Biomedical subjects
Publications and source records attributed to J C Bonneau.
Detection of sulphite sensitivity can be simplified by use of sulphite test. However, because of the precautions and limitations it is difficult to suggest its use for all patients.
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38% of subjects who presented with aspirin (Acetyl-salicylic acid AAS)-included asthma were also found to be intolerant to metabisulphites (MBS). The diagnosis was based on interrogation and an oral provocation test (TPO), to which the majority of the responses were similar, immediate and/or delayed. Atopy and other immunological tests are not involved in this type of asthma, which like AAS is has an intolerance mechanism.
We have observed in some patients that some Aspirin sensitive asthmatic present also a dyspnea after wine or foods containing sulfites ingestion. Owing to a study using ingestion test, with spirometric control, we show that sulfite sensitive asthma is more frequent in patients with Aspirin sensitive asthma than in the others. In the two cases, these molecules trigger off an asthma attack with same symptomatology, same severity, that is to say, frequently of IV type, with corticodependance. Diagnosis allow to an adapted treatment and so a better prognosis of these asthma.
The typing of common Phleol Pollen and wheat Antigen has been realized with these Antigens Fractions from PASTEUR Institute using FPLC PHARMACIA Chromatograph. The discover of commun Antigen has been obtained with RAST Inhibition technic. It exist common Antigen fractions between phleol and wheat, but no between wheat an phleol. The results are in favor of less allergic quality of wheat.
Challenge test puts in evidence the responsibility of a drug. The biological checking by plasmatic histamine leads to distinguish between a specific histamine-release reaction and a non-specific one. Thus, glafenine has proved to be a non specific histamine release where as in some cases, acetyl-salicylic-acid (A.S.A.) behaves like a specific histamine release.
General Anaesthetics are potentially more dangerous than local anaesthetics. Among the achievement of 25 provocation tests, it always shows good tolerance of the local anaesthetic, included in patients who had presented serious disorders after a previous local anaesthesia. Consequently, the local anaesthetic wasn't the real cause. However, there is to say that in one case 45 minutes after challenge, hand oedema (occurred). Research of hypersensitivity, remains very necessary in every doubtful case.
We rapport an original observation of adverse reaction (Arthus reaction) during a dust mite hyposensitisation with a aluminum hydroxide absorbed extract. We precise the way of beginning. In discussion, we try to precise the preliminary symptoms of such reaction to prevent it.
28 young adults suffering from allergic perennial asthma have been treated by Lomudal spray or a matching placebo for 4 weeks. Judgment criteria were symptoms evolution, number of crisis, functional respiratory tests before and after treatment, patients and clinician judgments of efficacy and tolerance. Results of functional respiratory tests remind unchanged while symptomatology improved significantly. The total number of crisis was dramatically reduced by sodium cromoglycate treatment compared to placebo. Judgments significantly favoured sodium cromoglycate. Tolerance was excellent in both group.
Drug allergy must be in relation with a phenomenon of immunopathology which induces: Anaphylactic shock; Toxidermia; Cytopenia; Allergic Hepatitis. Diagnosis is based on the cutaneous testing and "in vitro" tests. The evidence of drug responsibility will be supplied by challenge test, practised in hospital according to special conditions. Treatment is preventive with cortisone, epinephrine, antihistamine. Treatment is also curative with those same drugs in respect to the clinical pathology.
During the specific immunotherapy, we observe: -local reactions -systemic reactions. In most cases, it is an exacerbation of clinic symptomatology which may reach others organs nearby. Reactions will occur more or less quickly according to the kind of the extract: aqueous or delayed. Clinically, systemic reactions can induce a general trouble or an anaphylactic shock. Numerous causes could be at the beginning of these systemic reactions in relationship to an antigenic overdose or to a promoting state of health. We can observe systemic reactions at most for grass pollens or hymenoptera venoms. Standardisation of allergens is not riskless. On the opposite, it needs a best knowledge of standards which change from one laboratory to another. During specific immunotherapy of hymenoptera venom, when histamine release is positive again in more than sixty per cent we can observe correlation with systemic reactions. Epinephrine is mostly essential in treatment of anaphylactic reaction. Prevention of incidents and accidents of specific immunotherapy depends on a clinical care. This can be obtained by an expert of allergy who will be in relation with the family doctor.
We reported 38 observations with adverse reactions during anesthesia. These observations have collected over about one year. For each observation we studied some parameters like sex, aspect of the adverse reaction, number of general anesthesia before the accident, atopy, age etc. Among the parameters, we noticed the great frequency of reaction in the female group (81.5%) and an increased level of total IgE (greater than or equal to 150 Ul/ml) in 38%. For each investigated drug we realized skin test (Prick-test and when negative, intra-dermal test) and Lymphoblastic Transformation Test L.T.T.). The examinations are compared each other for a best diagnosis: when skin test (ST) and L.T.T. are together positive the allergic reaction is likely. when ST and L.T.T. are together negative, it is likely there is not allergic reactions with this drug. when there is a discordance between ST and L.T.T. prudently we recommend to avoid this drug for future anesthesia. Results of ST and L.T.T. are detailed for the 3 drugs which are more often investigated. That is to say: Thiopental, Suxamethonium, Fentanyl.
We reported one observation of a female patient who presented an half delayed hypersensitivity reaction to formaldehyde included in a root canal sealer. This reaction was loco-regional and late. It probably happened by over flowing demonstrated by radiography.
Two observations with induction of renal complications during immunotherapy are reported. For the first patient proteinuria and infections complications happened immediately after a rush immunotherapy with Yellow Jacket Venom Extract. For the second patient an "half-rush" immunotherapy with light doses of phleole extract (cumulative dose: 7 PNU) induced an immediate reaction with rhinitis, conjunctivitis and after 24 hours a macroscopic hematuria.
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This study deals with a family where three successive children presenting with a complicated polymalformative syndrome, died. The first child, a boy, had atrial and ventricular septal defect. The second and third children, both females, had cardiac abnormalities with a single ventricle with common auriculo-ventricular valve. Each case was associated with low ear insertion and first toe bilateral polysyndactyly. Familial inquiry showed neither consanguinity nor similar cases in relatives and ancestors within three generations. This polymalformative syndrome could be genetically determined.