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Biomedical subjects

T Carrillo

Publications and source records attributed to T Carrillo.

36 records · Page 2Linked to original sources

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

Diagnosis of pleural tuberculosis by detection of specific IgG anti-antigen 60 in serum and pleural fluid.

The objective of this study was the prospective evaluation of the IgG antibody levels to mycobacterial antigen 60 (A60) in serum and pleural fluid and their role in the diagnosis of tuberculous pleuritis. The level of IgG was measured by Elisa in 30 patients with tuberculous pleuritis and 48 control subjects with pleural effusion (24 with carcinoma, 10 with transudative pleural effusion, 11 with empyema or parapneumonic effusion, 1 with pulmonary embolism and 2 due to systemic lupus erythematosus). The median titers of IgG against A60 of both serum and pleural fluid from tuberculous patients [445.6 +/- 133.56 and 263 +/- 72.58 Elisa units (EU) respectively] were significantly higher than those of corresponding median values (97.3 +/- 8.35 and 41.3 +/- 4.93 EU) of the control group (p < 0.01 and p < 0.01, respectively). Considering 240 units as cutoff point for a positive test in serum, the sensitivity was 53.3% and the specificity 100%. In the pleural fluid the cutoff point value was established at 150 units, with a sensitivity of 50% and specificity of 100%. We concluded that Elisa using A60 is a reliable and rapid test with an acceptable sensitivity and magnificent specificity.

Antibodies, Bacterial

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

Squid hypersensitivity: a clinical and immunologic study.

Hypersensitivity to mollusk has rarely been described in the literature. Among the mollusks, the cephalopods are a group of great importance as a food source. We report seven patients who had had symptoms highly suggestive of IgE-mediated reactions after ingesting squid or inhaling vapors from cooking squid. All had previously suffered from persistent rhinitis or asthma for years. In addition, six of the seven patients had had symptoms after ingesting shrimp. Skin prick tests were strongly positive for boiled squid extract and for various commercial crustacean extracts. Specific IgE antibodies against boiled extract and several crustacean extracts were demonstrated in all patients by RAST and reverse enzyme immunoassay. Cross reactivity between squid and shrimp and other crustaceans was demonstrated by reverse immunoassay inhibition studies. Cross reactivity could not be demonstrated between squid and octopus, which are both cephalopods, nor between squid and other mollusks.

Adult

[Epidemiology of tuberculosis in the Gran Canary Island].

BACKGROUND: The aim of the present study was to obtain information about tuberculosis (TB) in our area that might contribute to assess the status in Spain. METHODS: A meticulous case finding was carried out during 1988 in all the hospitals of the Gran Canaria island. RESULTS: 214 cases were found (rate 32.2) and 77% were admitted to hospitals. In 160 (74%) the involvement was pulmonary and in 82 (37%) it was extrapulmonary. Mean age was 34 years (range 1-84) and 62% were younger than 40 years. 69% were males. Complete data were obtained in 183 cases (85%). 56% were smokers, 34% alcoholic abusers, 15% drug abusers (35% parenteral) and 4% homosexuals. 26% had some risk factor for TB; 14 of them had been infected by the HIV (8 had AIDS). In 64% there was a diagnostic delay longer than one month. Out of the 214 cases, the diagnosis was made by direct microscopy and/or culture in 110 (51%), by consistent pathological findings in 41 (19%), with some of these studies but with negative results in 35 (16%) and only with clinical and radiological criteria in 28 (13%). 96 (60%) of the pulmonary cases had cavitation. The most common therapeutic schedule (84%) was the recommended 9-month regimen. In 54% no recommendation for the investigation of contacts was made. CONCLUSIONS: In the authors' area, the prevalence of TB is higher than in developed countries. It is more common in middle aged individuals, many diagnoses are still made without bacteriologic studies and in a high number of cases investigation of contacts is not carried out.

Adolescent

Effect of cigarette smoking on the humoral immune response in pigeon fanciers.

Tobacco smoking is associated with increased prevalence of various diseases. In this study, we have used an indirect enzyme-linked immunosorbent assay (ELISA) to investigate the specific IgG response to pigeon serum and its relationship to tobacco smoking. In a large group of pigeon fanciers the development of pigeon breeder's disease and some of the clinical features were also investigated. We found a sensitization rate of 31.9%, a lower degree than that found by other authors, in spite of using a less specific antigen. We also found that fanciers who are current cigarette smokers had significantly lower levels of IgG antibody to pigeon serum (P less than 0.001). Finally, 11.9% of the population had chronic bronchitis as their only manifestation of possible pigeon-related disease. 19.6% of the sensitized fanciers had chronic bronchitis, were non-smokers and had no other risk factor for developing chronic bronchitis.

Adolescent

Allergy to limpet.

Allergy to mollusk has rarely been described. The limpet, belonging to Phylum mollusca, is one of the most frequent mollusks in the Canary Islands, as in all warm maritime regions. We report two cases of atopic patients who developed anaphylactic reactions after ingestion of this mollusk. Type I hypersensitivity to limpet antigens was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, and histamine release test to cooked limpet extract. The controls did not react to any of these tests. Allergic activity was only found with a cooked limpet extract; this suggests that the offending antigen/s may have been released by cooking this food.

Adult

Occupational asthma caused by African maple (Obeche) and Ramin: evidence of cross reactivity between these two woods.

