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Biomedical subjects

E Beaudouin

Publications and source records attributed to E Beaudouin.

29 records · Page 2Linked to original sources

[Rush desensitization to drugs: elements for protocol rationalization].

The need for some treatments that are without possible alternatives leads, for allergy or intolerance, to procedures of rapid re-introduction at increasing doses, under the term of rapid habituation (A.R.) which is different from specific immunotherapy. No postulated mechanism has been suggested. The successes reported in the literature are presented here. They raise a discussion on the indications, the rational and empirical elements and the preferable routes of introduction. The authors stress the need for biological studies of A.R.

Administration, Oral↗

Unusual manifestations of hypersensitivity after a tick bite: report of two cases.

BACKGROUND: Ticks are able to transmit, through biting, various viral, parasitic, and bacterial diseases, the best known being Lyme disease due to Borrelia burgdorferi. In addition, ticks may also induce allergic reactions. OBJECTIVE: A study of immediate and delayed skin reactions are undertaken to give evidence of an IgE-dependent mechanism. METHODS: Two lumbermen reported having had skin reactions following bites by ticks. Skin prick tests and intradermal tests were performed with what was most probably Ixodes ricinus extract in one case. Specific IgE to whole body extract of wood tick were assayed by radioimmunoassay. Histological and immunohistologic examinations of skin biopsy obtained from a pruriginous skin lesion and from a delayed reaction following the intradermal test, were performed. RESULTS: One of them had positive immediate reactions to a prick test and an intradermal test with the same extract. Both patients had significant levels of wood tick-specific IgE antibody as well as elevated serum total IgE levels. Histologic examinations of a pruriginous lesion revealed lymphocytic dermal and perivascular infiltration, with evidence of CD8+ T lymphocytes and Langerhans' cells in the perivascular infiltrates. A biopsy of the place of the delayed reaction following the intradermal skin test also showed the presence of dermal and perivascular lymphocytic infiltrates. CONCLUSION: IgE-dependent allergy to Ixodes ricinus can explain allergic reactions. Standardized extracts have to be prepared with sufficient amounts of the relevant tick salivary antigens to permit diagnosis by skin and serologic tests of patients, especially lumbermen who may be allergic to Ixodes ricinus.

Adult↗

Food anaphylaxis following ingestion of carmine.

BACKGROUND: The risk of sensitization to reactive dyes is well established. The clinical situation is caused most often by synthetic azo dyes and triphenylmethane derivatives but natural dyes such as carmine extracted from dried female insects, Coccus cacti (cochineal), have been incriminated. OBJECTIVE: Study of a case of anaphylaxis after ingestion of yogurt to establish the responsibility of carmine. METHOD: Case report of a patient who received skin prick test and leukocyte histamine release test with carmine and yogurt. CONCLUSIONS: This case provided evidence of an IgE-dependent mechanism and draws attention to the triggering dose of carmine (1 mg) although the acceptable daily intake is up to 5.0 mg per kg of body weight.

Adult↗

High risk of sensitization to latex in children with spina bifida.

The risk of per-operative anaphylactic shock in response to latex is established in children with spina bifida. This study focuses on 30 children with spina bifida and aims at evaluating the value of predictive tests (skin tests and RAST). No patient had shown a preoperative accident. Hypersensitivity to latex, sometimes suspected by questioning of the patient, was detected 12 times out of 30 (40%). 10 children of the 12 were atopic (83%). The incidence of atopy is significantly higher than that of the general pediatric population (14 out of 30; 46%). This study demonstrates the frequency of the latent hypersensitivity to latex and the subsequent potential risk of per-operative anaphylactic shock. This sensitization can be partly explained by multiple contacts with latex; urinary catheterization several times a day, daily use of latex gloves for routine care, repetitive surgery (more than 8 operations per child). However, atopy increases the risk of sensitization to latex. The authors underline the importance of taking preventive measures for these children such as the use of PVC, silicone or polyurethane catheters and of synthetic rubber. Hypoallergenic gloves are under investigation. A questionnaire and systematic preventive cutaneous assessment before each operation are strongly advised.

