanisms of anaphylactic shock still remain to be elucidated, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Searching current experimental and clinical literature on anaphylactic shock pathophysiology, causality, clinical appearance, and treatment via PubMed showed that differentiating global hypoperfusion from primary tissue suppression due to mast cell mediator constrictive action on systemic arterial vasculature is a challenging procedure. Combined tissue suppression from arterial involvement and peripheral vasodilatation, perhaps, occur simultaneously. In cases of anaphylactic shock treatment targeting the primary cause of anaphylaxis together with protection of coronary vasculature and subsequently the cardiac tissue seems to be of paramount importance.

  19. Atopic diseases: Risk factor in developing adverse reaction to intravenous N-Acetylcysteine

    Directory of Open Access Journals (Sweden)

    F Gheshlaghi

    2006-05-01

    Full Text Available Background: N-acetylcysteine (NAC is the choice treatment for acetaminophen overdose. The main side effect of intravenous NAC therapy is anaphylaxis or anaphylactoid reactions. We investigated the prevalence of anaphylactoid or anaphylaxis reactions to IV-NAC therapy in acetaminophen poisoned patients with atopic disease. Methods: A case series antrograde and descriptive–analytic study was done on acetaminophen poisoned patients who treated with IV-NAC from September 2003 to September 2004 in Isfahan, Iran. Results: Of 173 infused IV-NAC patients, 77 patients (44.5% developed an anaphylactoid reaction. Its side effects was nausea and vomiting (n=49, 63.15%, flashing (n=23, 30.26%, bronchospasm (n=20, 26.31%, vertigo (n=18, 23.68%, skin rash (n=25, 32.36% and hypotension (n=12, 15.75%. Also, 71 patients (41% had history of atopic disease. Atopic diseases were asthma (n=12, 6.9%, atopic dermatitis (n=7, 4%, allergic rhinitis (n=5, 2.8% and allergic conjunctivitis (n=1, 0.5%. Among 71 atopic patients, 59 patients (83.13 % developed side effects to NAC. There was a relation between previous history of atopic disease and anaphylactoid reaction to NAC. Conclusions: We report substantially higher incidence of anaphylactoid reactions to IV-NAC than previous studies. Different atopic diseases must be considered as a risk factor in the development of side effects to IV-NAC-therapy. Keywords: Poisoning, Acetaminophen, Anaphylactoid reaction, N-acetylcysteine, Atopic disease

  20. Anti-allergic and anti-anaphylactic activities of Dolichos biflorus

    Directory of Open Access Journals (Sweden)

    Anupama Ashok Suralkar

    2013-01-01

    Full Text Available Background: The seeds of Dolichos biflorus (DB have been traditionally used in the treatment of cough and asthma. Aim: Based on the traditional claim, the present study was planned to evaluate the anti-allergic and anti-anaphylactic activities of DB. Materials and Methods: The ethanolic extract of the seeds of DB was prepared by cold maceration process. DB was subjected to phytochemical screening, acute toxicity studies, mast cell-stabilizing activity using compound 48/80 and anti-allergic activity using milk-induced leukocytosis and eosinophilia and passive paw anaphylaxis. Statistical Analysis: Statistical analysis was done by using one-way analysis of variance followed by Dunnett′s test. Results: The phytochemical investigation showed presence of proteins, flavonoids and glycosides. DB extract inhibited milk-induced leukocytosis and eosinophilia and also the compound 48/80 induced mast cell degranulation. DB extract significantly reduced passive paw anaphylaxis in a dose-dependent manner. Conclusion : The results demonstrated that DB extract possesses anti-allergic and anti-anaphylactic potentials that might be useful in the management of asthma.

  1. Multiplex component-based allergen microarray in recent clinical studies.

    Science.gov (United States)

    Patelis, A; Borres, M P; Kober, A; Berthold, M

    2016-08-01

    During the last decades component-resolved diagnostics either as singleplex or multiplex measurements has been introduced into the field of clinical allergology, providing important information that cannot be obtained from extract-based tests. Here we review recent studies that demonstrate clinical applications of the multiplex microarray technique in the diagnosis and risk assessment of allergic patients, and its usefulness in studies of allergic diseases. The usefulness of ImmunoCAP ISAC has been validated in a wide spectrum of allergic diseases like asthma, allergic rhinoconjunctivitis, atopic dermatitis, eosinophilic esophagitis, food allergy and anaphylaxis. ISAC provides a broad picture of a patient's sensitization profile from a single test, and provides information on specific and cross-reactive sensitizations that facilitate diagnosis, risk assessment, and disease management. Furthermore, it can reveal unexpected sensitizations which may explain anaphylaxis previously categorized as idiopathic and also display for the moment clinically non-relevant sensitizations. ISAC can facilitate a better selection of relevant allergens for immunotherapy compared with extract testing. Microarray technique can visualize the allergic march and molecular spreading in the preclinical stages of allergic diseases, and may indicate that the likelihood of developing symptomatic allergy is associated with specific profiles of sensitization to allergen components. ISAC is shown to be a useful tool in routine allergy diagnostics due to its ability to improve risk assessment, to better select relevant allergens for immunotherapy as well as detecting unknown sensitization. Multiplex component testing is especially suitable for patients with complex symptomatology. PMID:27196983

  2. Wheat IgE-mediated food allergy in European patients: alpha-amylase inhibitors, lipid transfer proteins and low-molecular-weight glutenins

    DEFF Research Database (Denmark)

    Pastorello, Elide A; Farioli, Laura; Conti, Amedeo;

    2007-01-01

    BACKGROUND: Three main problems hamper the identification of wheat food allergens: (1) lack of a standardized procedure for extracting all of the wheat protein fractions; (2) absence of double-blind, placebo-controlled food challenge studies that compare the allergenic profile of Osborne's three ...... most important wheat allergen in food allergy and to play a role in wheat-dependent exercise-induced anaphylaxis, too. Other important allergens were LTP and the LMW glutenin subunits.......BACKGROUND: Three main problems hamper the identification of wheat food allergens: (1) lack of a standardized procedure for extracting all of the wheat protein fractions; (2) absence of double-blind, placebo-controlled food challenge studies that compare the allergenic profile of Osborne's three...... protein fractions in subjects with real wheat allergy, and (3) lack of data on the differences in IgE-binding capacity between raw and cooked wheat. METHODS: Sera of 16 wheat-challenge-positive patients and 6 patients with wheat anaphylaxis, recruited from Italy, Denmark and Switzerland, were used for...

  3. Optimising the management of wheeze in preschool children.

    Science.gov (United States)

    McVea, Steven; Bourke, Thomas

    2016-06-01

    One third of all preschool children will have an episode of wheeze and many of these present to primary care. Most will fall within a spectrum of diagnosis ranging from episodic viral wheeze to multiple trigger wheeze or early onset asthma. A small proportion will have other rare, but important, diagnoses such as foreign body aspiration, anaphylaxis, gastro-oesophageal reflux, congenital anatomical abnormalities or other chronic lung diseases. Clinical assessment should try to classify children into either episodic viral wheeze or multiple trigger wheeze phenotypes. In clinical practice children rarely fit neatly into either category and the phenotype may change overtime. Clinical examination may well be normal in a child presenting with chronic symptoms. Urgent outpatient review should be considered for symptoms present from early infancy, chronic wet cough, failure to thrive or systemic involvement. The child should be referred to hospital immediately if you suspect an inhaled foreign body or anaphylaxis (after administering IM adrenaline). NICE recommends immediate referral for children with wheeze and high-risk features and also those with intermediate-risk features failing to respond to bronchodilator therapy. Children with high-risk features on assessment should be treated immediately with inhaled bronchodilator therapy. Those with intermediate risk should be treated immediately with bronchodilator therapy and reassessed 15-30 minutes later. Intermediate-risk children who respond and low-risk children can be managed at home with bronchodilator therapy via a spacer device. PMID:27552795

  4. Diversity of Food Allergy.

    Science.gov (United States)

    Moriyama, Tatsuya

    2015-01-01

    Food allergy is defined as an immune system-mediated adverse reaction to food components. Food allergic reactions are mostly IgE mediated and also known as immediate type hypersensitivity (type I reaction). There are several characteristic clinical types of food allergy, such as Anaphylaxis, Food-dependent exercise-induced anaphylaxis (FDEIA), and Oral allergy syndrome (OAS). In addition, food allergy is also classified into two types (class 1 and class 2) based on the pathophysiological mechanism. In the class 2 food allergy, pollen allergy causes plant food allergy; therefore this type of allergy is sometimes called Pollen-food allergy syndrome (PFAS). The risk of food allergy (allergenicity) may vary with the treatment of the food allergens. The formation or status of the causative food affects its allergenicity. Class 1 food allergens are generally heat-, enzyme-, and low pH-resistant glycoproteins ranging in size from 10 to 70 kD. Class 1 food allergens induce allergic sensitization via the gastrointestinal tract and are responsible for systemic reactions. Class 2 food allergens are generally heat-labile, susceptible to digestion, and highly homologous with pollen allergens. Taken together, it may be important to consider the diversity of food allergy in order to fight against food allergy. PMID:26598816

  5. Identifying and managing Hymenoptera venom allergy.

    Science.gov (United States)

    Matron, Patricia Kane; Timms, Victoria; Fitzsimons, Roisin

    2016-05-25

    Hymenoptera venom allergy is an immunoglobulin E (IgE)-mediated hypersensitivity to the venom of insects from the Hymenoptera order and is a common cause of anaphylaxis. A diagnosis of venom allergy is made by taking an accurate medical, family and social history, alongside specific allergy testing. Systemic reactions to Hymenoptera venom occur in a small proportion of the population; these range from mild to life-threatening in severity. Treatment for local reactions involves the use of cold packs, antihistamines, analgesia and topical corticosteroids to help alleviate swelling, pain and pruritus. Venom immunotherapy is the treatment of choice for reducing the incidence of future anaphylactic reactions in individuals who have signs of respiratory obstruction or hypotension. Venom immunotherapy is the most effective treatment in reduction of life-threatening reactions to venom, and can improve quality of life for individuals. Treatment should only be provided by experienced staff who are able to provide emergency care for anaphylaxis and life-threatening episodes. A risk assessment to deliver treatment should be undertaken before treatment is commenced. PMID:27224630

  6. Mast Cell Stabilizing,Antianaphylactic and Antihistaminic Activity of Coccinia grandis Fruits in Asthma

    Institute of Scientific and Technical Information of China (English)

    Dnyaneshwar J Taur; Ravindra Y Patil

    2011-01-01

    Coccinia grandis Linn(Curcubitaceae)is a climber herb cultivated throughout India.In traditional medicine fruits have been used to treat leprosy,fever,asthma,bronchitis and jaundice.In present study,ethanol extract of C.grandis fruit(ECGF)at 100,125 and 150 mg·kg-1,i.p.,was evaluated for mast cell stabilizing,antianaphylactic and antihistaminic activity using egg albumin induced mast cell degranulation in mice;passive cutaneous anaphylaxis in rats and clonidine induced catalepsy in mice respectively.ECGF at(100-150 mg·kg-1,i.p.)significantly protected egg albumin induced degranulations of mast cells and caused reduction of blue dye leakage in passive cutaneous anaphylaxis in dose dependently.The treatment ECGF also inhibited clonidine induced catalepsy in dose dependent manner.Phytochemical studies observed presence of saponin,steroids,alkaloids,flavonoids and glycosides.In conclusion ECGF possesses mast cell stabilizing;anti anaphylactic and antihistaminic potential which might be used in treatment of asthma.

  7. Antiallergic Activity of Ethanol Extracts of Arctium lappa L. Undried Roots and Its Active Compound, Oleamide, in Regulating FcεRI-Mediated and MAPK Signaling in RBL-2H3 Cells.

    Science.gov (United States)

    Yang, Woong-Suk; Lee, Sung Ryul; Jeong, Yong Joon; Park, Dae Won; Cho, Young Mi; Joo, Hae Mi; Kim, Inhye; Seu, Young-Bae; Sohn, Eun-Hwa; Kang, Se Chan

    2016-05-11

    The antiallergic potential of Arctium lappa L. was investigated in Sprague-Dawley rats, ICR mice, and RBL-2H3 cells. Ethanol extract (90%) of A. lappa (ALE, 100 μg/mL) inhibited the degranulation rate by 52.9%, determined by the level of β-hexosaminidase. ALE suppressed passive cutaneous anaphylaxis (PCA) in rats and attenuated anaphylaxis and histamine release in mice. To identify the active compound of ALE, we subsequently fractionated and determined the level of β-hexosaminidase in all subfractions. Oleamide was identified as an active compound of ALE, which attenuated the secretion of histamine and the production of tumor necrosis factor (TNF)-α and interleukin-4 (IL-4) in cells treated with compound 48/80 or A23187/phorbol myristate acetate (PMA). Oleamide suppressed FcεRI-tyrosine kinase Lyn-mediated pathway, c-Jun N-terminal kinases (JNK/SAPK), and p38 mitogen-activated protein kinases (p38-MAPKs). These results showed that ALE and oleamide attenuated allergic reactions and should serve as a platform to search for compounds with antiallergic activity. PMID:27087645

  8. Urticaria and anaphilaxis in a child after inhalation of lentils vapours: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Vitaliti Giovanna

    2012-12-01

    Full Text Available Abstract Background Among legumes, lentils seem to be the most common legume implicated in pediatric allergic reactions in the Mediterranean area and India, and usually they start early in life, below 4 years of age. Case report A 22 -month-old child was admitted to our Pediatric Department for anaphylaxis and urticaria. At the age of 9 months she presented a first episode of angioedema and laryngeal obstruction, due to a second assumption of lentils in her diet. At admission we performed routine analyses that were all in the normal range, except for the dosage of specific IgE, that revealed a positive result for lentils. Prick tests too were positive for lentils, while they were all negative for other main food allergens. The child also performed a prick by prick that gave the same positive result (with a wheal of 8 mm of diameter. The child had not previously eaten lentils and other legumes, but her pathological anamnesis highlighted that the allergic reaction appeared soon after the inhalation of cooking lentil vapours when the child entered the kitchen Therefore a diagnosis of lentils vapours allergy was made. Conclusions Our case shows the peculiarity of a very early onset. In literature there are no data on episodes of anaphylaxis in so young children, considering that our child was already on lentils exclusion diet. Therefore a diet of exclusion does not absolutely preserve patients from allergic reactions, that can develop also after their cooking steams inhalation.

