Prevalence of latex allergy among greenhouse workers.
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Adult↗
Biomedical subjects
M Cuevas
Publications and source records attributed to M Cuevas.
Occupational asthma and immunologic responses induced by inhaled carmine among employees at a factory making natural dyes.
Carmine is a natural red dye widely used as a food coloring agent and for cosmetic manufacture. It is extracted from the dried females of the insect Dactylopius coccus var. Costa (cochineal). Although it has been reported that inhalation of carmine may give rise to occupational asthma and extrinsic allergic alveolitis, there is little evidence of its immunogenic capacity. We studied nine current employees at a factory making natural dyes and one former employee who had left this plant after occupational asthma developed. A current employee had work-related symptoms of rhinitis and asthma that were confirmed by bronchial provocation tests, and another worker had rhinitis. Immunologic sensitization to carmine and cochineal was evaluated by means of skin testing and determination of serum-specific IgE and IgG subclass antibodies by RAST and ELISA, respectively. The specificity of the RAST assay was investigated by RAST inhibition with different fractions of carmine. The three workers with respiratory symptoms had positive skin prick test reactions to both carmine and cochineal. An immediate response to the bronchial provocation test with carmine and cochineal was observed in the current employee with asthma. Specific IgE antibodies against carmine and cochineal were found only in this worker. RAST inhibition studies indicated that the main allergen had a molecular weight between 10 and 30 kd. Specific IgG antibodies against carmine and cochineal, mainly the subclasses IgG1, IgG3, and IgG4, were found in the 10 subjects surveyed. These findings suggest that carmine may induce immunologic responses, most likely IgE mediated in workers with symptoms of occupational asthma.
Adolescent↗
Specific skin tests in subjects with chronic bronchitis exposed to pigeons.
We have studied the diagnostic reliability of the specific skin tests done in 30 subjects who presented with chronic bronchitis (CB) as the only clinical manifestation related to exposure to pigeons and in 21 subjects with CB and known risk factors. Additionally, two control groups were included (24 asymptomatic subjects exposed and sensitized to pigeons and 10 subjects not exposed and not sensitized to pigeons). The skin prick tests with pigeon serum were negative in all the subjects tested. The intradermal skin tests showed an immediate positive reaction in 16 of the 30 CB-affected patients and in six of the control group of exposed asymptomatic subjects (chi square: 3.376) (P < 0.1; nearly significant); after 6 h, a positive reaction was recorded in 14 of the CB-affected patients and in three subjects of the control group (chi square: 5.187) (P < 0.005). A delayed reaction was seen in 10/30 CB patients and in only three of the 24 subjects of the control group (chi square: 2.218) (nonsignificant). In the group of the 21 CB patients with known risk factors and not sensitized to pigeons, only two patients showed immediate skin reactivity; the remaining readings were negative. Lastly, in the control group of 10 unexposed, nonsensitized subjects, the intradermal skin tests in the different readings were negative. Our results show that although the skin tests with pigeon serum have low sensitivity, they can be a useful supplement in distinguishing cases of CB attributable to chronic pigeon exposure from those cases attributable to another cause, especially in the consideration of immediate and late readings.
Adolescent↗
Asthma and contact urticaria caused by rice in a housewife.
We report the case of an atopic housewife who presented with rhinoconjunctivitis-asthma and contact urticaria from handling rice and other cereals. She tolerated cooke cereals. Both skin prick tests with a rice extract (20% w/v) and a rub test with raw rice gave positive results. Bronchial challenge test with methacholine revealed a PC20 of 0.45 mg/ml. The challenge test with raw rice resulted in immediate and late clinical and spirometric responses; pretreatment with DSCG inhibited both responses. The histamine release test (HRT) with rice was positive, and we detected rice-specific IgE antibodies by REIA in the patient's serum. Skin prick tests, HRT, and RAST with a battery of cereals gave positive results. Finally, the rice REIA was inhibited by rice (75%), rye (63%), corn (64%), and wheat (51%) extracts.
Adult↗
Avocado hypersensitivity.
The avocado (Av) is a fruit that belongs to the Lauraceae family. We report 17 patients with immediate hypersensitivity to avocado. Clinical manifestations in relation to avocado ingestion were as follows: systemic anaphylaxis in seven patients, angioedema/urticaria in six, vomiting in two, bronchial asthma in one, and rhinoconjunctivitis in one. Skin prick test (SPT) with fresh avocado was positive in all patients with the Strong avocado variety (SAv) and in 14 patients with the Hass avocado variety (HAv). Our patient-associated sensitizations were as follows: 10 to latex, eight to chestnut, eight to banana, four to kiwi, and four to walnut. Avocado-sensitized patients with latex allergy were typically middle-aged women, professionally exposed to latex, who also exhibited frequent associated sensitizations to chestnut, banana, and other fruits. Specific IgE against avocado was demonstrated in 11 of our patients, by both commercial CAP and RAST with avocado extract coupled to nitrocellulose disks. Despite its lower protein content, SAv seems to be more allergenic than HAv, both in vivo and in vitro. On incubating a pool of sera from our patients with avocado, latex, chestnut, and banana extracts, a progressive RAST inhibition was obtained, with SAv- and chestnut-marked disks. This suggests the existence of common antigenic determinants among these allergens.
