Biomedical subjects
Publications and source records attributed to R Gerth van Wijk.
The clinical features of exercise-induced anaphylaxis in 5 patients are described, with an accurate history, skin tests, IgE determinations and exercise tests. In these 5 patients we were able to distinguish three different forms of exercise-induced disease: exercise-induced anaphylaxis based upon an IgE-mediated allergy to foods, exercise-induced anaphylaxis without food allergy and cholinergic urticaria.
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Recently it has been shown that patients with atopic rhinitis and with an allergy to house dust mites have a stronger nasal response to insufflation of histamine, methacholine and phentolamine than a control group. This hyper-responsiveness could not be demonstrated in patients with perennial non-allergic rhinitis, unless the patients were selected according to the predominant symptoms in the history. Patients with rhinorrhoea ('runners') proved to be hyper-responsive to methacholine compared with normal controls. The existence of two subpopulations was emphasized by hyper-responsiveness to both histamine and methacholine in the runners group compared with the patients with a stuffy nose ('blockers'). Patients with chronic nasal infections (characterized by recurrent episodes of purulent discharge) showed no hyper-responsiveness at all, indicating that either hyper-reactivity does not play an important part in this patient population or methods to detect hyper-reactivity in this group are inadequate. In contrast to our earlier observations in patients with atopic rhinitis, increased responsiveness to phentolamine could not be detected either in the patients with perennial rhinitis or in the patients with infectious rhinitis, indicating that the possible alpha-adrenergic dysfunction found in patients with atopic rhinitis is restricted to this group.
Forty children underwent two different skin prick tests with allergen-coated Phazet needles and conventional skin prick tests using Pharmalgen extracts (100,000 BU/mL). Good correlation between both skin test methods was found with house dust mites (Rs = 0.61; P less than .001), timothy pollen (Rs = 0.77; P less than .001), and cat epithelium (Rs = 0.74, P less than .001). The correlation coefficient in the case of histamine was lower (Rs = 0.50; P less than .01) than that obtained from the allergens. Larger wheals were generated with Phazet than with conventional prick tests (median: 54.5 mm2 and 24.5 mm2, respectively; Wilcoxon signed rank test, P less than .0001). Comparison of wheal areas and specific IgE did not reveal large differences between the two skin test methods. In conclusion, Phazet, a recently introduced simple, standardized, skin prick test method can replace the conventional skin prick test for the most important allergens such as house dust mites, timothy pollen, and cat epithelium.
The symptoms of occupational pollinosis are described on the basis of case histories, skin tests and serological tests of six commercial gardeners. Exposure to gerberas, freesias, chrysanthemums and to genera of the nightshade family (Solanaceae) such as paprikas, tomatoes, egg plants and potatoes may lead to allergy with raised IgE levels.
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In 212 sera from budgerigar and canary fanciers with symptoms of rhinitis and/or bronchial asthma, IgE antibodies against budgerigar feathers (Budf) or canary feathers (Canf) were determined. In 25 of 98 Canf-specific IgE antibody measurements, and in 28 of 154 Budf-specific IgE antibody measurements, a significant (6% or more binding of 125I-anti-IgE) level of specific IgE was found. In 3 sera with the highest levels of Canf- or Budf-specific IgE, IgE antibodies against sera from both birds were present. It is concluded that IgE antibodies against canary and/or budgerigar feathers are present in about 20% of canary and budgerigar fanciers with symptoms of atopic disease. Canary and budgerigar feathers contain IgE-binding antigens that are not present in the corresponding bird sera and droppings.