  9. Use of Specific IgE and Skin Prick Test to Determine Clinical Reaction Severity.

    Science.gov (United States)

    Ta, Von; Weldon, Brittany; Yu, Grace; Humblet, Olivier; Neale-May, Susan; Nadeau, Kari

    2011-01-01

    AIMS: To determine whether specific IgE and skin prick test correlate better in predicting reaction severity during a double-blinded placebo controlled food challenge (DBPCFC) for egg, milk, and multiple tree nut allergens. STUDY DESIGN: Prospective study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Stanford University School of Medicine, August 2009 and ongoing. METHODOLOGY: We examined the reaction severity of twenty-four subjects to nine possible food allergens: milk, egg, almond, cashew, hazelnut, peanut, sesame, pecan and walnut. Specific IgE and SPT were performed before each DBPCFC. DBPCFC results were classified into mild (1), moderate (2), or severe (3) reactions using a modified Bock's criteria. RESULTS: Twenty four subjects underwent a total of 80 DBPCFC. Eighty percent of all DBPCFCs resulted in a positive reaction. A majority, 71%, were classified as mild. No reactions occurred with a SPT of zero mm while three reactions occurred with a negative specific IgE. All reactions were reversible with medication. CONCLUSION: These data suggest that SPT and specific IgE levels are not associated with reaction severity (p 5mm had a sensitivity of 91% and specificity of 50%. Combining SPT > 5mm and IgE > 7 resulted in a reduced sensitivity of 64%. Unexpectedly, a history of anaphylaxis 70% (n=17) was not predictive of anaphylaxis on challenge 4% (n=2). PMID:22993721

  10. Brain injury due to anaphylactic shock: broadening manifestations of Kounis syndrome.

    Science.gov (United States)

    Soufras, G D; Kounis, G N; Kounis, N G

    2014-04-01

    Anaphylactic shock is a real and life threatening medical emergency which is encountered in every field of medicine. The coronary arteries seem to be the primary target of anaphylaxis resulting in the development of Kounis syndrome. Kounis syndrome is a pan-arterial anaphylaxis -associated syndrome affecting patients of any age, involving numerous and continuously increasing causes, with broadening clinical manifestations and covering a wide spectrum of mast cell activation disorders. Recently, Kounis-like syndrome affecting the cerebral arteries was found to be associated with mast cell activation disorders. In anaphylactic shock, the decrease of cerebral blood flow is more than what would be expected from severe arterial hypotension. This is attributed to the early and direct action of anaphylactic mediators on cerebral vessels. While adrenaline is a life saving agent in the treatment of anaphylactic shock, it contains sodium betabisulfite as preservative and should be avoided in sulfite allergic patients. Potential allergens encountered in endodotic practice include formocresol, zinc compounds thiurams, sodium dimethyldithiocarbamade, and mercaptobenzothiazole that might have synergistic action. All these agents together with analgesics, antibiotics, antiseptics, formaldehyde, latex, local anaesthetics and metals used in dental practice, in general, can induce anaphylactic shock. Practitioners should be aware of these consequences. A careful history of previous atopy and reactions is of paramount importance for safe and effective management. PMID:23889503

  11. Values for preventing influenza-related morbidity and vaccine adverse events in children

    Directory of Open Access Journals (Sweden)

    Schwartz Benjamin

    2005-03-01

    Full Text Available Abstract Background Influenza vaccination recently has been recommended for children 6–23 months old, but is not currently recommended for routine use in non-high-risk older children. Information on disease impact, costs, benefits, risks, and community preferences could help guide decisions about which age and risk groups should be vaccinated and strategies for improving coverage. The objective of this study was to measure preferences and willingness-to-pay for changes in health-related quality of life associated with uncomplicated influenza and two rarely-occurring vaccination-related adverse events (anaphylaxis and Guillain-Barré syndrome in children. Methods We conducted telephone interviews with adult members selected at random from a large New England HMO (n = 112. Respondents were given descriptions of four health outcomes: uncomplicated influenza in a hypothetical 1-year-old child of their own, uncomplicated influenza in a hypothetical 14-year-old child of their own, anaphylaxis following vaccination, and Guillain-Barré syndrome. "Uncomplicated influenza" did not require a physician's visit or hospitalization. Preferences (values for these health outcomes were measured using time-tradeoff and willingness-to-pay questions. Time-tradeoff questions asked the adult to assume they had a child and to consider how much time from the end of their own life they would be willing to surrender to avoid the health outcome in the child. Results Respondents said they would give a median of zero days of their lives to prevent an episode of uncomplicated influenza in either their (hypothetical 1-year-old or 14-year-old, 30 days to prevent an episode of vaccination-related anaphylaxis, and 3 years to prevent a vaccination-related case of Guillain-Barré syndrome. Median willingness-to-pay to prevent uncomplicated influenza in a 1-year-old was $175, uncomplicated influenza in a 14-year-old was $100, anaphylaxis $400, and Guillain-Barré syndrome $4000

  12. Hypersensitivity to intravenous ondansetron: a case report

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    Mehra Karishma K

    2008-08-01

    Full Text Available Abstract Introduction Ondansetron, a 5-hydroxytryptamine3 receptor antagonist widely used in the prevention and treatment of chemotherapy-induced nausea and vomiting, is associated with various unusual adverse drug reactions. In this paper, we describe a hypersensitivity reaction to a single intravenous dose of ondansetron. Case presentation A 19-year-old woman presented to the emergency department of our institute with 3–4 episodes of nausea, vomiting and epigastric distress. She had a diagnosis of polycystic ovarian disease and had been on treatment with cyproterone acetate 2 mg, ethinyl estradiol 0.035 mg, finasteride 5 mg and metformin 500 mg for a month. She had been taking oral roxithromycin 500 mg per day for the past 3 days for treatment of a mild upper respiratory tract infection. She also occasionally took rabeprazole 10 mg for gastritis which had worsened after treatment with roxithromycin. She was treated with a single 4 mg dose of ondansetron intravenously. She immediately developed urticaria, which was treated with intravenous dexamethasone 4 mg and chlorpheniramine maleate 20 mg. The reaction abated within a few minutes and she was discharged within an hour. She was asymptomatic at 72 hours of follow-up. She had no history of ondansetron exposure, or drug or food allergies. On the Naranjo's causality assessment scale, the adverse event was 6 indicating a "probable" reaction to ondansetron. Conclusion 5-hydroxytryptamine3 receptor antagonists have been associated with life-threatening adverse reactions such as hypotension, seizures and anaphylaxis. The wide availability of these drugs in India has promoted their off label use in the treatment of gastritis, migraine and so on. Our case represents an off label use in a patient who could have been treated with a safer drug. Some authors have suggested that anaphylaxis may be a class effect while others think it may be drug specific. In our case, the reaction could be either

  13. Wheat allergy: diagnosis and management

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    Cianferoni A

    2016-01-01

    Full Text Available Antonella Cianferoni Department of Pediatrics, Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, PA, USA Abstract: Triticum aestivum (bread wheat is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy or wheat inhalation (respiratory allergy. A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker’s asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE or eosinophilic gastritis (EG, which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a

  14. Right ventricular hydatid cyst ruptured to pericardium

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    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  15. Food allergy

    Directory of Open Access Journals (Sweden)

    Youngshin Han

    2012-05-01

    Full Text Available Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal tract (class 1 food allergy or as a consequence of cross reactivity to structurally homologous inhalant allergens (class 2 food allergy. Allergenicity of food is largely determined by structural aspects, including cross-reactivity and reduced or enhanced allergenicity with cooking that convey allergenic characteristics to food. Management of food allergy currently focuses on dietary avoidance of the offending foods, prompt recognition and treatment of allergic reactions, and nutritional support. This review includes definitions and examines the prevalence and management of food allergies and the characteristics of food allergens.

  16. My patient is allergic to eggs, can i use propofol? A case report and review

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    Tashkandi Jamal

    2010-01-01

    Full Text Available Rather than other drugs, propofol is more likely to be used for induction of anesthesia to cause an allergic reaction. Propofol is becoming the most common intravenous agent used for induction as well as maintenance of anaesthesia. Allergy to propofol is rarely reported. We present a case of 4-year-old boy presented for elective adenotonsillectomy with past medical history of eczema and multiple allergies to food. He developed what seems to be an allergic reaction to propofol. We concluded that anaesthetists should be alerted when using propofol in patients with history of atopy or several drug allergies. Current evidence suggests that egg allergic patients are not more likely to develop anaphylaxis when exposed to propofol. If reactions to drugs occurred, it is always advisable to ascertain the exact allergen in each individual case before deciding causality. Serum tryptase, skin prick, intradermal testing, or serologic testing should be done to confirm the diagnosis of an anaphylactic reaction.

  17. Indigenous enteric eosinophils control DCs to initiate a primary Th2 immune response in vivo.

    Science.gov (United States)

    Chu, Derek K; Jimenez-Saiz, Rodrigo; Verschoor, Christopher P; Walker, Tina D; Goncharova, Susanna; Llop-Guevara, Alba; Shen, Pamela; Gordon, Melissa E; Barra, Nicole G; Bassett, Jennifer D; Kong, Joshua; Fattouh, Ramzi; McCoy, Kathy D; Bowdish, Dawn M; Erjefält, Jonas S; Pabst, Oliver; Humbles, Alison A; Kolbeck, Roland; Waserman, Susan; Jordana, Manel

    2014-07-28

    Eosinophils natively inhabit the small intestine, but a functional role for them there has remained elusive. Here, we show that eosinophil-deficient mice were protected from induction of Th2-mediated peanut food allergy and anaphylaxis, and Th2 priming was restored by reconstitution with il4(+/+) or il4(-/-) eosinophils. Eosinophils controlled CD103(+) dendritic cell (DC) activation and migration from the intestine to draining lymph nodes, events necessary for Th2 priming. Eosinophil activation in vitro and in vivo led to degranulation of eosinophil peroxidase, a granule protein whose enzymatic activity promoted DC activation in mice and humans in vitro, and intestinal and extraintestinal mouse DC activation and mobilization to lymph nodes in vivo. Further, eosinophil peroxidase enhanced responses to ovalbumin seen after immunization. Thus, eosinophils can be critical contributors to the intestinal immune system, and granule-mediated shaping of DC responses can promote both intestinal and extraintestinal adaptive immunity. PMID:25071163

  18. Thougths Emerged From the Anaphylactic Reactions Due to Fresh Prict Test with Fruit; are We Aware of the Potantial Danger?

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    Ali Kutlu

    2014-10-01

    Full Text Available Basic approach for food allergy is to avoide taking the food which is known to be allergic to the person. Minimal contact with allergen even such as skin prict test may also trigger the severe anaphylactic reactions. We want to share our exprience about a patient who exprienced anaphylaxis after fresh prick allergy skin test with fresh fruit (peach, apricot, plumb that we performed in our clinic. We belive that the patients who are known to have severe allergic reaction story must avoid to work in food proccesing and storage works, in case any contact with wounded skin area may result in severe allergic reaction [TAF Prev Med Bull 2014; 13(5.000: 435-436

  19. The expected number of background disease events during mass immunization in China.

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    Youxin Wang

    Full Text Available It is critical to distinguish events that are temporarily associated with, but not caused by, vaccination from those caused by vaccination during mass immunization. We performed a literature search in China National Knowledge Infrastructure and Pubmed databases. The number of coincident events was calculated based on its incidence rate and periods after receipt of a dose of hypothesized vaccine. We included background incidences of Guillain-Barré syndrome, anaphylaxis, seizure, sudden adult death syndrome, sudden cardiac death, spontaneous abortion, and preterm labour or delivery. In a cohort of 10 million individuals, 7.71 cases of Guillain-Barré syndrome would be expected to occur within six weeks of vaccination as coincident background cases. Even for rare events, a large number of events can be expected in a short period because of the large population targeted for immunization. These findings may encourage health authorities to screen the safety of vaccines against unpredictable pathogens.

  20. Patterns of suspected wheat-related allergy

    DEFF Research Database (Denmark)

    Junker Christensen, Morten; Eller, Esben; Mortz, Charlotte G;

    2014-01-01

    BACKGROUND: Allergy to wheat can present clinically in different forms: Sensitization to ingested wheat via the gastrointestinal tract can cause traditional food allergy or in combination with exercise, Wheat-Dependent Exercise-Induced Anaphylaxis (WDEIA). Sensitization to inhaled wheat flour may...... lead to occupational rhinitis and/or asthma. METHODS: We retrospectively reviewed the case notes of 156 patients (age 0.7 - 73.3 years) with a case history of wheat allergy. The population was divided into three groups, 1: Wheat allergy elicited by ingestion, 2: By inhalation and 3: WDEIA. All patients...... were examined with detailed case history, specific IgE (sIgE), Skin Prick Test (SPT) and wheat challenge (nasal or oral ± exercise). Details of the case history were extracted from the patients´ case records. RESULTS: Group 1: Twenty one of 95 patients were challenge positive (15 children, 6 adults...

  1. Quaternary ammonium compounds – New occupational hazards

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    Agnieszka Lipińska-Ojrzanowska

    2014-10-01

    Full Text Available Quaternary ammonium compounds (QACs, quats belong to organic ionic chemical agents which display unique properties of both surfactants and disinfectants. Their wide distribution in the work environment and also in private households brings about new occupational hazards. This paper reviews reports about the health effects of QACs. QACs could play a role of sensitizers and irritants to the skin and mucous membranes. It is suspected that particular QACs can display an immunologic crossreactivity between each other and with other chemical compounds containing ammonium ion, such as muscle relaxants widely used in anesthesia. They may promote the development of airway allergy, however, the background mechanisms are still unclear and need to be further investigated. Until now, a few cases of occupational asthma induced by QACs have been described and their involvement in contact dermatitis has been documented. The possibility of anaphylaxis due to QACs cannot be excluded as well. Med Pr 2014;65(5:675–682

  2. Latex allergy: an emerging problem in health care.

    Science.gov (United States)

    Kinnaird, S W; McClure, N; Wilham, S

    1995-10-01

    Allergy to latex has been increasing as the use of latex products has grown. The increase is disproportionately occurring in those people with myelodysplasias, those who have undergone multiple surgical procedures, and health care providers. Within those groups, the most susceptible to latex allergy are people with other allergies. Early identification of high-risk individuals and their avoidance of products containing latex can minimize the occurrence of this allergic response. Heightened awareness among health care providers is needed because latex is very common in hospitals and clinics. Inadvertent exposure places latex-sensitive individuals in danger of anaphylaxis. Nurses caring for infants and children are able to modify the environment of those at risk for latex allergy, reducing exposure to this potentially dangerous substance. Teaching families of children at risk will help them avoid latex in the home; many common household substances contain latex and are likely to trigger allergic responses. PMID:7565525

  3. Effect of disodium cromoglycate on mast cell-mediated immediate-type allergic reactions.

    Science.gov (United States)

    Shin, Hye-Young; Kim, Jung-Sook; An, Nyeon-Hyoung; Park, Rae-Kil; Kim, Hyung-Min

    2004-04-23

    We investigated the effect of disodium cromoglycate (DSCG) on mast cell-mediated immediate-type hypersensitivity. DSCG inhibited systemic allergic reaction induced by compound 48/80 dose-dependently. Passive cutaneous anaphylaxis was inhibited by 71.6% by oral administration of DSCG (1 g/kg). When DSCG was pretreated at concentration rang from 0.01-1000 g/kg, the serum histamine levels were reduced in a dose dependent manner. DSCG also significantly inhibited histamine release from rat peritoneal mast cell (RPMC) by compound 48/80. We confirmed that DSCG inhibited compound 48/80-induced degranulation of RPMC by alcian blue/nuclear fast red staining. In addition, DSCG showed a significant inhibitory effect on anti-dinitrophenyl IgE-mediated tumor necrosis factor-alpha production. These results indicate that DSCG inhibits mast cell-mediated immediate-type allergic reaction. PMID:15050425

  4. The Improvement of Mixed Human Serum-induced Anaphylactic Reaction Death Model in Guinea Pigs%混合人血清诱发豚鼠过敏反应死亡模型的改良

    Institute of Scientific and Technical Information of China (English)

