[The human basophil degranulation test in the diagnosis of drug allergies].
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Biomedical subjects
Publications and source records attributed to J Dry.
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The relatively simple and precise technique of direct immunofluorescence on a tissue section enables the study and enumeration of all types of plasma cells including mastocytes (stained with acridine orange) in normal conjunctiva (5 cases), chronic non-allergic conjunctivitis (5 cases), allergic conjunctivitis of the educt (11 cases) and vernal conjunctivitis (11 cases). There is evidence of elevation of IgE plasma cells in type I allergic conjunctivitis where they are twice as raised as in non-allergic cases in adult forms, and three times more elevated in vernal conjunctivitis. There was no correlation between the number of IgE plasma cells in the tissues and IgE level in sera. Thus in air-borne conjunctival allergies local hypersensitivity seems to be the predominant, even exclusive, feature.
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On the basis of three cases, the authors review the clinical picture of Hoigne's syndrome, characterised by the development of acute manifestations, essentially psycho-sensorial, immediately following the injection of procaine penicillin G (PPG). The syndrome is due to the passage into the circulation of micro-aggregates of PPG and has no immuno-allergic basis. Subsequent treatment with penicillin is not contraindicated.
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A quantitative counter-immunoelectrophoresis technique has been applied to the evaluation of antibodies against native and single-stranded DNA. Anti-DNA antibodies have been found at high dilutions in patients with systematic lupus erythematosus, without correlation with the existence of renal lesions or with the degree of DNA binding assessed by Farr assay. Significant precipitates were also observed at significantly lower dilutions in other pathological situations and in normal subjects, posing the problem of the nature of the precipitates in these cases.
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The notion of anaphylactic shock under anaesthesia implies sensitization, with a minimum delay of 1 week, on the occasion either of a previous anaesthesia with the responsible product, or with taking a drug with common antigenic determinants. Clinically this is reflected by the rapid and explosive appearance of symptoms which are always comparable: tendency to vascular collapse, respiratory bronchospastic distress, erythematous rash and Quincke's edema, gastrointestinal disorders, etc. These signs and symptoms of anaphylactic shock are closely related to the pharmacological actions of substances liberated during the reaction, of reaginic orgin (histamine, S.R.S.A.). It is reproduced by the direct effects of numerous anaesthetics on the liberation of theses very substances without the intermediary of an immunological mechanism. In consequence, the clinical argument alone is not sufficient to assert the true anaphylactic nature of a shock. Consequently, the elements of the history must be strongly borne in mind: notion ofsensitization during a previous anaesthesia, to the responsible product or to a drug which could have a crossed antigenicity with it.