Corticosteroid complications in respiratory disease.
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Biomedical subjects
Publications and source records attributed to L Tuft.
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This report reviews the results of prophylactic immunotherapy carried out on 105 ragweed hay fever patients treated for at least two years with an alum-precipitated pyridine ragweed (Allpyral) extracts prepared from equal parts of low and giant ragweed pollen. Good or excellent clinical results were obtained in most patients with a minimum of reaction, notably constitutional ones, even when the interval between injections was quite prolonged. Seasonal asthma rarely occurred in the treated patients. In the author's opinion, the advantages offered by these extracts, notably their relative safety and at least equal clinical effectiveness, seem to warrant their preference over similar aqueous ragweed extracts currently employed or over attempted modifications of aqueous extracts.
Excellent clinical results were obtained in 85 patients with chronic asthma who took corticosteroids (mostly triamcinolone) on a long-term basis for periods varying from one to 26 years. There was a minimum of side-effects, none serious; the most discomforting were ecchymosis and a tendency to easy bruising. The results of this and previous studies have convinced the author that corticosteroids, if judiciously used, are the most valuable adjunct we have in the treatment of acute and chronic asthma.
In 18 ragweed hay fever patients who received injections of alum-precipitated pyridine (Allpyral) ragweed extracts in maintenance doses of between 6000 and 8000 P.N.U. at intervals of between two and four months over a two-year period, the prolonged interval did not seem to influence either the clinical response or the tendency to reaction, or result in significant change in immunological tolerance as determined by antibody studies, which included fluorescent antibody assays, as well as hemagglutination and RAST technics.
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Hyposensitization therapy with APP extracts was found to be effective in 80% of 185 patients allergic to animals (96 to cats, 84 to dogs and 5 to horses) with a minimum of reactions (2.5 local and 0.2% constitutional). Lower respiratory symptoms were the most common complaints, followed by nasal, ocular and respiratory, singly or in combination.