    陈炯垣; 赖跃; 李冬日; 岳霞; 王慧君

    2012-01-01

    Objective To increase the death rate of fatal anaphylaxis in guinea pigs and the detectable level of the tryptase of mast cell in blood serum. Methods Seventy-four guinea pigs were randomly divided into five groups: original model group, original model control group, improved model group, improved model control group, improved model with non-anaphylaxis group. Using mixed human serum as the allergen, the way of injection, sensitization and induction were improved. ELISA was used to detect the serum mast cell tryptase and total IgE in guinea pigs of each group. Results The death rate of fatal anaphylaxis in original model group was 54.2% with the different degree of hemopericardium. The severe pericardial tamponade appeared in 9 guinea pigs in original model group and original model control group. The death rate of fatal anaphylaxis in improved model group was 75% without pericardial tamponade. The concentration of the serum total IgE showed no statistically difference between original model group and original model control group (P>0.05), but the serum mast cell tryptase level was higher in the original model group than that in the original model control group (P<0.05). The concentration of the serum total IgE and the serum mast cell tryptase level were significantly higher in improved model group than that in the improved model control group (P<0.05). Conclusion The death rate of the improved model significantly increases, which can provide effective animal model for the study of serum total IgE and mast cell tryptase.%目的 提高豚鼠过敏反应死亡的发生率和血清肥大细胞类胰蛋白酶检出水平.方法 74只清洁级豚鼠随机分为原模型组、原模型对照组、改良模型组、改良模型对照组和改良模型非致敏组.混合人血清作为过敏原,对注射方式、致敏、发敏方式进行改良,ELISA法测定各组豚鼠血清肥大细胞类胰蛋白酶和总IgE含量.结果 原模型组过敏反应死亡发生率为54.2

  5. New models for analyzing mast cell functions in vivo.

    Science.gov (United States)

    Reber, Laurent L; Marichal, Thomas; Galli, Stephen J

    2012-12-01

    In addition to their well-accepted role as critical effector cells in anaphylaxis and other acute IgE-mediated allergic reactions, mast cells (MCs) have been implicated in a wide variety of processes that contribute to disease or help to maintain health. Although some of these roles were first suggested by analyses of MC products or functions in vitro, it is critical to determine whether, and under which circumstances, such potential roles actually can be performed by MCs in vivo. This review discusses recent advances in the development and analysis of mouse models to investigate the roles of MCs and MC-associated products during biological responses in vivo, and comments on some of the similarities and differences in the results obtained with these newer versus older models of MC deficiency. PMID:23127755

  6. Diagnosis and pathogenesis of the anaphylactic and anaphylactoid reactions to anaesthetics.

    Science.gov (United States)

    Gueant, J L; Aimone-Gastin, I; Namour, F; Laroche, D; Bellou, A; Laxenaire, M C

    1998-09-01

    Immediate adverse reactions to anaesthetics have an immune mechanism in more than 50% of the cases. They are mainly due to muscle relaxant drugs. A prospective evaluation of tryptase, histamine and serotonin for diagnosing anaphylaxis to anaesthetics was performed over 2 years. The sensitivity of each marker was at 60-70% and it reached 80% when combining tryptase and histamine. Specific IgE have been already observed in serum from patients allergic to muscle relaxant, thiopentone, morphine, phenoperidine, propofol and radio-contrast media. However, the recent progress in the identification of drug epitopes by Sepharose-solid drug phase IgE radioimmunoassay has to be reconsidered as non-specific binding of hydrophobic drugs such as propofol to hydrophobic serum IgE has been observed recently in patients with drug allergy. In addition, association of drugs such as propofol and muscle relaxant may potentiate the mediator release by a non-elucidated mechanism. PMID:9761037

  7. Immune adjuvant activity of the olive, soybean and corn oils

    Directory of Open Access Journals (Sweden)

    Ana Claudia Marinho da Silva

    2016-08-01

    Full Text Available In the last half of the century, a large amount of substances has been used as immune adjuvant. The immune adjuvant effect of olive, soybean and corn oils in Swiss mice immunized with ovalbumin (OVA plus aluminum hydroxide or emulsified in Marcol, soybean, olive or corn oils was evaluated through the OVA-specific antibodies determined by ELISA and Passive Cutaneous Anaphylaxis. In this work the comparison of the intensity of the immune response was established by the Bayesian analysis. The adjuvant effect of the vegetable oils was shown to be more effective than aluminium hydroxide. Regarding to OVA-specific IgE synthesis, olive oil had the slowest adjuvant effect of the three vegetable oils. Accordingly, olive oil was the most convenient among the vegetable oils to be used as immune adjuvant, since it stimulated a higher production of OVA-specific Ig and lower levels of anti-OVA IgE.

  8. Patients with massive honeybee stings: report of four cases

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    Shahidi Sh

    2008-11-01

    Full Text Available "nBackground: Insect stings can cause local or systemic reactions that range from mild to fatal, and are among the most common causes of anaphylaxis. The major allergens of honeybee venom are phospholipase A2, hyaluronidase, acid phosphatase, allergen C and melitin. Phospholipase and melitin induce hemolysis, rhabdomyolysis and liver damage due to cell membrane breakdown, damage of the vascular endothelium and activation of the inflammatory response. Rhabdomyolysis has been implicated as the cause of acute renal failure in approximately 5-7% of cases. However, bee stings are a rare cause of rhabdomyolysis, and are usually associated with 50 or more stings. It has been reported that more than 250 bee stings are capable of causing death in humans. "nCase report: We report two cases of massive honeybee stings (>2000 with rhabdomyolysis, hemolysis and acute renal failure who survived with full recovery, and two cases of >500 honeybee stings who survived without significant complications.

  9. Brain Infarction: Rare Neurological Presentation of African Bee Stings

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    Hernando Raphael Alvis- Miranda

    2014-01-01

    Full Text Available Bee stings are commonly encountered worldwide. Various manifestations after bee sting have been described including local reactions which are common, systemic responses such as anaphylaxis, diffuse intravascular coagulation and hemolysis. We report a case of a 74-year-old man who developed neurologic deficit 5 hours after bee stings, which was confirmed to be left frontal infarction on brain CT-scan. The case does not follow the reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected. Diverse mechanisms have been proposed to give an explanation to all the clinical manifestation of both toxic and allergic reactions secondary to bee stings. Currently, the most accepted one state that victims can develop severe syndrome characterized by the release of a large amount of cytokines.

  10. Primary hydatid cyst in the soft tissue of the face: An exceptional occurrence

    Directory of Open Access Journals (Sweden)

    Cherry Bansal

    2011-01-01

    Full Text Available To emphasize that solitary hydatid cyst can be localized in the soft tissue and present as a soft tissue mass even in an unusual site like face, we report the case of a 42-year-old male patient presenting with a slowly growing mass in right temporal region. Computed tomography (CT scan showed an encapsulated mass with multiple cysts. Histopathological examination revealed the characteristic findings, which were consistent with soft-tissue hydatid disease. In the absence of visceral organ involvement, this is the first reported case of a primary subcutaneous hydatid cyst in the skin of face in India. In the English literature, only one case of this kind has been reported till date. When imaging methods confirm cystic nature of a swelling, even in unusual sites, one should always keep a possibility of hydatid cyst and manage accordingly during surgery to avoid precipitation of acute anaphylaxis.

  11. Radiologic Findings of Foreign Body Granuloma by the Bee Sting: A Case Report

    International Nuclear Information System (INIS)

    Bee sting therapy is a folk remedy used for arthralgia. An adverse reaction to bee sting therapy can be variable, ranging from a local inflammatory reaction to generalized anaphylaxis. There have been reports of dermatologic findings pertaining to bee sting granulomas, which results from a foreign body reaction to the persistence of venom and stinger at the sting site. However to the best of our knowledge, the radiologic findings of bee sting granulomas have not been reported on in Korea. We describe the ultrasound and MRI findings of bee sting granulomas at the lower extremity in a 36-year-old woman who underwent bee-sting therapy for osteoarthritis of the knee joints 3 months prior

  12. Should the host reaction to anisakiasis influence the treatment?: Different clinical presentations in two cases

    Directory of Open Access Journals (Sweden)

    Stefano Pontone

    2012-12-01

    Full Text Available Gastrointestinal anisakiasis is a parasitic infection occurring in people that consume raw or inadequately cooked fish or squid. It is frequently characterized by severe epigastric pain, nausea and vomiting caused by the penetration of the larvae into the gastric wall. Acute gastric anisakiasis with severe chest discomfort is rarely reported in Italy. On the other hand, gastro-allergic anisakiasis with rash, urticaria and isolated angioedema or anaphylaxis is a clinical entity that has been described only recently. Also, if patients usually develop symptoms within 12 hours after raw seafood ingestion, not always endoscopic exploration can promptly identify the Anisakis larvae. Moreover, some authors consider the prevailing allergic reaction as a natural and effective defense against the parasitic attack. We report two cases of peculiar manifestations of anisakiasis in both acute and chronic forms (severe chest discomfort and anaphylactoid reaction.

  13. Should the host reaction to anisakiasis influence the treatment?: Different clinical presentations in two cases ¿Debe la reacción frente la anisakiasis influir sobre el tratamiento?: Presentación clínica

    Directory of Open Access Journals (Sweden)

    Stefano Pontone

    2012-12-01

    Full Text Available Gastrointestinal anisakiasis is a parasitic infection occurring in people that consume raw or inadequately cooked fish or squid. It is frequently characterized by severe epigastric pain, nausea and vomiting caused by the penetration of the larvae into the gastric wall. Acute gastric anisakiasis with severe chest discomfort is rarely reported in Italy. On the other hand, gastro-allergic anisakiasis with rash, urticaria and isolated angioedema or anaphylaxis is a clinical entity that has been described only recently. Also, if patients usually develop symptoms within 12 hours after raw seafood ingestion, not always endoscopic exploration can promptly identify the Anisakis larvae. Moreover, some authors consider the prevailing allergic reaction as a natural and effective defense against the parasitic attack. We report two cases of peculiar manifestations of anisakiasis in both acute and chronic forms (severe chest discomfort and anaphylactoid reaction.

  14. Investigative methods for natural rubber latex allergy in the UK.

    Science.gov (United States)

    Lowe, J G; Green, C M; Nasser, S M

    2005-01-01

    Allergy to natural rubber latex (NRL) has become an important health issue in recent years, but little is known about how this condition is investigated by physicians in the UK. This postal questionnaire of British dermatology and allergy specialists shows substantial variation in diagnostic practice, most notably with regard to the utilization and choice of starting dose of commercial latex prick test dilutions, reliance on allergen-specific immunoglobulin E measurement, investigation of associated fruit allergy and provision of resuscitation equipment/method of consent when challenge testing. 17% of responding physicians who investigate for NRL allergy do not perform prick test or glove challenge because of the potential risk of anaphylaxis or lack of resuscitation facilities. 87% of allergy clinic specialists report no reduction in the number of patients presenting as new referrals with suspected NRL allergy. These findings suggest a need for robust guidance to achieve more consistent investigative practice by those dealing with this condition. PMID:15701123

  15. Immunologic therapeutic approaches in the management of food allergy.

    Science.gov (United States)

    Wang, Julie; Sicherer, Scott H

    2009-05-01

    Food allergy affects up to 6% of children and 3-4% of adults in Westernized countries, and is the most common cause of outpatient anaphylaxis in most studies. The mainstay of treatment is strict avoidance of the offending allergens and education regarding the use of emergency medication in cases of accidental ingestions or exposures. While these approaches are generally effective, there are no definitive treatments that cure or provide long-term remission from food allergy. However, with recent advances in characterizing food allergens and understanding humoral and cellular immune responses in food allergy, several therapeutic strategies are being investigated. Potential treatments include allergen-specific immunotherapy as well as allergen-nonspecific approaches to downregulate the overall allergic response in food-allergic individuals. PMID:20477008

  16. Characteristics of food-allergic patients placing them at risk for a fatal anaphylactic episode.

    Science.gov (United States)

    Muñoz-Furlong, Anne; Weiss, Christopher C

    2009-01-01

    Food allergy is a growing public health and food safety concern. Twelve million Americans-4% of the population-suffer from the disease, and the prevalence is increasing. There is no cure for food allergy; strict avoidance is the only way to prevent a reaction. Food allergy is a major cause of anaphylaxis, a severe, potentially life-threatening allergic reaction that results in an estimated 30,000 emergency department visits and 100 to 150 deaths annually. Factors that place food-allergic patients at greater risk for a fatal anaphylactic episode include asthma; being a teen or young adult; peanut, tree nut, and seafood allergy; not carrying epinephrine; restaurant food; spending time in schools and child care settings; and lack of information from health care providers. Better education of patients and their families about managing their food allergy and high-risk situations can help to prevent future fatalities. PMID:19063826

  17. Oral food challenges in children: review and future perspectives.

    Science.gov (United States)

    Greenhawt, Matthew

    2011-12-01

    Food allergy is a lifelong condition with no known treatment or cure. Allergy tests such as skin tests and blood tests are not always accurate when positive and are not necessarily diagnostic of a food allergy. A food allergy takes into consideration both the history of exposure and the testing. The food challenge is considered the diagnostic gold standard for food allergy. However, recent evidence suggests that not enough challenges are being performed. Several techniques exist with which clinicians can challenge patients. Providers who perform challenges should be familiar with assessing signs and symptoms of a potential reaction and must be prepared to treat anaphylaxis. The magnitude of the serum and skin tests may be of assistance in stratifying a patient's risk of passing a challenge, and newer diagnostic tests may help better stratify such risk of based on particular epitope recognition. PMID:21901306

  18. Cow milk allergy symptoms are reduced in mice fed dietary synbiotics during oral sensitization with whey.

    Science.gov (United States)

    Schouten, Bastiaan; van Esch, Betty C A M; Hofman, Gerard A; van Doorn, Suzan A C M; Knol, Jan; Nauta, Alma J; Garssen, Johan; Willemsen, Linette E M; Knippels, Léon M J

    2009-07-01

    Cow milk allergy is the most common food allergy in children. So far, no effective treatment is available to prevent or cure food allergy. The purpose of this study was to compare effects of dietary supplementation with a prebiotic mixture (Immunofortis), a probiotic strain [Bifidobacterium breve M-16V], or a synbiotic diet combining both on the outcome of the allergic response when provided during oral sensitization with whey in mice. Mice were fed diets containing 2% (wt:wt) Immunofortis and/or the B. breve M-16V (n = 6/group). The acute allergic skin response was determined by measuring ear swelling. Antigen-induced anaphylaxis was scored. Furthermore, whey-specific serum immunoglobulins and mouse mast cell protease-1 (mMCP-1) were determined. In mice fed the synbiotic mixture, the allergic skin response and the anaphylactic reaction were strongly reduced compared with whey-sensitized mice fed the control diet (P food allergens. PMID:19474160

  19. Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins

    Directory of Open Access Journals (Sweden)

    Sasmita Biswal

    2012-01-01

    Full Text Available We present a case of complete heart block (CHB in a 58-year-old female patient with acute myeloid leukemia (AML with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspofungins. Subsequent to induction chemotherapy the patient developed invasive pulmonary aspergillosis with sudden tachypnea, dyspnoea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency consequent to neutropenia with ANC<500. During the first dose of antifungal therapy with caspofungins, she developed complete atrioventricular block and cardiac arrest. Complete heart block is an unusual adverse effect of caspofungins which has not been reported previously. Caspofungins release histamine in peripheral blood cells, so possible histamine-mediated symptoms ranging from severe fatal anaphylaxis can occur. These data suggest that infusion-related reactions associated with caspofungin may be mediated by histamine release secondary to caspofungin therapy.

  20. Disease-specific health-related quality of life instruments for IgE-mediated food allergy

    DEFF Research Database (Denmark)

    Salvilla, S A; Dubois, A E J; Flokstra-de Blok, B M J;

    2014-01-01

    This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are...... significantly more sensitive than generic ones in measuring the response to interventions or future treatments, as well as estimating the general burden of food allergy. The aim of this systematic review was therefore to identify which disease-specific, validated instruments can be employed to enable assessment...... of the impact of, and investigations and interventions for, IgE-mediated food allergy on health-related quality of life (HRQL). Using a sensitive search strategy, we searched seven electronic bibliographic databases to identify disease-specific quality of life (QOL) tools relating to Ig...