Adolescent↗
Latex allergy: clinical features and cross-reactivity with fruits.
BACKGROUND: Latex IgE-mediated allergy is an important medical problem, but its clinical characteristics and association with food allergies are not well defined. OBJECTIVE: Our objectives were to determine the clinical features of latex-allergic patients, and latex-associated food hypersensitivities. METHODS: A prospective study was performed in our outpatient clinic. It consisted of a clinical questionnaire, skin prick tests with aeroallergens and foods, skin test with a latex extract, determination of total and specific IgE by CAP/RAST methods, and RAST inhibition. Latex and food allergies were diagnosed on the basis of a suggestive clinical history and a positive skin test with the corresponding allergen. RESULTS: Twenty-five patients were diagnosed as having latex allergy. Their mean age was 33 +/- 9.0 years, with female predominance (23:2). There were nine greenhouse and six hospital workers. Latex-induced reactions included systemic anaphylaxis in nine patients (36%). Average total IgE was 161 kU/L, and it was within normal limits in 16 cases. Latex skin prick tests had excellent diagnostic precision with no adverse reactions, and CAP for latex diagnostic sensitivity was 80%. Forty-two food allergies were diagnosed in 13 of our patients (52%), and 23 of these consisted of systemic anaphylaxis. The most frequent food hypersensitivities were to avocado (9), chestnut (9), banana (7), kiwi (5) and papaya (3). Through RAST-inhibition, cross-reactivity among latex, avocado, chestnut, and banana was demonstrated. CONCLUSIONS: In our experience, latex allergy affects middle-aged women in certain professions at increased risk. Our data suggest the existence of a "latex-fruit syndrome," because 52% of our latex allergic patients had allergies to certain fruits.
Adolescent↗
Anaphylaxis due to limpet ingestion.
BACKGROUND: The limpet, phylum Mollusca, is one of the most frequent sea mollusks in the Canary Islands. Limpet IgE hypersensitivity reactions have been described. OBJECTIVE: To describe six patients with anaphylactic reactions due to limpet ingestion and to demonstrate by in vivo methods and by in vitro techniques specific IgE responses. METHODS: Six subjects who developed severe bronchospasm 30 to 120 minutes after eating limpets were included in the present study. The antigenic material for the in vivo and in vitro studies was an extract of cooked limpet prepared in our laboratory. Skin prick tests were performed in all patients using commercially available aeroallergens, mollusk, and crustacean extracts; the same skin tests were performed using the extracts prepared in our laboratory. Specific IgE by CAP and RAST and CAP inhibition studies were also performed. Limpet contamination by mites was excluded through a commercial ELISA using monoclonal antibodies. RESULTS: All patients had positive skin prick tests to D. pteronyssinus and cooked limpet extract and weak reactivity to cockroach and raw limpet extract. Specific IgE to mites and cooked limpet extract was also found using CAP and RAST techniques, respectively. The possible existence of common epitopes between limpet and D. pteronyssinus was excluded by CAP inhibition studies. Finally, no significant mite concentration was detected in the cooked limpet extract analyzed by a commercially available ELISA. CONCLUSIONS: Limpet is a potentially dangerous allergen specially in patients sensitized to D. pteronyssinus.
Adolescent↗
Serum sickness-like illness associated with rifampicin.
We describe a patient with human immunodeficiency virus infection who developed the main clinical features of a serum sickness reaction while receiving treatment with daily therapeutic doses of tuberculostatic drugs. A decrease in complement titers as well as a detection of significant levels of circulating immune complexes were observed. A positive skin test result was observed six hours after an intradermal test with rifampicin. No immunoglobulin or complement deposition was observed by direct immunofluorescence of a punch biopsy specimen from the cutaneous lesion.
Adult↗
[Hypersensitivity to paracetamol].
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Acetaminophen↗
Metastatic pattern and DNA ploidy in stage IV breast cancer at initial diagnosis. Relation to response and survival.
