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Biomedical subjects

K J Kalveram

Publications and source records attributed to K J Kalveram.

7 recordsLinked to original sources

[Delayed hypersensitivity to protamine and immediate hypersensitivity to insulin].

A 63-year-old female, with type II diabetes mellitus, diagnosed in 1967, was started on combination therapy with sulphonylureas and human depot insulin in May 1989, because of inadequate blood sugar control with sulphonylureas alone. Within 3 months she began to develop nodular skin reactions at the site of injection, 12-24 hours after insulin injections. Intradermal testing demonstrated delayed (Gell and Coombs type IV) hypersensitivity to protamine. No specific IgE or IgG antibodies were demonstrable. She was changed to protamine-free human delayed action insulin. After an initial reaction-free period, red urticarial lesions, attributable to immediate (Gell and Coombs type I) hypersensitivity to human insulin, appeared at the injection sites. There were no other complications with continued insulin therapy, and after about 6 weeks no further local reactions were detectable. When an allergic reaction to an insulin preparation is suspected, careful immunological investigation should be performed, to ensure adequate treatment without risk to the patient.

Delayed-Action Preparations

Serum eosinophil chemotactic factor levels in patients with bullous pemphigoid, drug reactions and atopic eczema.

The sera of 4 patients with bullous pemphigoid, of 5 patients with drug reactions and of 13 patients with atopic eczema were examined for the occurrence of low molecular weight eosinophil chemotactic factor (ECF) by fractionation on a Sephadex G 25 column. Almost all patients had a peripheral eosinophilia, and many had raised total serum IgE levels. ECF was demonstrated in the sera of all 4 patients with bullous pemphigoid and in 4 of 5 patients with systemic drug reactions. In contrast, the sera of the 13 patients with atopic eczema did not contain any ECF activity, nor did the 13 control sera. These findings suggest that the ECF from phagocytosing polymorphonuclear leukocytes (PMN) and/or the mast cell derived ECF-A contribute to the elevated serum ECF levels in patients with bullous pemphigoid and drug reactions. A correlation between serum ECF and IgE levels and peripheral eosinophilia could not be established.

Chemotaxis, Leukocyte

[Pomade crust].

Exaggerated use of skin care topicals in infants may lead to brownish appositions in the inguinal and gluteal region described as pomade crust. Examination of scraping material by infra-red spectroscopy failed to reveal any residue of emollients but instead was characteristic of human scales. Certain topicals are apparently capable of inducing hyperkeratosis in these body regions.

Age Factors

Cross-reactivity between grass and corn pollen antigens.

Analogous reactions of grass and corn pollen extracts in skin tests on patients suffering from pollinosis might suggest an antigenic relationship between grass and corn pollens. This problem was studied using the RAST inhibition test. Tests were performed with cellulose discs labelled with commercial skin test extracts containing grass, rye, wheat, barley, oat and maize pollens. Different mutual inhibitions were measured showing various grades of antigenic relationship. Only grass pollen antigens could strongly inhibit all other antigen-antibody reactions. Thus, we suppose that the investigated grass pollen extract also contains all antigens typical of corn pollen. Therefore, exclusive use of this extract seems to be possible in diagnosis and perhaps therapy of combined grass and corn pollen allergy.

Cross Reactions

[Studies on antigenic relationship between grass- and cult. rye pollens by skin-test, RAST and RAST-inhibition-test in patients with pollinosis (author's transl)].

Skin tests on patients suffering from pollinosis suggest frequently an antigenic relationship between various grass and cult. rye pollens. This problem was further studied using both, RAST and RAST inhibition test. The tests were performed with commercial grass pollen discs as well as with self-prepared disc labeled with cult. rye pollens and a combination of various grass antigens. Good agreement was found between self-made and commercial (single antigen) grass pollen discs (95.9%). RAST and skin test correlated also extremely well (92.3%). Mutual inhibition between grass and cult. rye pollens was measured by RAST inhibition test using self-prepared discs. High antigenic relationship between grass and cult. rye pollens was found, however, it could be demonstrated that the antibody pattern varies and contains "grass specific" antibodies.

Antibody Specificity