Biomedical subjects
Publications and source records attributed to H Kästner.
There is an increasing number of reports on anaphylactic reactions due to latex. We report on a 9-year-old boy who developed anaphylaxis shortly after induction of anaesthesia due to a combined latex and ethylene oxide allergy. Patients with multiple medical treatment and those with atopy seem to be at risk.
We report on the patterns of specific IgE, IgG, and IgA antibodies during different kinds of hyposensitization. Whereas sIgE antibodies may even be influenced by environmental stimulants, the production of sIgG antibodies depends on the amount of antigens injected for therapy. There is some evidence that patients who do not reveal sIgG response have increased sIgA antibody titers, instead.
We report on veterinarians showing itching, swelling, and urticaria on hands and arms after contact with amniotic fluid of cows and/or pigs. Scratch tests with the corresponding fluid gave positive results. RAST investigations were done with self-prepared allergen discs. In all 6 cases, the RAST on amniotic fluid was positive, correlating well with the results of the skin tests. RAST tests on sera from the cattle were positive, too, whereas tests on the epithelia remained negative. Our findings show that the allergen causing contact urticaria is a compound of amniotic fluid and serum but not of the epithelia of these animals. Thus we can conclude that sensitized veterinarians do not have to avoid all contact with these species, but we recommend special protection.
In a prospective study we found 112 patients out of 9549 who had been given 3.5% plasma protein solution during the preceding year but no other blood derivatives and who had not received any immunosuppressive treatment. 68 patients agreed to be tested for sensitisation to 3.5% plasma protein solution. An intracutaneous test was performed as screening test. Two patients had a false positive reaction, but one of them had urticaria factitia and therefore a positive reaction to NaCl 0.9%. The other patient showed circumscribed reddening in the early phase only, whereas later readings were negative. Neither the test of total IgE by Paper Radio Immuno Sorbent Test (PRIST) nor the test for specific IgE antibodies by Radio Allergo Sorbent Test (RAST) showed any positive results. According to these findings there was no sensitisation to 3.5% plasma protein solution.
A further case of X-linked dominant chondridysplasia punctata is described. This syndrome is characterized by the following cutaneous anomalies: congenital ichthyosiform erythroderma with thick, adherent hyperkeratoses; widespread atrophic skin lesions discernible after the first weeks of life; patchy alopecia; coarse and lusterless hair; onychoschisis. The hyperkeratoses of the newborn as well as the ensuing atrophoderma predominantly involve the hair follicles and are distributed in a bizarre linear or blotchy pattern. In some instances, a linear pattern of pigmentary disturbance has also been observed. These cutaneous signs and symptoms are so typical that the diagnosis of X-linked dominant chondrodysplasia punctata can be established even without X-ray examination. The syndrome has so far been observed exclusively in females. Apparently, the underlying X-linked gene defect is lethal in hemizygous males.
The intestinal resorption of zinc using 65ZnCl2 was estimated in 3 patients with acrodermatitis enteropathica, 2 healthy controls, and 3 heterozygotes. After oral application of 65Zn the whole body activity was measured by a whole body counter for 34 days. The 65Zn resorption of the patients amounted to 16, 42 and 30% of the applied dose, whereas the resorption values of the heterozygotes and the controls were in the range of 58 and 77%. The elimination of 65Zn from the body amounted to about 0.7% of the applied dose with no difference between controls and patients with acrodermatitis enteropathica. Before therapy the serum-zinc levels of patients were markedly decreased. After oral application of high doses of zinc aspartate (2 times 400 mg/day) all clinical symptoms disappeared within a week. The results point at a causal connection between zinc and the pathogenesis of acrodermatitis enteropathica. Ultrastructural alterations of the Paneth cells of the intestines are also shown in this disease [12] as have also been seen in Paneth cells of zinc deficient rats [Beitr. Path. 145, 336 (1972)].
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