Four patients with occupational asthma were studied. All patients were exposed to African maple dust and two of them were also exposed to Ramin dust. Skin tests and bronchial provocation tests with African maple extracts revealed an immediate response in all patients, and the same tests performed with Ramin extracts again revealed an immediate reaction in either exposed or non-exposed patients to Ramin wood dust. Specific IgE antibodies against African maple extracts were demonstrated in all patients as measured by a reverse enzyme immunoassay. Cross reactivity between both woods was demonstrated by a reverse enzyme immunoassay inhibition study. Unexposed persons and exposed asymptomatic workers did not exhibit reactivity to both woods in any of the tests listed above. To the best of our knowledge, this is the first article in which occupational asthma due to Ramin is defined, and cross sensitivity between two different woods is demonstrated.

Adult

Contact urticaria and rhinitis from latex surgical gloves.

Latex used in the manufacture of surgical gloves should be included in a list of allergens. It is found in the tree Hevea braziliensis. For approximately the last year, minutes after using surgical gloves, a female doctor had severe pruritus followed by a rash and angio-oedema of the contact areas. During the last 4 months, on opening the glove-bag, she experienced severe rhinitis and respiratory distress. The symptoms ceased in 1 h. Standard patch tests and with substances used in the manufacture of rubber were negative. Prick tests with glove and natural latex were strongly positive. The presence of specific IgE against natural latex was demonstrated by means of a histamine release assay as well as by immunoenzymatic methods. The antigen seems to have a MW higher than 30,000 d and is trypsin-sensitive. These facts suggest that the allergen could be a protein present in the "crude natural latex".

Adult

Hereditary angioedema: a study of three families.

Familial angioedema is an autosomal dominant hereditary disease whose pathogenesis is attributed to a C1 inhibitor (C1 INH) deficit. Two genetic forms have been recognized related to the C1 inhibitor deficiency or its dysfunction. Antifibrinolytics as well as androgenic derivatives have proved to be effective in the prevention and treatment of this pathology. In this paper we present the studies carried out in three families affected by C1 inh. deficit and the treatment employed. Some of the members of these families showed symptoms related with this deficit. A satisfactory explanation has not been formulated to justify the reason why only some of the members in our study showed symptomatology, given that there were no differences between the C1 inh. levels in these patients and those who were not affected. The absence of family history connected with this disease does not necessarily suggest that a genetic mutation has been produced. This deficit could have been present in earlier generations but without clinical manifestations. Stanozolol proved effective in the control of symptoms in the two patients to whom this treatment was applied. However, the rise of C1 inh. levels was significative only in one of them. The lack of connection between the clinical improvement and the normalization of the C1 inh. levels led us to think that the main goal of the therapy should not be directed to the normalization of these levels but to keep the patient asymptomatic with the lowest possible doses of the selected medication.

Adult

Nasal candidiasis in an immunocompetent patient.

We report a case of nasal candidiasis in an immunocompetent host who denied the use of topical or systemic corticosteroids. The patient was treated with itraconazole 100 mg. with resolution of the symptoms.

Adult

Food hypersensitivity among adult patients: epidemiological and clinical aspects.

Food hypersensitivity (FH) is lesser frequent among adult patients than in childhood. Foods implicated in hypersensitivity reactions vary with sociocultural and diet habits from a geographic place to other. We studied 142 adult patients sensitized to foods, among 7698 patients visited at our Outpatient Clinic. Hundred and twenty patients referred clinical symptoms after consumption of one or more foods consistently. From the latest, 107 patients (89.2%) were atopics (92 of them sensitizes to dust mites) and 54 (45%) referred atopic familiar background. Most frequent recorded symptoms were: urticaria/angioedema 84 cases (70%), oral syndrome 65 (54%), asthma 48 (37%) and anaphylaxis 33 patients (27.5%). Shellfish sensitization occurred in 50 patients, fresh fruits in 33 and nuts in 29 cases. Shrimp (48 patients), squid (33), kiwi (14), papaya (14), avocado (13) and banana (12 cases) were the most frequent causes of FH. Significant statistical association between foods and inhalants was observed for fresh fruits and latex (p < 0.001), fresh fruits and pollens (p < 0.01), and shellfish and Blatta germanica (p < 0.001). Prevalence of FH among patients at our Area is around 1.6%. Tropical fruits, as other kind of fruits, seem to share common IgE-epitopes to pollens. High prevalence of shellfish and cockroach hypersensitivity could be more easily developed by previous domestic mites sensitization.

Adult

Indoor allergens and dwelling characteristics in two cities in Spain.

BACKGROUND: Indoor allergens are common causes of sensitization and asthma. Climatic and home conditions can modify their levels. OBJECTIVE: We studied the influence of climatic conditions and home characteristics on the exposure to indoor allergens of mite allergic asthmatic subjects in two Spanish cities with different climates (Las Palmas and Pamplona). METHODS: We included 65 subjects diagnosed with asthma caused by Dermatophagoides pteronyssinus. A questionnaire about their dwellings was completed. Home dust samples were collected. Mite (Der p1, Der f1, Der 2) and cat (Fel d1) allergens were measured by a monoclonal-antibodies based ELISA. RESULTS: Characteristics of dwellings were similar in both areas. Der p1 was the main allergen (0-44 micrograms/g). Der p1, Der f1 and Der 2 levels were higher in the homes in Las Palmas (p < 0.001, p < 0.01 and p < 0.001, respectively). Damp homes in Pamplona had higher Der p1 levels, similar to those detected in homes in Las Palmas. Fel d1 levels (0-78.90 micrograms/g) were only related to the presence of cats in the dwelling (p < 0.001). CONCLUSIONS: D. pteronyssinus allergen exposure was influenced by climatic conditions and dampness in homes in temperate regions. Humidity in homes can generate an ideal environment for mite growth despite unfavorable outdoor climatic conditions. Fel d1 levels were only related to the presence of a cat in the house.

Air Pollution, Indoor