Anaphylaxis↗

[Occupational allergic rhinitis].

The frequency of occupational allergic rhinitis has grown with the development of new allergens and the prodromic characteristic of occupational asthma. The clinician must carefully assess the often unimpressive symptomatology with a characteristic work/non work cycle. The nasal mucosa is examined rhinoscopically to eliminate a possible tumoural origin. The diagnosis is based on the results of the allergy tests (skin tests, laboratory tests, nasal allergen tests) and on knowledge of the patient's work environment. The diagnosis of occupational rhinitis requires eliminating the allergen(s). A report of an occupational disease is required. In the future, informing atopic subjects early, improving working conditions and modifying industrial techniques should lead to a reduction in the prevalence of allergic rhinitis and occupational pulmonary disease.

Endoscopy↗

Prospective study of risk factors in natural rubber latex hypersensitivity.

Five hundred sixty-nine subjects routinely underwent skin prick tests for latent sensitization to latex. The study of risk factors included skin tests to inhalant allergens, to diagnose atopy, and a questionnaire aimed at revealing frequent exposure to latex such as the wearing of gloves, multiple surgical procedures, or urinary catheterization. The subjects were categorized into five groups: group I, subjects with no risk factor (n = 272); group II, nonatopic subjects exposed to latex (n = 73); group III, atopic subjects not exposed (n = 180); group IV, exposed atopic subjects (n = 44); and group V, subjects with a history of intraoperative anaphylactic shock caused by latex (n = 13). Twenty-five subjects had spina bifida and were in either group II (14 subjects) or group IV (11 subjects). The questionnaire identified a probable allergy to latex in 18 subjects: 16 cases were confirmed by skin test, but responses were not informative in 23 patients who were sensitive to latex. Positive prick tests to latex were obtained in 0.37% of group I, 6.85% of group II, 9.44% of group III, and 36.36% of group IV. Of the children with spina bifida, 32% had positive skin test results. As risk factors, atopy and exposure were synergistic. We recommend predictive prick tests not only in children with spina bifida but also in any atopic subject or in any patient with a history of frequent exposure to latex. Latex could be considered a habitual allergen. The use of latex urinary catheters should be avoided in patients who are catheterized on a daily basis.

Adolescent↗

[Anaphylaxis caused by carboxymethylcellulose: report of 2 cases of shock from injectable corticoids].

Two cases of anaphylactic shock are reported, occurring after intra-articular injections of corticosteroids, containing carboxymethylcellulose (CMC), benzylic acid, polysorbate 80, and merthiolate. Skin tests and leukocyte histamine release are positive to CMC and negative to the other substances including the corticosteroids: prednisolone acetate and cortivazol . No cross-reactivity with hydroxypropylcellulose was demonstrated. These tests lead to incriminate CMC in these patients. Anaphylaxis to CMC seems exceptional, though CMC is widely used in agro-alimentary and pharmaceutical industries, as well as hydroxypropylcellulose. In one case, the possibility of a sensitization by CMC as a food additive is discussed, insofar as the patient has a fixed eruption which has been suspected to be owed to intolerance to food additives.

Anaphylaxis↗

[Hypersensitivity accidents to thrombin following the use of biological glues].

Biological adhesives are made of human plasma and bovine heterologous proteins. These entail a poorly documented risk of sensitization. We report about two allergic accidents caused by the injection of Tissucol in the pituitary mucosa of patients suffering from the Rendu-Osler-Weber disease. The clinical picture of the first case was that of a serum sickness, and leukocytoclastic vasculitis was demonstrated. The second case was a delayed hypersensitivity accident, which was confirmed by the subsequent allergological investigation. Although the responsibility of thrombin seems to be evidenced in these two cases, it nevertheless remains exceptional. However, the risk of sensitization following repeated injections of heterologous proteins in a mucosa with a particularly high immunological responsiveness must be well-known. The increasing use of these biological products will probably result in a growing number of accidents, and we must now contemplate the possibility of screening this sensitization before using biological adhesive. Finally, the possibility of latent sensitization by the ingestion of beef must also be considered.

Aged↗