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PubMed2001

A case of allergic reaction to surgical metal clips inserted for postoperative boost irradiation in a patient undergoing breast-conserving therapy.

We report a case of a 28-year-old woman with right-sided breast cancer. The patient had been treated for atopic dermatitis since her infancy. She underwent breast-conserving surgery (BCS) in July 1998, and three titanium clips were placed at the margin of the excision cavity at the time of surgery. Two months after surgery, the patient exhibited a rapid exacerbation of atopic dermatitis. Various drugs were suspected to be the cause of the allergic reaction, but the results of a bi-digital O-ring test (BDORT) suggested an allergic reaction to titanium clips. In August 1999, the patient underwent a second operation to remove the titanium clips under local anesthesia. Allergy to surgical titanium clips is a rare complication, but in patients with a history of severe allergic diseases, a preoperative immunologic examination should be performed and the patient's history of metal allergy should be investigated.

Adult↗
PubMed2005

[Clinical manifestations of cross-allergic reactions to food among children].

Scientists have recently studied the frequency and possible forms of clinical manifestations of cross-reactivity to food among 239 of Abakan at the age from 6 month to 15 years with skin, respiratory and combined manifestation of atopy It was proved that risk factors of development of cross-reactivity to food occur among 80% of children who have various forms of allergic diseases moreover the cross allergic reactions between the foodstuffs most frequently occur with the gastrointestinal and with skin forms of food allergy and the cross allergic reactions between the pollen and food allergens more frequently occut with the respiratory forms of atopy and dermorespiratory syndrome. Considerably more rarely this type of reactions is discovered between the epidermal and food allergens, which most frequently were revealed with the dermatorespiratory syndrome.

Adolescent↗
PubMedDate not supplied

[Allergic reactions to local anesthetics].

We studied 35 patients which had been sent by various specialists to the Allergy department of a general hospital because they had an adverse reaction to some type of local anesthetic. The subjects underwent three types of tests: a prick test, an intradermoreaction test and a provocation test using three local anesthetics: procaine 2%, lidocaine 2%, mepivacaine 1% with no vasoconstrictors or parabens in order to rule out the possibility that the reaction was due to these substances rather than the local anaesthetic being tested. The results indicated that both the prick test and the provocation test of the local anesthetics included in the study were negative for all of the patients. One patient who had an adverse reaction to Hostacain was tested with that same anesthetic. The patient tested positive in the intradermoreaction test with a 1/10 solution but was not able to be tested with a solution free of parabens due to lack of availability. The results of our study coincide with the bibliographic research done in that real allergic reactions to local anesthetics are infrequent. The methodology used effectively distinguishes those patients with a risk of real allergic reactions there by indicating to the physician the safest local anesthetic for the patient.

Adolescent↗
PubMed1988

The release of prostaglandin D2 from human skin in vivo and in vitro during immediate allergic reactions.

1. The release of prostaglandin D2 (PGD2) during immediate allergic reactions in human skin was investigated in vivo and in vitro. 2. Skin exudates were collected from abraded sites on the thigh of atopic subjects sensitive to D. pteronyssinus antigen and from non-atopic control subjects. Challenge with antigen caused the release of PGD2 and histamine, but not PGE2, from the skin of the atopic subjects. The molar ratio of histamine to PGD2 was about 140:1. Control subjects were unresponsive. 3. PGD2 was released from passively sensitized human skin challenged with antigen in vitro. The time course was similar in vitro and in vivo. The ratio of histamine to PGD2 in vitro was 78:1. 4. The identities of the prostaglandins were confirmed by high performance liquid chromatography and radioimmunoassay to PGD2 and PGE2. 5. PGD2 is the major arachidonic acid cyclo-oxygenase product synthesized by human mast cells. It is pro-inflammatory in human skin but its functions as a mediator in immediate hypersensitivity reactions in human skin are not clear. The results of this study suggest that, relative to histamine, PGD2 contributes little to the oedema and erythema of immediate reactions in human skin.

Adult↗
PubMedDate not supplied

[Allergic reactions to glucocorticoids].

The possibility of anaphylactoid or contact-allergic reactions to corticosteroids should always be considered when the underlying disease deteriorates or specific signs of allergy or pseudoallergy appear during treatment with corticosteroids. Appropriate diagnostic procedures should be extensive enough to exclude hypersensitivity to other constituents of the commercial preparation used as well as multiple or cross-allergies to other corticosteroids.