  1. The Anisakis allergy debate: does an evolutionary approach help?

    Science.gov (United States)

    Daschner, Alvaro; Cuéllar, Carmen; Rodero, Marta

    2012-01-01

    Allergic phenomena share common pathways with the immune response against helminth parasites. The definitions regarding allergens and their related concepts have their roots in the area of allergy research. The experience with the fish parasite Anisakis simplex-associated allergic features still nurtures an open debate on the necessity of larvae being alive to induce allergic reactions such as urticaria or anaphylaxis. Conceptual definitions of allergen, major allergen, as well as putatively crossreacting antibodies, as are used in food allergy, depend on the clinical relevance of specific IgE and deserve careful interpretation in the various forms of A. simplex-associated allergic features. Conversely, an evolutionary based interpretation of the presence of specific IgE depends on the viability of A. simplex. PMID:22079162

  2. [Systemic mastocytosis: a heterogeneous disease].

    Science.gov (United States)

    Hermans, M A W; Verburg, M; van Laar, J A M; van Hagen, P M; Pasmans, S G M A; van Daele, P L A

    2016-01-01

    Systemic mastocytosis (SM) is an acquired myeloproliferative disease, which is caused by an uncontrolled proliferation of aberrant mast cells. SM patients can have very different clinical phenotypes and may therefore initially present to different specialties. Diagnosis is often delayed because many physicians are unfamiliar with this illness. This can lead to substantial morbidity and puts patients at risk of complications such as severe anaphylaxis. Measurement of serum tryptase levels is always a sensible first step in the diagnostic work-up, but a normal serum tryptase does not rule out SM completely, and a bone marrow biopsy is essential for a conclusive diagnosis. Here, we describe two patient cases to illustrate the heterogeneous nature of this disease, and provide an overview of the symptoms, diagnostic work-up and current treatments options for SM. PMID:27229688

  3. Food Allergy: Our Evolving Understanding of Its Pathogenesis, Prevention, and Treatment.

    Science.gov (United States)

    Iweala, Onyinye I; Burks, A Wesley

    2016-05-01

    Food allergy is defined as an IgE-mediated hypersensitivity response to ingested food with allergic symptoms ranging from urticaria to life-threatening anaphylaxis. Food allergy is thought to develop because of (1) failed induction of tolerance upon initial exposure to food antigen or (2) breakdown of established tolerance to food antigen. We review current understanding of the pathogenesis, epidemiology, and natural history of food allergy, including the unconventional IgE-mediated food allergy to mammalian meat known as alpha-gal food allergy. We highlight emerging data on food allergy treatment and prevention, emphasizing the growing appeal of manipulating the gut microenvironment using probiotics and helminth products to blunt systemic allergic responses to food. PMID:27041704

  4. Extractable low mass proteins <30kDa from peanut display elevated antigenicity (IgG-binding) and allergenicity (IgE-binding) in vitro and are attenuated by thermal reactivity with non-peanut food ingredients.

    Science.gov (United States)

    Bennett, Louise; Lee, Alvin

    2016-03-01

    Human allergic reactions to peanut proteins and the associated risk of life-threatening anaphylaxis requires vigilant management of peanuts in food processing. Processed forms of peanuts with attenuated antigenicity and less severe immunogenic responses may lower the risk. Molecular subfractions of raw (UP), blanched (BP) and roasted (RP) peanuts were prepared including water-insoluble (P1), water-soluble high mass (>30kDa, P2) and water-soluble low mass (3). The results showed that IgE titres were highest for total extracts of RP, particularly for P3 fractions of UP and RP, and were affected by further heating. Antigenicity was also modulated by heating in the presence of either peanut oil or non-peanut food ingredients (lactose, coconut oil). Results support several alternative methods for regulating peanut antigenicity using food processing approaches but require further substantiation in larger numbers of allergic and control donor sera. PMID:26471622

  5. Quality of life in families with peanut/egg/hazelnut allergy

    DEFF Research Database (Denmark)

    Stensgaard, Anette

    2013-01-01

    help, guidance and support. Focus can be directed to how food allergy affects everyday life. It may also increase awareness in their respective social networks such as kindergarten, school and in the working environment. The results will also provide knowledge to health professionals improving......Quality of life in families with peanut/egg/hazelnut allergy Anette Stensgaard, Audrey DunnGalvin, Dorthe Nielsen, Carsten Bindslev-Jensen (Department of Dermatology and Allergy Centre, ORCA (Odense Research Centre for Anaphylaxis), Odense University Hospital, DK-5000 Odense C, Denmark) Aim......: International research shows that Food Allergy has an impact on the quality of life for the affected child, adolescent and even in adulthood – as well for the parents. The aim of this study is to gain more knowledge on quality of life for Danish patients diagnosed with peanut, egg or/and hazelnut allergy and...

  6. Green self-assembly of zein-conjugated ZnO/Cd(OH)Cl hierarchical nanocomposites with high cytotoxicity and immune organs targeting

    Science.gov (United States)

    Wang, Hua-Jie; Cao, Ying; Wang, Cai-Feng; Cui, Shi-Zhong; Mi, Li-Wei; Miyazawa, Teruo

    2016-04-01

    Inorganic nanomedicines in the fight against cancer have progressed rapidly during recent years, with the synergistic advantages of multifunctional nanosystems compared to single component. Herein, a drug-combination opinion was introduced into “nanomedicine” based on the understanding of Trojan horse-anti-tumor mechanism of inorganic nano-medicines. Moreover, we reported the green and facile synthesis route of mono-dispersed and rod-like zein-conjugated ZnO/Cd(OH)Cl hierarchical nanocomposites. We found that the nanocomposites exhibited high-efficiency killing ability to tumor cells through lipid peroxidation mediated-membrane disintegration route. The safety studies in BALB/c mice didn’t detect injection anaphylaxis, hemolysis and cytotoxicity. More interestingly, the nano-composites could specially accumulate in liver and kidney, which will be helpful for targeting cure to these regional cancers.

  7. FOOD ALLERGY AND ORAL ALLERGY SYNDROME. Part I. A review.

    Directory of Open Access Journals (Sweden)

    Miglena Balcheva

    2013-09-01

    Full Text Available Food allergy and intolerance are wide spread nowadays. However, the problem existed and was registered and described still by the ancients. It was fully understood and scientifically depicted in the 20th century after IgE and anaphylaxis were discovered, new diagnostic tests were initiated and the term “allergy” was introduced. There are some interesting aspects of the problem. Epidemiology is the first one – in the last two decades the number of people suffering from food allergy increased significantly and reached 4% of the population. Food allergy covers all ages, both sexes; atopic people and these with other allergic or digestive diseases are in the risk group also. There is certain influence of the eating habits as well. Etiology is rich and varied. It includes all foodstuffs of plant and animal origin, spices, honey, medicinal products - milk, eggs, meat, fish, nuts, fruits and vegetables, etc. Pathogenesis is complex.

  8. Allergic urticaria: A case report of rare skin allergy with a common mouthwash

    Directory of Open Access Journals (Sweden)

    Viresh Chopra

    2013-01-01

    Full Text Available Chlorhexidine is a widely used antiseptic and disinfectant in medical and non-medical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. Chlorhexidine has been used for more than 50 years but it was only in the last two decades, that reports of immediate- type reactions to chlorhexidine were seen. Reactions ranging from localized urticaria to anaphylactic shock and hypersensitivity reactions, including delayed hypersensitivity reactions such as contact dermatitis, fixed drug eruptions, and photosensitivity reactions, began to appear more frequently. However the prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. In this case report we have reported a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by a skin prick test.

  9. Prospective, double-blind, placebo-controlled trials of ecallantide for acute attacks of hereditary angioedema.

    Science.gov (United States)

    Stolz, Leslie E; Sheffer, Albert L

    2012-01-01

    Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable, episodic, incapacitating attacks of well-demarcated angioedema in the absence of urticaria and pruritus. HAE is due to deficient or dysfunctional C1-esterase inhibitor activity, which results in unopposed activation of plasma kallikrein, resulting in increased levels of bradykinin. Ecallantide is a potent and specific plasma kallikrein inhibitor approved for the treatment of acute attacks of HAE affecting any anatomic site. In Phase III clinical trials, subcutaneously administered ecallantide demonstrated significant, rapid and durable symptom relief. Ecallantide was effective for all attack types, including potentially life-threatening laryngeal attacks. The main safety concern is potentially serious hypersensitivity reactions, including anaphylaxis. Ecallantide represents an important treatment option for the management of acute attacks of HAE. PMID:22149337

  10. Brain Infarction: Rare Neurological Presentation of African Bee Stings.

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Duarte-Valdivieso, Nancy Carolina; Alcala-Cerra, Gabriel; Moscote-Salazar, Luis Rafael

    2014-01-01

    Bee stings are commonly encountered worldwide. Various manifestations after bee sting have been described including local reactions which are common, systemic responses such as anaphylaxis, diffuse intravascular coagulation and hemolysis. We report a case of a 74-year-old man who developed neurologic deficit 5 hours after bee stings, which was confirmed to be left frontal infarction on brain CT-scan. The case does not follow the reported  pattern  of hypovolemic or anaphylactic shock, hemolysis and/or  rhabdomyolysis, despite the potentially lethal amount of venom injected. Diverse mechanisms have been proposed to give an explanation to all the clinical manifestation of both toxic and allergic reactions secondary to bee stings. Currently, the most accepted one state that victims can develop severe syndrome characterized by the release of a large amount of cytokines. PMID:27162866

  11. Quality of Life Among Food Allergic Patients and Their Caregivers.

    Science.gov (United States)

    Warren, Christopher M; Otto, Alana K; Walkner, Madeline M; Gupta, Ruchi S

    2016-05-01

    Food allergy is increasing in prevalence worldwide. This review summarizes progress made studying relationships between food allergy and quality of life (QOL), with an emphasis on recent work in the field. Early work examining QOL among food allergy patients established that stress and anxiety associated with continuous allergen avoidance and the looming threat of anaphylaxis were associated with significantly impaired food allergy quality of life (FAQOL) for children with food allergy and their caregivers. Recent clinical studies suggest that undergoing oral food challenge to confirm food allergy and oral immunotherapy to treat food allergy may each improve FAQOL among both patients and their caregivers. Other intervention modalities, such as nurse-facilitated counseling and educational workshops, also hold promise, but additional work is needed. Future work must strive to recruit more representative, population-based samples, including adult patients, in order to improve the generalizability and clinical relevance of findings. PMID:27048239

  12. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

    Directory of Open Access Journals (Sweden)

    Nicholas G Kounis

    2015-01-01

    Full Text Available Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  13. Solar urticaria successfully treated with intravenous immunoglobulin.

    LENUS (Irish Health Repository)

    Hughes, R

    2012-02-01

    Idiopathic solar urticaria (SU) is a rare, debilitating photodermatosis, which may be difficult to treat. First-line treatment with antihistamines is effective in mild cases, but remission after phototherapeutic induction of tolerance is often short-lived. Other treatment options include plasma exchange, photopheresis and cyclosporin. We present two cases of severe, idiopathic SU, which were resistant to conventional treatment. Both patients achieved remission after administration of intravenous immunoglobulin (IVIg) and have remained in remission at 13 months and 4 years, respectively. There are only two case reports of successful treatment of solar urticaria with IVIg. In our experience IVIg given at a total dose of 2 g\\/kg over several 5-day courses about a month apart is an effective treatment option for severe idiopathic SU. It is also generally safe, even if certainly subject to significant theoretical risks, such as induction of viral infection or anaphylaxis.

  14. Rupturedhydatidcystinapatientwithshock

    Institute of Scientific and Technical Information of China (English)

    Diego Castanares-Zapatero; Pierre François Laterre

    2009-01-01

    Echinococcosis is a severe helminthic zoonosis largely caused by Echinococcus granulosus and frequently encountered in endemic areas. The liver and lung are the most frequently involved organs. Cyst rupture into the peritoneal cavity represents a rare but serious complication. Herein, we describe an acute occurrence of anaphylactic shock due to a spontaneous rupture of hydatid cyst in a 21-year-old Turkish patient unwittingly infected by Echinococcosis. Resection surgery of the perforated cyst in combination with cleaning of the abdominal cavity was performed. The patient rapidly improved and no relapse occurred during a follow-up of 8 months. Anaphylaxis is a serious complication of hydatid cyst rupture and needs to be promptly diagnosed. The main objective of our report is to underscore this life-threatening complication that should be considered when anaphylactic shock of unknown origin occurs, even in non-endemic regions. Moreover, we emphasize the need for a radical surgical approach to avoid widespread dissemination.

  15. Allergenic activity of honey

    Directory of Open Access Journals (Sweden)

    Bogdan Kędzia

    2012-12-01

    Full Text Available An allergy to honey is a rare symptom. It usually occurs when people are allergic to food components, pollen and bee venom. Most often an allergy to honey is manifested by disturbances of skin and digestive system. Anaphylaxis is seldom, pollen proteins are more often the cause of an allergy to honey than honeybee ones. In particular cases an allergy can be caused by moulds, yeasts and secretion of sapsucking insects. An allergy to honey is often caused by pollen of floral plants from Compositae family (e.g.: sunflower, mugwort, marguerite, dandelion, golden rod, ragweed. It is caused more rarely by grass pollen (timothy and trees (birch, hazel, olive. The cross allergy between two kinds of pollen of the same family (dandelion and sunflower and between pollen of different families (sunflower and celery is well-known. On this basis one can consider that the allergy to one monofloral honey can cause the allergy to other monoflower ones.

  16. [In Process Citation].

    Science.gov (United States)

    Konradsen, Jon; Arvidsson, Monica

    2016-01-01

    Allergen immunotherapy (AIT) to patients with allergy towards pollens, cats or house dust mite provides longstanding improvement of symptoms of rhinoconjunctivitis and allergic asthma and reduces the need for symptomatic medication. In addition, some studies suggest that AIT can protect from the development of asthma in children with allergic rhinitis. The clinical effects of AIT are explained by a shift from a Th2 to a Th1-mediated immune response upon allergen exposure. In Sweden the treatment is given as sublingual tablets (grass) or subcutaneous injections, and a treatment period of 3-4 years is necessary to ensure longstanding effect of the treatment. Serious side-effects such as asthma attacks or anaphylaxis are uncommon, if the treatment is provided by staff specifically trained to administer AIT. Intralymphatic administration of the allergen extract is a novel and promising approach that might shorten the treatment period with similar clinical effects. PMID:27046757

  17. Collagen fleece-bound fibrin sealant is not associated with an increased risk of thromboembolic events or major bleeding after its use for haemostasis in surgery: a prospective multicentre surveillance study

    DEFF Research Database (Denmark)

    Birth, Mathias; Figueras, Joan; Bernardini, Stéphane;

    2009-01-01

    with particular focus on the occurrence of thromboembolic events (TEEs), major bleeding and immunological events. METHODS: This was a non-interventional, multicentre, prospective, surveillance study in which a collagen fleece-bound fibrin sealant was prescribed in accordance with its marketing authorisation....... The decision to use the sealant was based solely on current surgical practice. All patients that received the sealant and provided informed consent were included. TEEs (any coagula-based occlusion in a vessel or the heart identified by symptomatic clinical signs and/or verified by paraclinical examination......), major bleeding (any bleeding that required intervention), and immunological events (hypersensitivity including anaphylaxis) that occurred during surgery, post-operative hospital stay or 6 months of follow-up were reported as adverse events. The primary endpoint was the proportion of patients...

