Biomedical subjects
Publications and source records attributed to M D Alonso.
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.
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Vegetable-induced asthma is an uncommon hazard. We report an atopic housewife, in whom rhinoconjunctivitis and acute asthma were associated with two vegetables of taxonomically unrelated botanical families (Swiss chard/Chenopodiaceae family and green beans/legume family). Type I hypersensitivity to the antigens in Swiss chard and green beans was demonstrated by means of skin tests, histamine release test, and specific IgE determination by RAST. Bronchial responses after specific bronchial challenges indicated that Swiss chard and green beans might be the causative factor for the acute asthma.
The association of systemic lupus erythematosus (SLE) and autoimmune thyroiditis has been previously described. We report a woman with negative antinuclear antibodies (ANA) and criteria for the diagnosis of SLE. The patient was also diagnosed with autoimmune thyroiditis. We review the clinical characteristics and the association of both entities. We also remark in this case the association of autoimmune thyroiditis with seronegative SLE.
We describe a man with common variable immunodeficiency and polyarthritis. He had suffered several infections, including septic arthritis. For this reason we commenced treatment with antibiotics without obtaining a good response. Three weeks' later, and after knowing that the results of all the cultures were negative, we discontinued the antibiotic therapy and started treatment with indomethacin. A dramatic response was rapidly observed. We feel that an arthritis in a patient with a history of previous infections should alert us to the diagnostic possibility of primary antibody deficiency.
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Allergic reactions to legumes through inhalation have rarely been described. We report the case of a 20-year-old man who experienced asthmatic attacks when exposed to the steam from cooking either chick pea or lentil. Type I hypersensitivity to the antigens in these legumes was demonstrated by means of immediate skin reactivity, histamine release tests, RAST and RAST inhibition. Specific bronchial challenges with the heated (75 degrees for 30 min) extracts of chick pea and lentil elicited isolated immediate responses.
We present two patients who experienced life-threatening immediate reactions and one patient who developed generalized urticaria following oral administration of trimethoprim (TMP) and sulfamethoxazole (SMX) combination. Skin prick tests with TMP were positive in the three patients. No patients reacted to skin prick tests with SMX. No significant levels of IgE antibodies to TMP were found by RAST in the serum of the patients. Normal subjects used as controls did not react to any of these tests. Single-blind, placebo-controlled oral challenges were positive with TMP and negative with SMX in all patients. These results suggest that the three patients developed type I hypersensitivity reactions to TMP. In our patients skin prick tests with TMP were useful in TMP hypersensitivity diagnosis.
We describe 2 cases of paediatric patients who developed the main clinical features of a serum sickness reaction, while on treatment with cefaclor. A decrease in complement values was observed in both cases. Physicians should be aware of the possibility of such drug adverse reaction.
A case of a 74-year-old woman, with a histological diagnosis of Transient Arteritis two years before and Nodose Polyarteritis, is described. Although the coexistance of these two vasculitis in a same patient has been rarely described in the literature, we considered that the diagnostic suscpiction of Nodose Polyarteritis should be maintained in a patient with Transient Arteritis developing multisystemic signs.
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Giant cell arteritis, temporal arteritis (TA), is a vasculitis which affects large and medium-sized vessels. The von Willebrand factor (vWF) is synthesized by endothelial cells and megakaryocytes. Increased amounts of vWF are released into plasma in response to an endothelial damage. vWF levels were studied by Electro-Immunodiffusion in 16 patients with TA (8 of them with a positive biopsy) and their values were compared with 5 patients with Polymyalgia Rheumatica (PMR) and 32 controls. We found higher amount of vWF in global TA, biopsy-positive TA, biopsy-negative TA, and PMR than in controls. There were no relationship between vWF amounts in plasma and clinical findings nor the laboratory parameters. We feel that although in our study vWF might be of some help as an alternative to the biopsy in those patients with high suspicion of TA, the results of other authors raise doubt about the usefulness of the determination of vWF in TA.
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