Sixty-nine patients with metastatic breast cancer (MBC) at initial diagnosis were analyzed to verify if metastatic pattern and clinical outcome are related to DNA ploidy determined by flow cytometry (FCM). Characteristics of 55 fully evaluable patients were as follows: median age: 61 years; postmenopausal: 75%; bone-only metastases (BM): 60%; extraosseous-only metastases (EM): 40%. Overall response rates (CR + PR) obtained with different chemotherapies and/or hormonal therapies were 58% and 68% for patients with BM and EM, respectively. Sixty percent of specimens resulted aneuploid, and the mean coefficient of variation of the complete series was 5.1%. In the whole group of patients DNA ploidy of primary tumor did not predict the metastatic pattern and had no influence upon response to treatment, duration of response, time to progression, and overall survival. When analyses were carried out according to metastatic pattern, those patients with BM showed similar results. However, within the group with EM, those with diploid tumors presented a significantly better survival (median 18 vs 13 months, p = .04). FCM-DNA analysis seems to identify a subgroup of patients with poor prognosis constituted by those who had aneuploid primary tumors and metastases to extraosseous sites.
Adenocarcinoma↗
Pistachio nut hypersensitivity: identification of pistachio nut allergens.
Type I hypersensitivity to pistachio nut antigens was demonstrated in three patients by means of immediate skin-test reactivity, specific IgE determination by a fluoroimmunoassay (CAP), CAP-inhibition and leucocyte histamine release. Sensitization to other dried fruits and pollens was observed in the patients. The CAP-inhibition studies revealed significant crossreactivity between pistachio and cashew nut belonging to the Anacardiaceae family, and between pistachio nut and other dried fruits belonging to taxonomically unrelated botanical families. No relevant crossallergenicity was observed between pistachio nut and Lolium and Olea pollens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of a pistachio nut extract followed by immunoblotting analysis identified four IgE-binding bands with molecular weights of 34, 41, 52 and 60 kD.
Allergens↗
Paracetamol anaphylaxis.
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Acetaminophen↗
Occupational protein contact dermatitis from herring.
We present a case of occupational protein contact dermatitis caused by herring in a dolphinarium worker. The in vivo and in vitro tests results indicated a type I allergic mechanism. In vivo cross-reactivity among fish belonging to the Clupeiformes order was observed.
Adult↗
Occupational protein contact dermatitis from lettuce.
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Adult↗
IgG subclass response to Aspergillus fumigatus.
The exact clinical meaning of the IgG subclass antibodies remains obscure. In order to contribute to the study of the IgG subclass response, specific IgGtotal and IgG subclass antibodies to Aspergillus fumigatus (Af) were determined by enzyme-linked immunosorbent assay (ELISA) in three groups of patients: 30 asthmatics due to an IgG-mediated hypersensitivity to Af, 30 atopic and 30 nonatopic controls. The results demonstrated that Af-specific IgGtotal, IgG2 and IgG4 antibodies are increased in Af-sensitive patients, although detectable levels of each specific IgG subclass could be found in all the three groups. No differences between atopic and non-atopic controls could be demonstrated.
Adolescent↗
Serologic response to itraconazole in allergic bronchopulmonary aspergillosis.
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Administration, Oral↗
Relationships between characteristics of exposure to pigeon antigens. Clinical manifestations and humoral immune response.
An extensive clinical study has been performed on pigeon breeders in the Canary Islands. Three hundred forty-three subjects have participated in this study through the filling of a clinical and epidemiologic questionnaire. A venous blood sample was also taken from each fancier for a further serologic analysis. Detection of specific IgG antibodies was made by an indirect enzyme-linked immunosorbent assay (ELISA) using pigeon serum as antigenic material. Twenty-nine (8 percent) breeders fulfilled the "classic" pigeon breeders' disease (PBD) criteria. One hundred six (31 percent) had rhinitis, 62 (19 percent) had immediate bronchial symptoms, and 51 (15 percent) suffered from chronic bronchitis. A significant level of specific IgG was detected in 139 (40 percent) cases. Rates were correlated with pneumonitis symptomatology (p < 0.001) and with chronic bronchitis (p < 0.05). There was a significant association between the number of pigeons and the level of sensitization (p < 0.001). Finally, a statistical relationship between the intensity of exposure and specific IgG response was also found (p < 0.001). Titers of specific IgE could not be related either to the reported symptomatology in the questionnaire or to any of the exposure parameters analyzed.
Adolescent↗
Immediate adverse reaction to aminophylline.
We present a patient who experienced an immediate adverse reaction following intravenous administration of aminophylline. Skin prick, intradermal, and patch tests, RAST and indirect ELISA assays with aminophylline, theophylline and ethylenediamine were negative. A positive histamine release test was found only with ethylenediamine. Single-blind placebo-controlled challenges were positive with aminophylline and negative with theophylline. Our results suggest the reaction was a type I hypersensitivity reaction to ethylenediamine, but a nonimmune mechanism could not be excluded.
Administration, Oral↗