  18. ALIMENTARY ALLERGY AND HYPERSENSIVITY TO SOYA BEAN PROTEINS

    Directory of Open Access Journals (Sweden)

    V. B. Gervazieva

    2014-07-01

    Full Text Available Abstract. In connection with the increasing number of allergic diseases in Russia and in the world, the exogenic factor responsible for the development of food allergy in children have been discussed. The main types of alimentary allergens have been determined; their biochemical features, as well as aggravation of the food allergy clinical symptoms to the extent of anaphylaxis, have been reported. With the development of genetic engineering food products, the special attention has been paid to hypersensitivity to soya bean proteins. The major and minor allergens of soya beans, their homologues in other vegetable allergens, e.g. birch pollen allergens, have been described. (Med. Immunol., 2005, vol.7, № 1, pp. 15520

  19. Complements Are Not Always a Good Thing: Novel Therapies for Angioedema.

    Science.gov (United States)

    Bailey, Abby Mynatt; Reed, Brittany S; Weant, Kyle A; Justice, Stephanie Baker

    2016-01-01

    Hereditary angioedema attacks are rare, but emergency care providers must be aware of the clinical presentation and treatment of these patients because the emergency department remains the most common setting where these patients seek treatment. If providers are not aware of the past medical history of these patients, they are likely to receive standard therapies for respiratory distress and anaphylaxis including antihistamines, corticosteroids, and epinephrine. However, these medications may not work in these patients, given the pathophysiology of their underlying disease. Since 2009, several new therapies have been approved for the treatment of acute hereditary angioedema attacks. This article discusses pathophysiology, clinical presentation, and use of novel therapies for the management of angioedema. PMID:27139131

  20. Food allergy: Definitions,prevalence,diagnosis and therapy

    DEFF Research Database (Denmark)

    van Ree, Ronald; Poulsen, Lars K; Wong, Gary Wk;

    2015-01-01

    to dietary habits. Molecular allergology and biotechnology now offer the possibility to combat the increasing burden of food allergy by developing safe immunotherapies for food allergy, using hypoallergenic mutant recombinant molecules. The first clinical trials to evaluate such approaches are underway. Last......Food allergy is phenotypically an extremely heterogeneous group of diseases affecting multiple organs, sometimes in an isolated way, sometimes simultaneously, with the severity of reactions ranging from mild and local to full-blown anaphylaxis. Mechanistically, it is defined as a Th2-driven immune...... disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions. The sites of sensitization and symptoms do not necessarily overlap. Food allergy, which is the theme of this paper, is often confused with other adverse reactions to food of both animmune (e.g., celiac...

  1. IgE-mediated chlorhexidine allergy: a new occupational hazard?

    DEFF Research Database (Denmark)

    Nagendran, Vasantha; Wicking, Jennifer; Ekbote, Anjali;

    2009-01-01

    BACKGROUND: Chlorhexidine is an effective antimicrobial agent commonly used in UK hospitals, primarily for skin decontamination. Recent UK infection control guidelines recommend the use of 2% chlorhexidine solution in specific clinical settings, thus increasing chlorhexidine use by health care...... workers (HCWs). Chlorhexidine has been widely reported to cause IgE-mediated allergic reactions (from urticaria and angioedema to anaphylaxis) among patients undergoing surgery/invasive procedures. Despite its widespread use in health care settings, there are no reports of clinically confirmed...... occupational IgE-mediated chlorhexidine allergy. AIMS: To identify cases of chlorhexidine allergy among health care workers. METHODS: A questionnaire was distributed among HCWs in wards and operating theatres at a UK district general hospital to raise awareness of potential chlorhexidine allergy and to invite...

  2. Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism

    Directory of Open Access Journals (Sweden)

    Michael D. Benson

    2012-01-01

    Full Text Available Amniotic fluid embolism (AFE is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation?

  3. [Poisoning by bee sting].

    Science.gov (United States)

    de Roodt, Adolfo R; Salomón, Oscar D; Orduna, Tomás A; Robles Ortiz, Luis E; Paniagua Solís, Jorge F; Alagón Cano, Alejandro

    2005-01-01

    Among the human pathologies produced by venomous animals, bee stings constitute the largest number of accidents in several countries, exceeding the mortality rate caused by other venomous animals such as snakes, spiders or scorpions. The clinical picture after the bee sting may include anaphylaxis or poisoning. The latter is produced by massive attacks and is a serious problem that may put the patient's life at risk. People that are poisoned display hemolysis, rhabdomiolysis and acute renal failure that together with other systemic failures can bring about death. The knowledge of the physiopathological mechanisms involved in the massive attack of bees is crucial for health care professionals as to date we do not have antivenoms with proven clinical efficacy. In this review we include the bee's biological aspects, venom composition and its relation with the occurrence and severity of accidents as well as epidemiological data that can be useful for this type of accidents. PMID:16025987

  4. The inhibition of kallikrein-bradykinin pathway may be useful in the reduction of allergic reactions during honeybee venom immunotherapy

    Directory of Open Access Journals (Sweden)

    Ervin Ç. Mingomataj

    2009-05-01

    Full Text Available "nVenom immunotherapy (VIT protects patients with hymenoptera venom anaphylaxis from subsequent potentially life-threatening reactions. The most important side effects during VIT are systemic anaphylactic reactions (SAR, which are more prevalent during honeybee VIT. Despite the demonstrated diversity with regard to venom compounds, previous publications did not mention the plausible reason that can justify the difference of SAR frequency between honeybee and wasps. On the other hand, pre-treatment with H1-blocking antihistamines reduces the frequency and intensity of local and mild systemic anaphylactic reactions during VIT, but not appropriately moderate adverse reactions such as abdominal pain or angioedematous reactions, which can occur more prevalently also during honeybee VIT. In contrast to hymenoptera venom (HV anaphylaxis, these symptoms are very common during hereditary angioedema (HAE. In addition, in some patients who repeatedly experienced anaphylactic reactions during hyposensitization with HV are reported significantly lower renin, angiotensinogen I, and angiotensinogen II plasma levels. These facts may indicate that during honeybee VIT could be occurred a defective implication of renin-angiotensin system. This may be possible, because among hymenoptera, only the HV contains the antigen melittin, a potent kallikrein activator. These effects during honeybee VIT are similar to the HAE, because melittin-induced kallikrein activation on the first hand, as well as the implication of complement classical pathway during HAE on the second one, can lead both to increased bradykinin (BK secretion, plasma extravasation, and therefore to the occurrence of angioedema and abdominal symptoms. Consequently, the clinical effectiveness of BK receptor and generator blockers such as icatibant, ecallantide or NPC 18884, shown recently during the treatment of HAE attacks and acetic acid-induced abdominal constrictions in mice, may lead to the hypothesis

  5. IL-10 Enhances IgE-Mediated Mast Cell Responses and Is Essential for the Development of Experimental Food Allergy in IL-10-Deficient Mice.

    Science.gov (United States)

    Polukort, Stephanie H; Rovatti, Jeffrey; Carlson, Logan; Thompson, Chelsea; Ser-Dolansky, Jennifer; Kinney, Shannon R M; Schneider, Sallie S; Mathias, Clinton B

    2016-06-15

    IL-10 is a key pleiotropic cytokine that can both promote and curb Th2-dependent allergic responses. In this study, we demonstrate a novel role for IL-10 in promoting mast cell expansion and the development of IgE-mediated food allergy. Oral OVA challenge in sensitized BALB/c mice resulted in a robust intestinal mast cell response accompanied by allergic diarrhea, mast cell activation, and a predominance of Th2 cytokines, including enhanced IL-10 expression. In contrast, the development of intestinal anaphylaxis, including diarrhea, mast cell activation, and Th2 cytokine production, was significantly attenuated in IL-10(-/-) mice compared with wild-type (WT) controls. IL-10 also directly promoted the expansion, survival, and activation of mast cells; increased FcεRI expression on mast cells; and enhanced the production of mast cell cytokines. IL-10(-/-) mast cells had reduced functional capacity, which could be restored by exogenous IL-10. Similarly, attenuated passive anaphylaxis in IL-10(-/-) mice could be restored by IL-10 administration. The adoptive transfer of WT mast cells restored allergic symptoms in IL-10(-/-) mice, suggesting that the attenuated phenotype observed in these animals is due to a deficiency in IL-10-responding mast cells. Lastly, transfer of WT CD4 T cells also restored allergic diarrhea and intestinal mast cell numbers in IL-10(-/-) mice, suggesting that the regulation of IL-10-mediated intestinal mast cell expansion is T cell dependent. Our observations demonstrate a critical role for IL-10 in driving mucosal mast cell expansion and activation, suggesting that, in its absence, mast cell function is impaired, leading to attenuated food allergy symptoms. PMID:27183617

  6. Protective Effect of an Antibody against Specific Extracellular Domain of TLR2 on Agonists-Driven Inflammatory and Allergic Response

    Science.gov (United States)

    Guo, Tianwu; Cai, Jun; Peng, Yanxia; Zhang, Lifang; Lan, Qiaofen; Chen, Yanwen; Liao, Huanjin; Xie, Tong; Wu, Ping; Pan, Qingjun

    2016-01-01

    Specific blocking strategies of TLR2-mediated inflammatory signaling and hypersensitivity reactions may offer novel therapeutic strategies to prevent a variety of diseases. In this study, we investigated the blocking effects of a new anti-TLR2 antibody anti-T20 against a 20 mer peptide T20 located in the extracellular specific domain of mouse TLR2. In addition, the effects of the anti-T20 in vitro, measuring the inhibition of the IL-6 and TNF-α production in response to PGN, LTA, and Pam3CSK4-stimulated RAW264.7 cells, were determined. In vivo, the effects of anti-T20 on a lethal anaphylaxis model using PGN-challenged OVA allergic mice, including the rectal temperature and mortality, and serum levels of TNF-α, IL-6, and LTC4 were assayed. The results showed that anti-T20 specifically bound to TLR2 and significantly inhibited PGN, LTA, and Pam3CSK4-driven TNF-α and IL-6 production by RAW264.7 cells. Also, anti-T20 protected OVA allergic mice from PGN-induced lethal anaphylaxis, and the serum levels of TNF-α, IL-6, and LTC4 of anti-T20 treated PGN-challenged OVA allergic mice were decreased as compared to isotype control of anti-T20 treated mice. In summary, this study produced a new antibody against the specific extracellular domain of TLR2 which has protective effect on TLR2 agonists-driven inflammatory and allergic response.

  7. Differential eosinophil and mast cell regulation: mast cell viability and accumulation in inflammatory tissue are independent of proton-sensing receptor GPR65.

    Science.gov (United States)

    Zhu, Xiang; Mose, Eucabeth; Hogan, Simon P; Zimmermann, Nives

    2014-06-01

    Extracellular acidification has been observed in allergic inflammatory diseases. Recently, we demonstrated that the proton-sensing receptor G protein-coupled receptor 65 (GPR65) regulates eosinophil survival in an acidic environment in vitro and eosinophil accumulation in an allergic lung inflammation model. For mast cells, another inflammatory cell type critical for allergic responses, it remains unknown whether GPR65 is expressed and/or regulates mast cell viability. Thus, in the present study, we employed in vitro experiments and an intestinal anaphylaxis model in which both mastocytosis and eosinophilia can be observed, particularly in the gastrointestinal tract, to enable us to directly compare the effect of GPR65 expression on these two cell types. We identified GPR65 expression on mast cells; however, unlike eosinophil viability, mast cell viability in vitro is not affected by acidification or GPR65 expression. Mechanistically, we determined that mast cells do not respond to extracellular acidification with increased cAMP levels. Furthermore, in the intestinal anaphylaxis model, we observed a significant reduction of eosinophils (59.1 ± 9.2% decrease) in the jejunum of allergen-challenged GPR65-deficient mice compared with allergen-challenged wild-type mice, despite the degree of antigen sensitization and the expression levels of Th2 cytokines (Il4, Il13) and eosinophil chemokines (Ccl11, Ccl24) in the jejunum being comparable. In contrast, the accumulation of mast cells in allergen-challenged mice was not affected by GPR65 deficiency. In conclusion, our study demonstrates differential regulation of eosinophils and mast cells in inflammatory tissue, with mast cell viability and accumulation being independent of GPR65. PMID:24742990

  8. Regulatory T cells enhance mast cell production of IL-6 via surface-bound TGF-β.

    Science.gov (United States)

    Ganeshan, Kirthana; Bryce, Paul J

    2012-01-15

    Mast cell degranulation is a hallmark of allergic reactions, but mast cells can also produce many cytokines that modulate immunity. Recently, CD25(+) regulatory T cells (Tregs) have been shown to inhibit mast cell degranulation and anaphylaxis, but their influence on cytokine production remained unknown. In this study, we show that, rather than inhibit, Tregs actually enhance mast cell production of IL-6. We demonstrate that, whereas inhibition of degranulation was OX40/OX40 ligand dependent, enhancement of IL-6 was due to TGF-β. Interestingly, our data demonstrate that the Treg-derived TGF-β was surface-bound, because the interaction was contact dependent, and no TGF-β was detectable in the supernatant. Soluble TGF-β1 alone was sufficient to enhance mast cell IL-6 production, and these supernatants were sufficient to promote Th17 skewing, but those from Treg-mast cell cultures were not, supporting this being surface-bound TGF-β from the Tregs. Interestingly, the augmentation of IL-6 production occurred basally or in response to innate stimuli (LPS or peptidoglycan), adaptive stimuli (IgE cross-linking by specific Ag), and cytokine activation (IL-33). We demonstrate that TGF-β led to enhanced transcription and de novo synthesis of IL-6 upon activation without affecting IL-6 storage or mRNA stability. In vivo, the adoptive transfer of Tregs inhibited mast cell-dependent anaphylaxis in a model of food allergy but promoted intestinal IL-6 and IL-17 production. Consequently, our findings establish that Tregs can exert divergent influences upon mast cells, inhibiting degranulation via OX40/OX40 ligand interactions while promoting IL-6 via TGF-β. PMID:22156492

  9. Mast cells and IgE in defense against venoms: Possible “good side” of allergy?

    Directory of Open Access Journals (Sweden)

    Stephen J. Galli

    2016-01-01

    Full Text Available Physicians think of mast cells and IgE primarily in the context of allergic disorders, including fatal anaphylaxis. This ‘bad side’ of mast cells and IgE is so well accepted that it can be difficult to think of them in other contexts, particularly those in which they may have beneficial functions. However, there is evidence that mast cells and IgE, as well as basophils (circulating granulocytes whose functions partially overlap with those of mast cells, can contribute to host defense as components of adaptive type 2 immune responses to helminths, ticks and certain other parasites. Accordingly, allergies often are conceptualized as “misdirected” type 2 immune responses, in which IgE antibodies are produced against any of a diverse group of apparently harmless antigens, as well as against components of animal venoms. Indeed, certain unfortunate patients who have become sensitized to venoms develop severe IgE-associated allergic reactions, including fatal anaphylaxis, upon subsequent venom exposure. In this review, we will describe evidence that mast cells can enhance innate resistance to reptile or arthropod venoms during a first exposure to such venoms. We also will discuss findings indicating that, in mice which survive an initial encounter with venom, acquired type 2 immune responses, IgE antibodies, the high affinity IgE receptor (FcɛRI, and mast cells can contribute to acquired resistance to the lethal effects of both honeybee venom and Russell's viper venom. These findings support the hypothesis that mast cells and IgE can help protect the host against venoms and perhaps other noxious substances.