Anaphylaxis↗
PubMedDate not supplied

[Pseudo-allergic reactions].

The pathogenetic, clinical and epidemiological aspects of Pseudo-Allergic Reactions (PAR) are reported, as well as the diagnostic approach. PAR represent an emerging syndrome with increasing frequency, correlated to the increasing diffusion of drugs, foods and food-additives, which should draw the care and research of Allergologists.

Drug Hypersensitivity↗
PubMed1993

Systemic allergic reaction and diarrhoea after pineapple ingestion.

Some foods may initiate allergic reactions. Anaphylaxis due to mangoes, oranges, nuts and other foods has been reported earlier. We report the clinical and laboratory features of 32 patients who became symptomatic shortly after they had eaten pineapples. Seventeen patients were males and 15 females with ages ranging from 5 to 70 years. Most of the patients complained of intense itching and urticarial rashes, followed by abdominal pain, vomiting and diarrhoea. Sixty-eight percent of the patients became symptomatic within half an hour of eating the pineapple. On examination 18 patients had an urticarial rash and a flushed face. Although none of the patients were severely dehydrated, 20 patients presented with shock. Their peripheral pulse and blood pressure were low or absent suggesting an anaphylactoid reaction. The median total eosinophil count was 1850 (250-6375/mm3). The serum IgE level measured in 4 patients was raised. The patients were treated with intravenous fluids and antihistamine. Some patients also received steroid and adrenaline. All patients recovered uneventfully. Our findings suggest that ingestion of pineapple may occasionally cause an anaphylactoid reaction.

Adolescent↗
PubMed1995

Allergic reaction involving liver dysfunction and disseminated intravascular coagulation caused by a health food, Proporis.

A 43-year-old woman was hospitalized with skin eruption and liver dysfunction complicated with disseminated intravascular coagulation (DIC) after taking Proporis, a so-called health food. Her clinical course was well correlated with discontinuation and the retaking of Proporis. No other reason for the development of DIC was detected except for allergic reaction to Proporis, as demonstrated by a patch skin test. DIC subsided after the discontinuation of Proporis and treatment with gabexate mesilate and heparin. The consumption of health foods with various ingredients is recently increasing. Thus, attention should be paid to any possible serious allergic reaction related to such foods.

Adult↗
PubMed1999

Heparin, derived from the mast cells of human lungs is responsible for the generation of kinins in allergic reactions due to the activation of the contact system.

BACKGROUND: In a recent study mast cell heparin proteoglycan (HepPG) of a cell line derived from a mouse mastocytoma was isolated. Glycosaminoglycans proved to be an initiating surface for starting contact activation and could explain kinin generation present in allergic reactions. It is the aim of the present study to prove that HepPG or glycosaminoglycan derived from human mast cells is also capable of acting as a physiologic macromolecule and to induce contact activation. METHODS: HepPG molecules were isolated by anionic column chromatography. Their ability to accelerate reciprocal activation of factor XII was investigated by spectrophotometry. The anticoagulant effect was demonstrated by an increase in partial thromboplastin time. HPLC was performed to correlate these effects with molecular weight (MW). RESULTS: The isolated heparin showed high contact-activating and anticoagulant potency. Both actions were suppressed by incubation with heparinase I. The maximum contact activation peak appeared at a lower MW than the anticoagulant effect. CONCLUSION: These in vitro results explain the results of in vivo allergen challenge studies where a high degree of kinin generation occurs. Heparin derived from human mast cells therefore seems to represent the physiological macromolecule capable of activating the contact system and could be a missing link between cellular and humoral responses in allergic reactions.

Animals↗
PubMed1991

Expression of endothelial-leukocyte adhesion molecule-1 in elicited late phase allergic reactions.

To better understand the events involved in the local migration of inflammatory cells into sites of allergic reactions, we studied expression of the cytokine inducible endothelial cell (EC) neutrophil adhesion molecule, endothelial-leukocyte adhesion molecule (ELAM-1), in sequential skin biopsies from patients with respiratory allergy during the late phase reaction (LPR) between 20 min and until 24 h after intradermal allergen (ragweed or dust mites) injection. In 7 of 7 atopic patients but in only 1 of 4 apparently normal controls, allergen induced appearance of ELAM-1 on EC. ELAM-1 expression occurred concurrently with the development of inflammatory cell infiltrates by 3-4 h after intradermal injection. Saline injected sites in all subjects were negative. Skin organ cultures demonstrated that allergen could produce the same EC changes in vitro whether allergen was injected in vivo 20 min before culture or added during skin culture. These EC changes in organ culture were inhibited by the presence of combined anti-sera to both TNF-alpha and IL-1, but not by antisera to either cytokine alone. We conclude that EC activation occurs in elicited LPR and suggest that cytokine-induced EC activation may play a role in the migration of inflammatory cells into allergic skin reactions. Furthermore, resident cells in the skin rather than infiltrating leukocytes appear to be the source of the cytokines that mediate endothelial activation.

