Biomedical subjects
Publications and source records attributed to C Marcos.
We report a rare case of non-Hodgkin lymphoma located in the vulva. The diagnosis was supported by the cytological anomalies in material obtained by fine needle aspiration. The tumor was removed with wide excision, and the patient was alive and in good health ten months after surgery.
Thymostimulin is a partially purified extract of calf thymus, consisting of a group of polypeptides with a total molecular weight of approximately 12,000 D. It is used as an immunologic response modifier in primary and secondary immunodeficiencies. We report a patient who had a severe anaphylactic reaction with the first injection of thymostimulin. Type I hypersensitivity to thymostimulin was suggested by an immediate skin test response, specific IgE determination by indirect ELISA and a positive histamine release test. This patient also reacted to bovine serum albumin (BSA), fetal calf serum (FCS) and cow hair and dander. The controls did not react to any of these tests. Clinicians need to be aware that the use of medical products of xenogeneic origin may lead to severe allergic reactions.
We present a non-atopic 85-year-old woman, with a late-onset recidivant tongue angio-edema due to pomegranate intake, as proven by a double blind oral challenge test. This is the first case ever reported about adverse reaction to pomegranate. We have been unable to demonstrate an IgE-mediated mechanism (prick test, histamine release test and RAST with pomegranate were all negative). We emphasize the importance of clinical history and oral challenge test in the diagnosis of food allergy.
Since 1979 several reports of contact urticaria due to natural latex have been well documented. Recent case reports suggest that rhinitis and asthma may also be due to rubber exposure. We describe an operating room nurse who was exposed at work to natural rubber (latex) due to the use of latex surgical gloves. After 25 years, she developed contact urticaria, rhinoconjunctivitis and acute asthma following the handling of rubber gloves for surgical purposes. She was symptom-free when on vacation. Skin prick testing demonstrated an immediate skin reaction to latex. Rub testing with surgical gloves was positive. Specific IgE antibodies to latex were found by indirect ELISA. Specific bronchial challenge with latex extract elicited an isolated immediate asthmatic reaction that was inhibited with cromolyn sodium pretreatment. Patch testing to common rubber additives was negative. These results suggest that latex present in surgical rubber gloves and probably acting as inhalant allergen may produce occupational asthma in exposed subjects, probably by means of an IgE-mediated mechanism.
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We studied the lipidic metabolism and the atherogenic risk factors non related to lipidic metabolism in two groups of patients: group 1 with only coronary disease and group 2 with coronary disease and atherosclerosis in the cerebral and/or peripheric artery territories. Patients of group 2 showed a cholesterol, cLDL, and B-apoprotein titers significantly higher than group 1. Systolic and diastolic blood pressure were higher in group two. Also the incidence of diabetes mellitus in group 2 was higher than in group 1. In a stepwise discriminating analysis the diastolic arterial pressure and cholesterol titers were the parameters with a greatest predictive potential for the presence of localized or generalized ischemic disease. B-apoprotein was the lipidic parameter with the greatest predictive potential. All together these data suggest that in coronary patients, a discrete increase in plasma cholesterol can imply a risk of suffering ischemia in some other arterial territories. Diastolic blood pressure, cholesterol and diabetes mellitus are the factors with the highest predictive potential for the generalization of arteriosclerosis.
We described two cases of meningococcal infection in a family. Both were detected in a period of seven months. We studied the epidemiological markers of strains isolated from cases and close contacts of the second case. The isolate of first case is identical to the rest of strains studied and we suggest the possibility of persistence and transmission of infection of the index case to the close contacts and the second case. In this paper it is discussed the application of control measures to eradicate the meningococcus from the nasopharynx of patients after the illness, principally in workers with close contacts with populations at risk and in epidemic periods.
A study of 216 noncapsular strains of Neisseria meningitidis isolated from patients and carriers received in the Meningococcus Reference Laboratory between 1978 and 1984 is reported. The characterization of the strains consisted of biochemical tests for the following characteristics used for the differentiation of Neisseria species: oxidase, catalase, and beta-galactosidase activities; sugar degradation; nitrate and nitrite reduction; DNase activity; polysaccharide production with 5% sucrose; aminopeptidase activity; and growth in Thayer-Martin and Catlin media. Of the strains studied, 50 showed characteristics of a new taxon recently described (Neisseria polysacchareae). Characteristics that differentiated these strains from meningococcal isolates were polysaccharide production with 5% sucrose, gamma-glutamylaminopeptidase activity, and a requirement for cysteine or cystine for growth in Catlin medium. All of the N. polysacchareae strains identified were isolated from the nasopharynx of healthy carriers.
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A prospective, multicenter pharmacovigilance study was carried out to evaluate the safety of a new 7-dose treatment schedule of subcutaneous immunotherapy as opposed to the conventional 13 doses normally recommended. The study was carried out in 14 centers and included 261 patients (children and adults) with respiratory allergic disease due to sensitization to mites (Dermatophagoides pteronyssinus and/or farinae). A total of 2290 doses were administered under the direct supervision of the participating specialists. One hundred and ten reactions in 63 patients (24.1%) were recorded, representing 4.8% of the total doses administered. Most of the reactions (98) were local. Only 12 were systemic (0.5% of the administered doses) and occurred in 10 patients (3.8% of the sample). Ten reactions reverted quickly with rescue medication. The maintenance dose had to be lowered in one patient and another patient was withdrawn from the study after suffering two asthmatic crises after two consecutive doses. In view of the results obtained, we can conclude that the new schedule shows an acceptable tolerance profile and does not present a greater risk of reactions than the conventional scheme of 13 doses using an identical extract. Moreover, the new schedule represents substantial savings in the number of doses and visits required to reach the maintenance dose.
Since 1979 several reports of contact urticaria due to natural latex have been documented. In recent years cases of anaphylaxis, rhinitis, and asthma due to latex have appeared. Nine patients, studied in our clinic between 1986-1991, suffered immediate allergic reactions caused by rubber products. All showed an immediate skin reaction to latex extract. Rub testing with surgical gloves was positive in eight patients. Immunological techniques (RAST, ELISA, HRT) demonstrated specific IgE against latex. Specific bronchial provocation testing was performed in one patient who presented with asthma when she used latex surgical gloves. Patch testing to common rubber additives were negative in our patients. These results suggest that natural latex antigens present in rubber objects can cause hypersensitivity reactions probably due to IgE-mediated mechanisms.
Treatment with heterologous insulin preparations induce insulin antibody formation in most of the patients. A hundred of diabetic individuals in treatment with human insulin (HI) for at least 6 months at the time of the study and without any clinical immunological reaction, were selected in order to study the development of specific IgE antibodies against HI by in vivo and in vitro methods. Serologic specific IgE antibodies to HI were measured by RAST (Pharmacia) and 5 RAST-positive subjects were found. The specificity of these results were confirmed in 4 of the 5 subjects by RAST-inhibition. Thus, the prevalence of specific serologic IgE to HI in our study was 4% (1.1%-9.9%, p < 0.05). Only two of the RAST-positive subjects had cutaneous reactivity to HI by intradermal technique and one of the RAST-negative subjects presented also insulin skin reactivity. HI skin reactivity was found in 3% (0.6%-8.5%, p < 0.05) of the 100 diabetic subjects. These results differ from others obtained with heterologous insulins.