  10. An approach to death as an adverse event following immunization.

    Science.gov (United States)

    Gold, Michael S; Balakrishnan, Madhava Ram; Amarasinghe, Ananda; MacDonald, Noni E

    2016-01-01

    Co-incidental death occurring proximate to vaccination may be reported as an adverse event following immunization. Such events are particularly concerning because they may raise community and health provider concerns about the safety of the specific vaccine and often the immunization programme in general. Coincidental events need to be differentiated from vaccine reactions, such as anaphylaxis, which may very rarely result in death. In 2013, the World Health Organization (WHO) released an updated manual for the Causality Assessment of an AEFI. The purpose of this review is to apply the WHO causality methodology to death when this is reported as an AEFI. The causality assessment scheme recommends a four step process to enable classification of the AEFI and to differentiate events which are causally consistent from those that are inconsistent with immunization. However, for some events causality maybe indeterminate. Consistent causal reactions that may result in death are very rare and maybe related to the vaccine product (e.g. anaphylaxis, viscerotrophic disease), vaccine quality defect (e.g. an incompletely attenuated live vaccine agent) or an immunization error (e.g. vaccine vial contamination). Events that are inconsistent with immunizations are due to co-incidental conditions that may account for infant and childhood mortality. In countries with a high infant mortality rate the coincidental occurrence of death and immunization may occur not infrequently and a robust mechanism to obtain information from autopsy and perform an AEFI investigation and causality assessment is essential. Communication with the community and all stakeholders to maintain confidence in the immunization programme is critical. PMID:26608326

  11. Mastocytosis: the puzzling clinical spectrum and challenging diagnostic aspects of an enigmatic disease.

    Science.gov (United States)

    Gülen, T; Hägglund, H; Dahlén, B; Nilsson, G

    2016-03-01

    Mastocytosis is a complex disorder characterized by the accumulation of abnormal mast cells (MC) in the skin, bone marrow and/or other visceral organs. The clinical manifestations result from MC-derived mediators and, less frequently, from destructive infiltration of MCs. Patients suffer from a variety of symptoms including pruritus, flushing and life-threatening anaphylaxis. Whilst mastocytosis is likely to be suspected in a patient with typical skin lesions [i.e. urticaria pigmentosa (UP)], the absence of cutaneous signs does not rule out the diagnosis of this disease. Mastocytosis should be suspected in cases of recurrent, unexplained or severe insect-induced anaphylaxis or symptoms of MC degranulation without true allergy. In rare cases, unexplained osteoporosis or unexplained haematological abnormalities can be underlying feature of mastocytosis, particularly when these conditions are associated with elevated baseline serum tryptase levels. The diagnosis is based on the World Health Organization criteria, in which the tryptase level, histopathological and immunophenotypic evaluation of MCs and molecular analysis are crucial. A somatic KIT mutation, the most common of which is D816V, is usually detectable in MCs and their progenitors. Once a diagnosis of systemic mastocytosis (SM) is made, it is mandatory to assess the burden of the disease, its activity, subtype and prognosis, and the appropriate therapy. Mastocytosis comprises seven different categories that range from indolent forms, such as cutaneous and indolent SM, to progressive forms, such as aggressive SM and MC leukaemia. Although prognosis is good in patients with indolent forms of the disease, patients with advanced categories have a poor prognosis. PMID:26347286

  12. Immunological reactions caused by helminthes and diagnosis of parasites using different methods

    Directory of Open Access Journals (Sweden)

    LEDIA VASJARI

    2014-06-01

    Full Text Available Helminthes are one of the causer agents of the type I reactions of hypersensitivity. In this article will review the findings of recent human studies of the association between helminth parasite infections and allergy and discuss their potential relevance to public health. The parasitic worms are an important risk factor for anaphylaxy reaction, but this could be explained by an enhanced ability of atopics to produce IgE. The human immune response to helminth infections is associated with elevated levels of IgE, tissue eosinophilia and mastocytosis. The involvement of immunologic mechanisms in the pathogenesis which are caused by worms in the gastro-intestinal tract are associated with anaphylaxy response. For this study, faeces were collected primary in children aged 1-15 years old, because the worms are most frequent in these ages. Through the coproscopic method were analyzed as biological materials, the feces of 300 children for the presence of protozoa’s eggs, helminthes larva, trophosoids, cists, etc. We have taken the photo of the positive cases. The analysis have been done in the Parasitological Laboratory of the Institute of Public Health, Tirana through the method of concentration with floatation in sulphat zinc; the permanent color as Ziehln-Neelsen stain, Giemsa stain, Blu-metilen, etc. We have used the color methods and blood striche to diagnose the eosiniphilia presence. To determine the IgE are used the EIA kits. The level of the eosinophyle and IgE in the blood is performed in 152 individes who had been positive cases by helminths.

  13. Management of acute attacks of hereditary angioedema: role of ecallantide

    Science.gov (United States)

    Duffey, Hannah; Firszt, Rafael

    2015-01-01

    Hereditary angioedema (HAE) is characterized as an episodic swelling disorder with autosomal dominant inheritance. Clinical features include nonpitting edema of external or mucosal body surfaces, and patients often present with swelling of the extremities, abdominal pain, and swelling of the mouth and throat, which can lead to asphyxiation. Patients with HAE classically have no associated urticaria, which is often referred to as nonhistaminergic angioedema. Treatment for HAE involves long-term prophylaxis, short-term prophylaxis, and management of acute attacks. Up until the past few years, acute HAE episodes were predominately treated with supportive measures. Three classes of medications have recently been approved by the US Food and Drug Administration (FDA) for the management of acute HAE attacks. Ecallantide, a recombinant protein that acts as a reversible inhibitor of kallikrein, is currently indicated for acute attacks of HAE in those aged ≥12 years. In two randomized, double-blind, placebo-controlled, multicenter trials, EDEMA3 and EDEMA4, patients treated with 30 mg of ecallantide demonstrated statistically significant improvement in symptoms compared to those on placebo. In addition to its use as treatment for HAE, ecallantide has been used off label in the management of nonhistaminergic angioedema, not due to HAE. Ecallantide has shown promise in the treatment of these other forms; however, data are limited to mainly case reports at this time. Ecallantide is generally a safe and well-tolerated medication; however, based on reports of anaphylaxis, ecallantide does contain a black box warning. Due to the risk of anaphylaxis, ecallantide cannot be self-administered and must be given by a health care professional. Overall, ecallantide is a safe and effective medication for the treatment of acute attacks of HAE. PMID:25931832

  14. Prospective, consecutive case series of 158 snakebite patients treated at Savannakhet provincial hospital, Lao People's Democratic Republic with high incidence of anaphylactic shock to horse derived F(ab')2 antivenom.

    Science.gov (United States)

    Vongphoumy, Inthanomchanh; Chanthilat, Phankham; Vilayvong, Phongmany; Blessmann, Joerg

    2016-07-01

    Snakebites are a seriously neglected public health problem in Lao PDR. Community-based cross-sectional surveys in two districts of Savannakhet province in Southern Laos revealed an incidence of up to 1105 snakebites per 100,000 persons per year. In contrast the number of snakebite patients treated in district and provincial hospitals are low. In order to improve health care for snakebite victims, antivenom was introduced to Savannakhet provincial hospital in July 2013 and medical staff has been trained in management of venomous snakebites at the same time. After the intervention the number of snakebite patients treated at the provincial hospital increased significantly from 4 patients in 2012 to 158 snakebite patients between July 2013 and November 2015. They were included into a prospective, consecutive case series. Median age was 32 years (range 1.5-70 years) and male-to-female ratio 2.2:1. Forty patients were bitten by Malayan pit vipers, 26 by green pit vipers, 24 by cobras, including 3 cases of venom ophthalmia, 5 by kraits, 8 by non-venomous species and in 55 cases the snake could not be identified. Forty-three out of 158 patients received horse derived F(ab')2 antivenom from Queen Saovabha Memorial Institute (QSMI) in Bangkok. Twenty-three patients (53%) developed early adverse reactions (EARs) within one hour after antivenom administration, including 13 patients (30%) with severe anaphylaxis. This extremely high rate of severe EARs turns the use of antivenom into a risky intervention. In contrast a retrospective chart review from Chulalongkorn University in Bangkok found only 3.5% early reactions including 1.2% severe anaphylactic reactions using the same antivenom from QSMI between 1997 and 2006. The reason for this enormous difference remains unclear. A better understanding of the aetiology and pathophysiology behind antivenom induced anaphylaxis is crucial in order to identify patients at risk and to improve safety of antivenom administration. PMID

  15. Seasonal split influenza vaccine induced IgE sensitization against influenza vaccine.

    Science.gov (United States)

    Nakayama, Tetsuo; Kumagai, Takuji; Nishimura, Naoko; Ozaki, Takao; Okafuji, Teruo; Suzuki, Eitaro; Miyata, Akiko; Okada, Kenji; Ihara, Toshiaki

    2015-11-01

    Although anaphylaxis is an extremely rare vaccine-associated adverse event, it occurred in young children following administration of the 2011/12 seasonal split influenza vaccine, which contained 2-phenoxyethanol as the preservative. These children had high levels of IgE antibodies against influenza vaccine components. We herein investigated why these children were sensitized. One hundred and seventeen series of serum samples were obtained immediately before, and one month after the first and second immunizations with the HA split vaccine of 2011/12. Forty-two sequential serum samples were collected in the acute and convalescent phases (2 and 4 weeks) after natural infection with H1N1 Pdm in 2009. IgE antibodies developed following the vaccination of young children with seasonal split vaccines, whereas no significant IgE response was observed following natural infection with H1N1 Pdm 2009. The prevalence of IgE antibodies was not influenced by outbreaks of H1N1 Pdm. Repeated immunization with the HA split vaccine induced IgE sensitization against the influenza vaccine irrespective of the H1N1, H3N2, or B influenza subtypes. The reasons why anaphylaxis only occurred in recipients of the influenza vaccine containing 2-phenoxyethanol are still being investigated, and the size distribution of antigen particles may have shifted to a slightly larger size. Since the fundamental reason was IgE sensitization, current split formulation for the seasonal influenza vaccine needs to be reconsidered to prevent the induction of IgE sensitization. PMID:26188254

  16. Antianaphylactic and mast cell stabilization activity of Strychnos potatorum Linn. seed

    Directory of Open Access Journals (Sweden)

    Umesh Jayantarao Patil

    2011-01-01

    Full Text Available Aim: The antianaphylactic activity of Strychnos potatorum Linn seed extract was evaluated by using compound 48/80 induced anaphylaxis and mast cell stabilization was studied by using peritoneal mast cells of rats. The possible antianaphylactic and mast cell stabilization mechanism was evaluated by using compound 48/80 induced mast cell activation and level of nitric oxide in rat peritoneal mast cells. Materials and Methods: Anaphylactic shock in mice was induced by the intraperitoneal administration of 8 mg/kg compound 48/80, prior to induction of anaphylaxis the animals were treated with S. potatorum Linn. seed extract administered orally 1 h before administration of compound 48/80, the rate mortality was observed in each group of animals. Mast cell stabilization was seen by preincubation of mast cells with the compound 48/80 and the extracts. Results: This study indicates that the chloroform, petroleum ether, and methanolic extracts were shown potent and has significant (P < 0.01 and P < 0.001 inhibitory effects on compound 48/80 induced anaphylactic reaction and mast cell activation. This compound also inhibited significantly compound 48/80 induced increased level of nitric oxide in rat peritoneal mast cells. Conclusion: We conclude from this study that the different extracts of S. potatorum seed have potent antianaphylactic activity through mast cell stabilization and inhibition of nitric oxide synthesis. The inhibitory effect of S. potatorum Linn. on release of histamine and nitric oxide protects from compound 48/80 induced anaphylactic reaction may be through blocking vasodilatation, decrease vascular resistance, hypotension and tachycardia induced by immunogenic agent used in this study.

  17. Inhibitory effect of putranjivain A on allergic inflammation through suppression of mast cell activation

    International Nuclear Information System (INIS)

    A great number of people are suffering from allergic inflammatory disease such as asthma, atopic dermatitis, and sinusitis. Therefore discovery of drugs for the treatment of these diseases is an important subject in human health. Putranjivain A (PJA), member of ellagitannin, is known to possess beneficial effects including anti-cancer and anti-viral activities. The aim of the present study was to elucidate whether PJA modulates the allergic inflammatory reaction and to study its possible mechanisms of action using mast cell-based in vitro and in vivo models. The study was performed in anaphylaxis mouse model and cultured mast cells. PJA inhibited the expression of pro-inflammatory cytokines in immunoglobulin E-stimulated mast cells. PJA reduced this expression by inhibiting nuclear factor (NF)-κB and nuclear factor of activated T cell. The oral administration of PJA reduced systemic and cutaneous anaphylaxis, the release of serum histamine, and the expression of the histamine H1 receptor. In addition, PJA attenuated the activation of mast cells. PJA inhibited the release of histamine from various types of mast cells by the suppression of intracellular calcium. The inhibitory activity of PJA on the allergic reaction was similar to that of disodium cromoglycate, a known anti-allergic drug. These results suggest that PJA can facilitate the prevention or treatment of allergic inflammatory diseases mediated by mast cells. - Highlights: • PJA reduced the degranulation of mast cells. • PJA inhibited the production of inflammatory cytokines. • The effect of PJA on allergic reaction was comparable to the DSCG. • PJA might be a candidate for the treatment of allergic inflammatory diseases

  18. Inhibitory effect of putranjivain A on allergic inflammation through suppression of mast cell activation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hui-Hun; Park, Seung-Bin; Lee, Soyoung [CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu 700-422 (Korea, Republic of); Kwon, Taeg Kyu [Department of Immunology, School of Medicine, Keimyung University, Daegu 704-701 (Korea, Republic of); Shin, Tae-Yong [College of Pharmacy, Woosuk University, Jeonju 565-701 (Korea, Republic of); Park, Pil-Hoon; Lee, Seung-Ho [College of Pharmacy, Youngnam University, Kyungsan 712-749 (Korea, Republic of); Kim, Sang-Hyun, E-mail: shkim72@knu.ac.kr [CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu 700-422 (Korea, Republic of)

    2014-02-01

    A great number of people are suffering from allergic inflammatory disease such as asthma, atopic dermatitis, and sinusitis. Therefore discovery of drugs for the treatment of these diseases is an important subject in human health. Putranjivain A (PJA), member of ellagitannin, is known to possess beneficial effects including anti-cancer and anti-viral activities. The aim of the present study was to elucidate whether PJA modulates the allergic inflammatory reaction and to study its possible mechanisms of action using mast cell-based in vitro and in vivo models. The study was performed in anaphylaxis mouse model and cultured mast cells. PJA inhibited the expression of pro-inflammatory cytokines in immunoglobulin E-stimulated mast cells. PJA reduced this expression by inhibiting nuclear factor (NF)-κB and nuclear factor of activated T cell. The oral administration of PJA reduced systemic and cutaneous anaphylaxis, the release of serum histamine, and the expression of the histamine H{sub 1} receptor. In addition, PJA attenuated the activation of mast cells. PJA inhibited the release of histamine from various types of mast cells by the suppression of intracellular calcium. The inhibitory activity of PJA on the allergic reaction was similar to that of disodium cromoglycate, a known anti-allergic drug. These results suggest that PJA can facilitate the prevention or treatment of allergic inflammatory diseases mediated by mast cells. - Highlights: • PJA reduced the degranulation of mast cells. • PJA inhibited the production of inflammatory cytokines. • The effect of PJA on allergic reaction was comparable to the DSCG. • PJA might be a candidate for the treatment of allergic inflammatory diseases.