Cell Adhesion↗
PubMed1997

Allergic reactions to workplace allergens.

Allergic sensitization to workplace allergens can result in occupational asthma (OA), rhinitis, and dermatoses. Occupational asthma, accounting for 2% to 15% of all new cases of asthma, is caused by more than 240 reactive chemicals or natural proteins. Diisocyanates, used in urethane production and spray painting, are the leading causes of OA. Occupational asthma must be objectively confirmed by demonstrating significant decreases in lung function associated with exposure to a causative agent. An early diagnosis of OA followed by elimination of exposure to a causative agent may be curative and prevent progression to chronic asthma. In the last decade, protein allergens in natural rubber latex gloves have emerged as the leading cause of work-related cutaneous and respiratory allergic disorders in health care workers. In the workplace, occupational allergic contact dermatitis is almost always caused by chemicals, including nickel, chromates, and epoxy resins, whereas contact urticarial reactions are most often due to protein allergens. The primary treatment of occupational allergic disorders is strict avoidance of exposure to the inciting agent.

Allergens↗
PubMed1987

Immunopharmacological studies of wen-qing-yin, a Chinese blended medicine: effects on type IV allergic reactions and humoral antibody production.

Wen-Qing-Yin, a Chinese blended medicine, is reported to be effective against aphthous stomatitis and ulcus vulvae acutum of Behçet's syndrome, although there are no basic experimental studies supporting its clinical effectiveness. Although pathogenesis of Behçet's syndrome is not known, involvement of cellular immunodeficiency has been suggested. In the present paper, the effect of Wen-Qing-Yin on type IV allergic reactions concerned with cellular immunity, and to a lesser extent, formation of humoral antibodies were investigated. Wen-Qing-Yin did not affect the effector phases of type IV allergic reactions including picryl chloride-induced contact dermatitis and footpad reactions induced by sheep red blood cells and tuberculin in mice. However, the induction phases of all these reactions were significantly inhibited with Wen-Qing-Yin. Local graft vs host reaction induced by lymphocytes of Balb/c mice into the footpads of CBF1 mice, was significantly inhibited with Wen-Qing-Yin. The formation of hemolytic plaque forming spleen cells (IgG-PFC and IgM-PFC) from mice were inhibited or tended to be inhibited with Wen-Qing-Yin. Hemolysin formation in the blood of these animals was inhibited or tended to be inhibited with Wen-Qing-Yin. It is suggested that the therapeutic effect of Wen-Qing-Yin on Behçet's syndrome may be mainly due to an inhibitory action on the early phases of the cellular immune response.

Animals↗
PubMed1992

PAF acether release on antigenic challenge. A method for the investigation of drug allergic reactions.

This study describes an in vitro method to evaluate a PAF acether release test (PART) from white blood cells after antigenic challenge. PAF acether activity of the supernatant was tested by platelet aggregation. The aggregating power was abolished by using SRI 63-441 (Sandoz), a PAF acether inhibitor. This method was applied to 57 patients with allergic or pseudo-allergic reactions to drugs by using different drug protein conjugates. The results of PART were evaluated in relation to the clinical history (score of imputability) and to other tests (skin tests, lymphocyte transformation tests (LTT), IgE-RAST). A good correlation was found between the release of PAF acether and a high predictability score: sensitivity 75%, specificity 83.8%. PART also correlated with skin tests (75% agreement, n = 60), with LTT (67.7% agreement, n = 74) and in 65.6% of cases with positive penicillin IgE-RAST (n = 32). This method brings a new possibility for the investigation of drug-allergic and pseudo-allergic reactions.

Antigens↗
PubMed2003

Relationship between a history of systemic allergic reactions and risk of subsequent carboplatin hypersensitivity.