  19. Laser-facilitated epicutaneous immunotherapy to IgE-mediated allergy.

    Science.gov (United States)

    Kumar, Mudnakudu Nagaraju Kiran; Zhou, Chang; Wu, Mei X

    2016-08-10

    Allergen specific immunotherapy has been shown to be the only effective treatment for long-lasting clinical benefit to IgE-mediated allergic diseases, but a fewer than 5% of patients choose the treatment because of inconvenience and a high risk of anaphylaxis. Recently, epicutaneous allergen-specific immunotherapy (EPIT) has proven effective, yet with limitations owing to strong skin reactions. We demonstrate here safer and faster EPIT, named μEPIT, by delivering powdered allergen and adjuvants into many micropores in the epidermis. We fabricated a microarray patch fractionally coated with a powder mixture of ovalbumin (OVA) model allergen, CpG, and 1,25-dihydroxyvitamin D3 (VD3). Topical application of the patch onto laser-microperforated skin resulted in a high level of epidermal delivery while greatly minimizing allergen leakage into circulation system as compared to current subcutaneous immunotherapy (SCIT). Moreover, only three times of μEPIT over two weeks could sufficiently inhibit allergen-specific IgE responses in mice suffering OVA-induced airway hyperresponsivness (AHR), which was unattainable by eight times of SCIT over three weeks. Mechanistically, μEPIT preferably enhanced IgG2a production suggesting TH1-biased immune responses and induced a high level of T-regulatory (Treg) cells against repeated allergen sensitization. The immune tolerance was confirmed by marked reduction in airway wall thickness as well as eosinophil and neutrophil infiltration into the respiratory airway. The μEPIT represents a novel and painless technology to treat IgE-mediated allergic diseases with little local skin reaction and a minimal risk of anaphylaxis. PMID:27235977

  20. 不同来源白花蛇舌草注射液过敏反应比较研究%Comparison of allergic reactions of different Hedyotis diffusa Willd injection

    Institute of Scientific and Technical Information of China (English)

    刘骅

    2013-01-01

    Objective To study the allergic reactions of Hedyotis diffusa Willd injection, to compare the allergic reaction with respect to different Hedyotis diffusa Willd injections produced by different factories and to evaluate the qualities of them. Methods Experimental animals were divided into negative control group, positive control group (egg albumin) ,and Hedyotis diffusa Willd injections groups. The allergic reactions caused by Hedyotis diffusa Willd injections were studied by active systemic anaphylaxis (ASA) test and passive cutaneous anaphylaxis( PCA) test. Results ASA tests were negative and PCA tests were negative on samples from A and C factory. PCA tests were positive on two samples from B factory, the rest of samples'tests were negative. Conclusions It showed the responses to Hedyotis diffusa Willd injections produced by different factories were different. The content of Tannin may be associated with adverse effects of Hedyotis diffusa Willd injections in PCA test.%目的 研究白花蛇舌草注射液的致敏性并比较不同来源白花蛇舌草注射液过敏反应的差别,遴选优质药品.方法 将实验动物分为阴性对照组、阳性对照组(卵清蛋白)、白花蛇舌草注射液组,通过豚鼠主动全身过敏反应(ASA)试验和大鼠皮肤被动过敏反应(PCA)试验对白花蛇舌草注射液的致敏性进行研究.结果 A厂家和C厂家ASA试验和PCA试验均为阴性,B厂家除两批样品PCA试验为阳性外,其余样品ASA试验和PCA试验为阴性.结论 不同厂家生产的白花蛇舌草注射液由于生产条件不同等原因,其过敏反应存在差别,其鞣质的含量可能与PCA有关.

  1. Study on the Immunotoxicity of Ribosome Inhibiting Protein of Momordica Charantia%苦瓜蛋白RIP的免疫毒性研究

    Institute of Scientific and Technical Information of China (English)

    万莉; 孟延发; 沈富兵; 郑崛村; 邓念华; 张立实

    2009-01-01

    目的 分离纯化苦瓜籽核糖体失活蛋白(RIP),对RIP在动物体内急性毒性和免疫毒性进行研究.方法 采用离子交换层析、凝胶过滤层析等方法提取苦瓜籽RIP,对其进行小鼠急性毒性实验,确定小鼠半数致死量(LD_(50)),并通过豚鼠全身主动过敏试验和大鼠被动皮肤过敏试验,探讨苦瓜籽RIP的免疫毒性. 结果苦瓜籽RIP对小鼠的LD_(50)为25.2 mg/kg,全身主动过敏试验中,RIP高、低剂量组豚鼠出现明显过敏反应,多数迅速死亡,被动皮肤过敏试验中,RIP组大鼠皮肤出现明显蓝斑. 结论 苦瓜籽核糖体失活蛋白具有较强的免疫毒性.%Objective To separate and purify ribosome inhibiting protein (RIP) from Momordica charantia (bitter melon) seeds and to evaluate its acute toxicity and immunotoxicity in animal. Methods Ion exchange chromatography and gel filtration chromatography were applied in the separating and purifying of RIP from Momordica charantia seeds. Then the acute toxicity testing of RIP in mice was conducted to obtain its half lethal dose (LD_(50)). Active systemic anaphylaxis (ASA) test in guinea pig and passive cutaneous anaphylaxis test (PCA) in rat were performed to evaluate its immunotoxicity. Results The LD_(50) (iv) in mice of RIP was 25. 2 mg/kg in ASA. guinea pigs of the higher and lower RIP group all appeared stong allergic responses and most of them died quickly. In PCA. obvious blue dye in skin were observed in SD rats of the RIP group. Conclusion RIP getting from Momordica charantia seeds had a relatively strong immunotoxicity in animals.

  2. Safety evaluation of edaravone injection%依达拉奉注射液安全性实验研究

    Institute of Scientific and Technical Information of China (English)

    刘良刚; 宋继胜; 沈怀桂; 乌彪

    2011-01-01

    目的 对依达拉奉注射液进行豚鼠主动全身过敏反应试验、家兔溶血试验和血管刺激性试验,为其临床应用提供安全性依据.方法豚鼠主动全身过敏反应,在第一次给药后21 d,从耳缘静脉注射依达拉奉注射液观察注射后30 min动物的过敏症状;体外溶血试验,观察本品在3h内有无溶血和聚集现象;血管刺激性试验,观察连续用药7d依达拉奉注射液及生理盐水,以及恢复2d和14 d后的注射局部血管和周围组织反应情况.结果依达拉奉注射液对豚鼠主动全身过敏反应未见明显过敏反应;未见明显体外溶血作用;对家兔耳缘静脉未见明显刺激作用.结论依达拉奉注射液的安全性试验结果提示其安全可靠.%Objective To evaluate the reliability of edaravone injection by testing the vessel stimulation, active systemic anaphylax-is, and haemolytic test. Methods The active systemic anaphylaxis was investigated by guinea pigs, reaction was observed when had injected edaravone injection on 21d after the first treatment. In the vessel stimulation, 12 rabbits were observed for 7d after injecting edaravone injection, and the reaction after stopping treatment for 14d. In the haemolytic test, hemolysis and coagulation were mainly observed. ResultsThere was no stimulation to ear vein of rabbits, and no allergic reaction and without hemolytic reaction to the guinea pigs. Conclusion Edaravone injection is safe and reliable based on the animal experiments.

  3. Experimental study on anaphylactoid reactions of guinea pig induced by Danshen injection and its components%丹参滴注液及其组分致豚鼠过敏反应的实验研究

    Institute of Scientific and Technical Information of China (English)

    杨伟峰; 余学钊; 何萍; 郝伟; 李贻奎

    2012-01-01

    Objective: To compare the anaphylactoid effect of Danshen injection and its components on guinea pig. Method: Applying active systemic anaphylaxis (ASA) tests, the corresponding experimental injections were administrated to guinea pigs to sensitized, and allergen with double doses was injected to stimulate in the 11 days after the last sensitized. The anaphylaxis situation of guinea pigs was observed. Result: Danshen injection and its components are suspicion on guinea pigs, while negative reaction was observed on guinea pigs which injected by the liquid excipients of Danshen injection. Conclusion: Danshen injection using the ultrafiltra-tion method still have some antigenic impurities which cannot be removed completely, and this may be one of the reasons for anaphylactic reaction.%目的:采用豚鼠过敏试验研究丹参滴注液及其组分的致敏性,为改进该药,提高临床用药安全性提供参考.方法:采用全身主动过敏试验方法,豚鼠腹腔注射各组受试药物以致敏,致敏期间每日观察动物状态.在末次致敏后的第11天用致敏量的2倍量进行激发,观察激发前15 min及激发后40 min豚鼠反应,评价动物反应症状.激发后40 min采血制备血清,ELISA检测血清IgE,组胺含量,并结合反应症状结果综合评价药物致敏性.结果:各组豚鼠致敏期间无异常反应,激发后综合判定致敏性,丹参滴注液、丹参精制液为可疑,辅料组为阴性.结论:丹参滴注液在除去大分子成分后,其余成分仍可能导致机体出现过敏反应.

  4. Wheat allergy: diagnosis and management.

    Science.gov (United States)

    Cianferoni, Antonella

    2016-01-01

    Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy) or wheat inhalation (respiratory allergy). A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker's asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG), which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a wheat allergy is based on avoidance of wheat altogether. However, in the near future immunotherapy may represent a valid way to treat IgE mediated reactions to

  5. T-cell response to allergens.

    Science.gov (United States)

    Ozdemir, Cevdet; Akdis, Mübeccel; Akdis, Cezmi A

    2010-01-01

    Anaphylaxis is a life-threatening IgE-dependent type 1 hypersensitivity reaction in which multiple organ systems are involved. The existence of allergen exposure and specific IgE are the major contributors to this systemic reaction. The decision of the immune system to respond to allergens is highly dependent on factors including the type and load of allergen, behavior and type of antigen-presenting cells, innate immune response stimulating substances in the same micromilieu, the tissue of exposure, interactions between T and B lymphocytes, costimulators, and genetic propensity known as atopy. Antigen-presenting cells introduce processed allergens to T-helper lymphocytes, where a decision of developing different types of T-cell immunity is given under the influence of several cytokines, chemokines, costimulatory signals and regulatory T cells. Among Th2-type cytokines, interleukin (IL)-4 and IL-13 are responsible for class switching in B cells, which results in production of allergen-specific IgE antibodies that bind to specific receptors on mast cells and basophils. After re-exposure to the sensitized allergen, this phase is followed by activation of IgE Fc receptors on mast cells and basophils resulting in biogenic mediator releases responsible for the symptoms and signs of anaphylaxis. Since the discovery of regulatory T cells, the concepts of immune regulation have substantially changed during the last decade. Peripheral T-cell tolerance is a key immunologic mechanism in healthy immune response to self antigens and non-infectious non-self antigens. Both naturally occurring CD4+CD25+ regulatory T (Treg) cells and inducible populations of allergen-specific, IL-10-secreting Treg type 1 cells inhibit allergen-specific effector cells and have been shown to play a central role in the maintenance of peripheral homeostasis and the establishment of controlled immune responses. On the other hand, Th17 cells are characterized by their IL-17 (or IL-17A), IL-17F, IL-6

  6. Evaluation of antiasthmatic activity of Cassia sophera linn

    Directory of Open Access Journals (Sweden)

    D H Nagore

    2009-01-01

    Full Text Available Cassia sophera from the family caesalpiniaceae is being used in local traditional medicine for asthma and bronchitis. Powdered leaves of C. sophera was extracted with ethanol and subjected for sequential fractionation with chloroform, ethyl acetate and ethanol respectively. Phytochemical analysis demonstrated the presence of flavonoids and antraquinone glycosides in all of the fractions. In the present study, antiasthmatic activity of parent ethanol extract and chloroform, ethyl acetate and ethanol fractions of C. sophera were evaluated. For the evaluation, carrageenan induced paw edema, histamine induced bronchoconstriction, clonidine and haloperidol induced catalepsy, milk induced leukocytosis, and eosinophilia and passive paw anaphylaxis has performed. The paw edema significantly (p< 0.05 inhibited by the parent extract, ethyl acetate, chloroform and ethanol fraction at 4th hr with the percent inhibition 54.2%, 50.4%, 44.3%, 60.7% respectively. In the present study C. sophera significantly (P< 0.05 protected the bronchoconstriction in guinea pigs against histamine-induced bronchospasm. The parent extract, ethyl acetate, chloroform and ethanol fractions showed 62.7%, 60%, 55% and 64% protection at 4th hour respectively. The clonidine induced catalepsy was found to be inhibited significantly (P< 0.05 by parent extract, ethyl acetate, chloroform and ethanol fraction at 120 min (144.00±4.830, 150.50±9.773 175.33, ±13.990, 142.50 ±4.233 sec. The parent extract, ethyl acetate, chloroform and ethanol fractions failed to revert the haloperidol induced catalepsy. In milk induced leukocytosis, milk treated group showed 4575.0 ±117.44 per cu mm leukocyte. The parent extract, ethyl acetate, chloroform and ethanol fractions reduced leukocyte count (1550.0±78.528, 2083.3±35.746, 2750.0±73.030, 1266.7±72.648 per cu mm resp. and eosinophil count (38.333±2.216, 82.333±2.1246, 2.500±1.057, 40.500±2.078 per cu mm resp. where milk treated group

  7. Management of acute attacks of hereditary angioedema: role of ecallantide

    Directory of Open Access Journals (Sweden)

    Duffey H

    2015-04-01

    Full Text Available Hannah Duffey,1 Rafael Firszt1,2 1Department of Pediatrics, 2Division of Allergy, Immunology and Rheumatology, University of Utah, Salt Lake City, UT, USA Abstract: Hereditary angioedema (HAE is characterized as an episodic swelling disorder with autosomal dominant inheritance. Clinical features include nonpitting edema of external or mucosal body surfaces, and patients often present with swelling of the extremities, abdominal pain, and swelling of the mouth and throat, which can lead to asphyxiation. Patients with HAE classically have no associated urticaria, which is often referred to as nonhistaminergic angioedema. Treatment for HAE involves long-term prophylaxis, short-term prophylaxis, and management of acute attacks. Up until the past few years, acute HAE episodes were predominately treated with supportive measures. Three classes of medications have recently been approved by the US Food and Drug Administration (FDA for the management of acute HAE attacks. Ecallantide, a recombinant protein that acts as a reversible inhibitor of kallikrein, is currently indicated for acute attacks of HAE in those aged 12 years. In two randomized, double-blind, placebo-controlled, multicenter trials, EDEMA3 and EDEMA4, patients treated with 30 mg of ecallantide demonstrated statistically significant improvement in symptoms compared to those on placebo. In addition to its use as treatment for HAE, ecallantide has been used off label in the management of nonhistaminergic angioedema, not due to HAE. Ecallantide has shown promise in the treatment of these other forms; however, data are limited to mainly case reports at this time. Ecallantide is generally a safe and well-tolerated medication; however, based on reports of anaphylaxis, ecallantide does contain a black box warning. Due to the risk of anaphylaxis, ecallantide cannot be self-administered and must be given by a health care professional. Overall, ecallantide is a safe and effective medication for the

  8. Severe asthma and the omalizumab option

    Directory of Open Access Journals (Sweden)

    Johnston Chambless

    2008-05-01

    Full Text Available Abstract Atopic diseases and asthma are increasing at a remarkable rate on a global scale. It is now well recognized that asthma is a chronic inflammatory disease of the airways. The inflammatory process in many patients is driven by an immunoglobulin E (IgE-dependent process. Mast cell activation and release of mediators, in response to allergen and IgE, results in a cascade response, culminating in B lymphocyte, T lymphocyte, eosinophil, fibroblast, smooth muscle cell and endothelial activation. This complex cellular interaction, release of cytokines, chemokines and growth factors and inflammatory remodeling of the airways leads to chronic asthma. A subset of patients develops severe airway disease which can be extremely morbid and even fatal. While many treatments are available for asthma, it is still a chronic and incurable disease, characterized by exacerbation, hospitalizations and associated adverse effects of medications. Omalizumab is a new option for chronic asthma that acts by binding to and inhibiting the effects of IgE, thereby interfering with one aspect of the asthma cascade reviewed earlier. This is a humanized monoclonal antibody against IgE that has been shown to have many beneficial effects in asthma. Use of omalizumab may be influenced by the cost of the medication and some reported adverse effects including the rare possibility of anaphylaxis. When used in selected cases and carefully, omalizumab provides a very important tool in disease management. It has been shown to have additional effects in urticaria, angioedema, latex allergy and food allergy, but the data is limited and the indications far from clear. In addition to decreasing exacerbations, it has a steroid sparing role and hence may decrease adverse effects in some patients on high-dose glucocorticoids. Studies have shown improvement in quality of life measures in asthma following the administration of omalizumab, but the effects on pulmonary function are

  9. A novel IgE antibody targeting the prostate-specific antigen as a potential prostate cancer therapy

    International Nuclear Information System (INIS)

    Prostate cancer (PCa) is the second leading cause of cancer deaths in men in the United States. The prostate-specific antigen (PSA), often found at high levels in the serum of PCa patients, has been used as a marker for PCa detection and as a target of immunotherapy. The murine IgG1 monoclonal antibody AR47.47, specific for human PSA, has been shown to enhance antigen presentation by human dendritic cells and induce both CD4 and CD8 T-cell activation when complexed with PSA. In this study, we explored the properties of a novel mouse/human chimeric anti-PSA IgE containing the variable regions of AR47.47 as a potential therapy for PCa. Our goal was to take advantage of the unique properties of IgE in order to trigger immune activation against PCa. Binding characteristics of the antibody were determined by ELISA and flow cytometry. In vitro degranulation was determined by the release of β-hexosaminidase from effector cells. In vivo degranulation was monitored in human FcεRIα transgenic mice using the passive cutaneous anaphylaxis assay. These mice were also used for a vaccination study to determine the in vivo anti-cancer effects of this antibody. Significant differences in survival were determined using the Log Rank test. In vitro T-cell activation was studied using human dendritic cells and autologous T cells. The anti-PSA IgE, expressed in murine myeloma cells, is properly assembled and secreted, and binds the antigen and FcεRI. In addition, this antibody is capable of triggering effector cell degranulation in vitro and in vivo when artificially cross-linked, but not in the presence of the natural soluble antigen, suggesting that such an interaction will not trigger systemic anaphylaxis. Importantly, the anti-PSA IgE combined with PSA also triggers immune activation in vitro and in vivo and significantly prolongs the survival of human FcεRIα transgenic mice challenged with PSA-expressing tumors in a prophylactic vaccination setting. The anti-PSA IgE exhibits

  10. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records.

    Science.gov (United States)

    Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk

    2016-05-01

    We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted. PMID:27149503

  11. Effects of Cymbidium Root Ethanol Extract on Atopic Dermatitis.

    Science.gov (United States)

    Kim, Wan-Joong; Cha, Hae-Sim; Lee, Myung-Hun; Kim, Sun-Young; Kim, Seo Ho; Kim, Tack-Joong

    2016-01-01

    Cymbidium has known antibacterial and antiedema activity and has been used as an ingredient in cosmetics and fragrances. The effects of Cymbidium ethanol extract (CYM) on allergic response and the underlying mechanisms of action have not been reported. Therefore, the purpose of this study was to determine the effect of CYM on allergic responses. Topical application of CYM was effective against immunoglobulin E (IgE)/dinitrophenyl-conjugated bovine serum albumin- (DNP-BSA-) induced degranulation of RBL-2H3 cells and anaphylaxis in ICR mice. An allergic dermatitis-like mouse model was used to evaluate the therapeutic potential of CYM in vivo. Continuous application of 2,4-dinitrochlorobenzene (DNCB) not only induced dermatitis in ICR mice but also aggravated the skin lesioning. However, the application of CYM decreased skin lesion severity, scratching behavior, and IgE levels. In addition, CYM downregulated the expression of the proinflammatory cytokines interleukin- (IL-) 4, IL-13, and tumor necrosis factor- (TNF-) α. Studies of signal transduction pathways showed that CYM suppressed the phosphorylation of spleen tyrosine kinase (Syk), an upstream molecule. It also inhibited the phosphorylation of Akt, phospholipase C- (PLC-) γ, and mitogen-activated protein kinase kinase kinase (MEKK). These results indicate that CYM may be effective in preventing and reducing allergic response and may have therapeutic potential as an antiallergic agent in disorders such as atopic dermatitis. PMID:26981139

  12. Regina House Community Nursing Unit, Cooraclare Road, Kilrush, Clare.

    LENUS (Irish Health Repository)

    Reynolds, A

    2016-03-01

    Our aim was to establish the feeding history, presentation, management and rate of resolution for an Irish cohort of children with cow’s milk protein allergy (CMPA) attending a hospital-based outpatient service. This was a cohort study consisting of two parts: a retrospective chart review and a follow-up questionnaire. Fifty-one infants (male: 61%, n=31) were enrolled. Twenty-one (41%) had IgE-mediated allergy. Twenty-nine (57%) had non-IgE mediated allergy. Twenty-two (49%) had tried ≥3 different formulas prior to diagnosis. Of the children who had reached two years, the overall rate of tolerance was 53% (IgE: 35%, non-IgE: 67%). Mild cases of CMPA can be managed in the community. Potential severe complications include faltering growth and anaphylaxis. CMPA should be managed using a multi-disciplinary approach. Increased awareness of CMPA may speed diagnosis and decrease the use of inappropriate formulas.

  13. February 2014 critical care case of teh month: a rush of blood

    Directory of Open Access Journals (Sweden)

    Udovcic M

    2014-02-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness: A 51 year old African-American woman was admitted from the emergency department with hemoptysis. She had blood tinged sputum earlier in the day followed by about ½ cup of hemoptysis which led her to seek care. PMH, SH, FH: She is known to have stage IV sarcoidosis with bronchiectasis and cavitation. A right upper lobectomy was performed in 1996 and embolization of 3 left bronchial arteries in 2011 for hemoptysis. She has a history of anaphylaxis with iodinated radiocontrast dye. However, no reaction occurred with premedication in 2011. She also has a history of asthma, but has been out of her medications for several days. Since this time she has noted increased cough. She is a nonsmoker and a Jehovah’s Witness. Her family history is noncontributory. Medications: Albuterol HFA, Montelukast, Fluticasone propionate nasal spray, Loratidine. Physical Examination: VS: 36.9°C, 106 beats/min, 135/83 ...

  14. Salmon caviar-induced anaphylactic shock.

    Science.gov (United States)

    Flais, Michael J; Kim, Susan S; Harris, Kathleen E; Greenberger, Paul A

    2004-01-01

    Foods, particularly shellfish and nuts, are commonly implicated as causes of anaphylaxis. Salmon caviar, to our knowledge, is an exceedingly rare cause of anaphylactic shock. This study describes a patient who experienced anaphylactic shock on her initial ingestion of caviar. Skin testing and inhibition assays using the enzyme-linked immunosorbent assay were performed. On the percutaneous test, the patient had a 7 x 9 mm/15 x 55 mm wheal/ erythema reaction to caviar liquid. Caviar liquid caused 68, 73, and 73% inhibition of immunoglobulin E (IgE) binding at concentrations of 0.01, 0.1, and 1.0 mg/mL in an enzyme-linked immunosorbent assay, respectively. There was no evidence for IgE antibodies that could be demonstrated to bind to the caviar eggs. Despite using both metoprolol and lisinopril, the patient responded promptly to subcutaneous epinephrine. This report indicates that an IgE-mediated response occurred after caviar ingestion. Although she experienced anaphylactic shock, the patient recovered quickly after epinephrine administration despite routine use of a 3-adrenergic blocker and angiotensin-converting enzyme inhibitor. PMID:15510582

  15. Cow’s milk allergy: a cohort of patients from a university hospital

    LENUS (Irish Health Repository)

    Reynolds, A

    2016-03-01

    Our aim was to establish the feeding history, presentation, management and rate of resolution for an Irish cohort of children with cow’s milk protein allergy (CMPA) attending a hospital-based outpatient service. This was a cohort study consisting of two parts: a retrospective chart review and a follow-up questionnaire. Fifty-one infants (male: 61%, n=31) were enrolled. Twenty-one (41%) had IgE-mediated allergy. Twenty-nine (57%) had non-IgE mediated allergy. Twenty-two (49%) had tried ≥3 different formulas prior to diagnosis. Of the children who had reached two years, the overall rate of tolerance was 53% (IgE: 35%, non-IgE: 67%). Mild cases of CMPA can be managed in the community. Potential severe complications include faltering growth and anaphylaxis. CMPA should be managed using a multi-disciplinary approach. Increased awareness of CMPA may speed diagnosis and decrease the use of inappropriate formulas.

  16. Population pharmacokinetic and pharmacodynamic modeling of epinephrine administered using a mobile inhaler.

    Science.gov (United States)

    Frechen, Sebastian; Suleiman, Ahmed Abbas; Mohammad Nejad Sigaroudi, Ali; Wachall, Bertil; Fuhr, Uwe

    2015-12-01

    Inhaled epinephrine is a potential alternative to self-administered intramuscular epinephrine in imminent anaphylactic reactions. The objective was to develop a pharmacokinetic-pharmacodynamic model describing exposure and effects on heart rate of inhaled epinephrine. Data from a 4-phase cross-over clinical trial in 9 healthy volunteers including 0.3 mg intramuscular epinephrine, two doses of inhaled epinephrine (4 mg/mL solution administered during [mean] 18 and 25 min, respectively) using a mobile pocket inhaler, and an inhaled placebo were analyzed using mixed-effects modeling. Inhaled epinephrine was available almost immediately and more rapidly than via the intramuscular route (absorption half-live 29 min). Epinephrine plasma concentrations declined rapidly after terminating inhalation (elimination half-life 4.1 min) offering the option to stop exposure in case of adverse events. While the expected maximum concentration was higher for inhaled epinephrine, this was not associated with safety concerns due to only moderate additional hemodynamic effects compared to intramuscular administration. Bioavailability after inhalation (4.7%) was subject to high interindividual and interoccasional variability highlighting that training of inhalation would be essential for patients. The proposed model suggests that the use of a highly concentrated epinephrine solution via inhalation may offer an effective treatment option in anaphylaxis, while efficacy in patients remains to be shown. PMID:26615448

  17. The natural compound nujiangexanthone A suppresses mast cell activation and allergic asthma.

    Science.gov (United States)

    Lu, Yue; Cai, Shuangfan; Nie, Jia; Li, Yangyang; Shi, Guochao; Hao, Jimin; Fu, Wenwei; Tan, Hongsheng; Chen, Shilin; Li, Bin; Xu, Hongxi

    2016-01-15

    Mast cells play an important role in allergic diseases such as asthma, allergic rhinitis and atopic dermatitis. The genus Garcinia of the family Guttiferae is well known as a prolific source of polycyclic polyprenylated acylphloroglucinols and bioactive prenylated xanthones, which exhibit various biological activities including antibacterial, antifungal, anti-inflammatory, antioxidant, and cytotoxic effects. Nujiangexanthone A (N7) is a novel compound isolated from the leaves of Garcinia nujiangensis. In this paper, we sought to determine the anti-allergic and anti-inflammation activity of N7 in vivo and its mechanism in vitro. We found N7 suppressed IgE/Ag induced mast cell activiation, including degranulation and production of cytokines and eicosanoids, through inhibiting Src kinase activity and Syk dependent pathways. N7 inhibited histamine release, prostaglandin D2 and leukotriene C4 generation in mast cell dependent passive cutaneous anaphylaxis animal model. We also found N7 inhibited the IL-4, IL-5, IL-13 and IgE levels in ovalbumin-induced asthma model. Histological studies demonstrated that N7 substantially inhibited OVA-induced cellular infiltration and increased mucus production in the lung tissue. Our study reveals the anti-allergic function of N7, thereby suggesting the utility of this compound as a possible novel agent for preventing mast cell-related immediate and delayed allergic diseases. PMID:26571438

  18. Clinical presentation, allergens, and management of wheat allergy.

    Science.gov (United States)

    Quirce, Santiago; Boyano-Martínez, Teresa; Díaz-Perales, Araceli

    2016-05-01

    IgE-mediated allergy to wheat proteins can be caused by exposure through ingestion, inhalation, or skin/mucosal contact, and can affect various populations and age groups. Respiratory allergy to wheat proteins is commonly observed in adult patients occupationally exposed to flour, whereas wheat food allergy is more common in children. Wheat allergy is of growing importance for patients with recurrent anaphylaxis, especially when exercise related. The diagnosis of wheat allergy relies on a consistent clinical history, skin prick testing with well-characterized extracts and specific IgE tests. The accuracy of wheat allergy diagnosis may be improved by measuring IgE responses to several wheat components. However, a high degree of heterogeneity has been found in the recognition pattern of allergens among patient groups with different clinical profiles, as well as within each group. Thus, oral provocation with wheat or the implicated cereal is the reference test for the definitive diagnosis of ingested wheat/cereal allergy. PMID:26800201

  19. Translation, adaptation and initial validation of Food Allergy Quality of Life Questionnaire: child form in Greek

    Directory of Open Access Journals (Sweden)

    Zoe Morou

    2016-06-01

    Full Text Available The aim of the study is to determine the reliability and validity of the Greek version of the Food Allergy Quality of life Questionnaire- Child Form (FAQLQ-CF. After linguistic validation, the Greek FAQLQCF, Food Allergy Independent Measure (FAIM and Pediatric Quality of Life Inventory (PedsQL™ were used by a physician to interview children diagnosed with food allergy and aged 8-12 via telephone. Cronbach’s alpha was used to evaluate reliability, and factor analysis to assess construct validity. The correlation between FAQLQ-CF and FAIM was moderate (rho=0.509, P<0.001 and internal consistency was strong (Cronbach’s alpha 0.905. FAQLQ-CF discriminated well each question’s contribution to children’s quality of life deterioration (32- 80%, each child’s quality of life (17-89%, children differing in doing things with others (total score 3.55 vs 2.57, difference =0.98 > minimal clinical importance difference = 0.5; P<0.001, but not children differing in reporting anaphylaxis. The total FAQLQ-CF score correlated with the total PedsQL™ score and with the score of one of PedsQL™ subscales, demonstrating convergent validity. Factor analysis uncovered an underlying structure of four factors, explaining 50% of the variance. We can conclude that Greek FAQLQ-CF is a reliable, valid, discriminant tool for interviewing food allergic children aged 8- 12, detecting those in need for immediate care.

  20. Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report.

    Science.gov (United States)

    Badik, Jennifer; Chen, Jimmy; Letvak, Kira; So, Tsz-Yin

    2016-01-01

    Allergy to human insulin or its analogs is rare, but it is still a significant issue in current diabetes care. Allergic reactions can range from localized injection site reactions to generalized anaphylaxis, and they can be caused by excipients or the insulin molecules themselves. We presented a case of a 14-year-old male patient with generalized allergic reactions to insulin glargine and insulin detemir. The patient was successfully managed by being switched to a continuous subcutaneous insulin infusion with insulin aspart. Allergic reactions to insulin detemir and insulin glargine have both been well described, with insulin detemir allergy appearing to be more common. There are several potential mechanisms for insulin allergy, and immunologic characteristics vary among different insulin analogs. After confirming insulin allergy in practice, management involves treating symptoms and switching insulin preparations. This is the first documented case of allergies to both insulin glargine and insulin detemir in a pediatric patient. Exact mechanism of insulin allergy is unknown, and management strategies must be individualized for each patient. PMID:26997933