OBJECTIVE: The establishment of clinical features identifying patients at a heightened risk for the development of carboplatin hypersensitivity may assist in the management of this important toxicity. Based on a previous report suggesting a history of "bee sting" allergy predicted for paclitaxel hypersensitivity, we attempted to determine if there was a relationship between a history of prior systemic allergic reactions and the subsequent development of carboplatin hypersensitivity. PATIENTS AND METHODS: The medical records of all women treated in the Gynecologic Cancer Program of the Cleveland Clinic from June 1995 to May 2002 who received >6 cycles of platinum-based chemotherapy were retrospectively reviewed for a history of prior systemic hypersensitivity (e.g., medications, environmental exposure). The incidence of "positive" allergic histories was then examined in relation to the subsequent risk of patients developing either a documented carboplatin hypersensitivity reaction or a "positive" carboplatin skin test. RESULTS: The analysis included 174 patients (91 undergoing "carboplatin skin testing") who received > 6 courses of carboplatin. Of 53 patients with no recorded history of systemic hypersensitivity treated prior to our routine use of carboplatin skin testing, 19% experienced an allergic reaction, in contrast to a 40% incidence of a documented carboplatin reaction in 30 patients with a recorded history of hypersensitivity to a medication or environmental exposure (P < 0.05). For the 55 patients with no history of systemic hypersensitivity who underwent carboplatin skin-testing, 27% had a positive test result, in comparison to a 36% positive test rate in women with a previous history of a systemic hypersensitivity reaction recorded in the medical record (P > 0.05). CONCLUSION: This analysis suggests that patients with a prior history of systemic hypersensitivity to medications or environmental exposures may be at a heightened risk for experiencing allergic reactions to carboplatin.

Anaphylaxis↗
PubMed2005

Dynamics of airborne pollen particles from inhalation to allergic reaction in the nose.

BACKGROUND: Pollinosis is common worldwide, and has been frequently studied. However, the intranasal dynamics of pollen grains have not yet been documented. The purpose of this study is to elucidate for the first time the dynamics of Japanese cedar pollen (JCP) in the human nose at consecutive steps from inhalation to allergic reaction together with release of Cry j 1 (a major allergenic component of JCP) in the nose. METHODS: A personal sampler collected airborne pollens at head height outdoor on the street, while intranasal pollens after natural or experimental inhalation were collected by irrigation with 200ml saline. Cry j 1 in the supernatant after in vitro incubation with phosphate buffered saline or lavage was determined by enzyme-linked immunoassay. RESULTS: Head-height pollen was 183.0 +/- 43.1/300L/h, with 99% of the inhaled pollens deposited on the nasal surface. Eighty eight% of the inhaled pollen was transported to the out-side of the nose by ciliary function within 3 hours. During this process, considerable amounts of Cry j 1 were released in the nose reaching its plateau within 30 min. When the number of pollen deposited exceeded more than approximately 65 particles, symptoms may occur, leading presumably up to a 74% reduction of the intra-nasal pollen. CONCLUSION: The majority of inhaled airborne pollens was deposited on the nasal mucosal surface and moved out from the nose by mucociliary transportation. During this process, when allergenic substances are released up to a critical concentration, allergic reactions occur leading to expelling of pollen from the nose followed by subsiding of the symptoms.

Adult↗
PubMed1988

Response of nasal ciliated cells of the guinea-pig during allergic reactions in human blood.

Nasal mucosal samples from thirty-five guinea-pigs were placed in a chamber, containing the medium RPMI 1640. Ciliary activity (beats.s-1) of the most active cell in each mucosal culture was measured using a photoelectric method. The RPMI 1640 was then replaced by 2 ml of RPMI 1640 and 1 ml of heparinized human blood from a non-allergic patient, with a ragweed-sensitive nasal allergy, or patients with D. farinae-sensitive nasal allergy: the ciliary activity of the same ciliated cell in each culture did not change significantly. We then added 1 micrograms of D. farinae extracts to evoke an in vitro allergic reaction. Ciliary excitation was induced when D. farinae extracts were added to the blood from D. farinae-sensitive subjects but not when added to blood from subjects without sensitivity to D. farinae. The peak and plateau of such an event occurred after 20-30 min. Ciliary stimulations were correlated with D. farinae-induced histamine release from whole blood. Thus, in vitro allergic reactions stimulate activity in cilia from normal nasal mucosa.

Allergens↗
PubMed1996

[Allergic reactions during anesthesia].

Anaphylactic reaction during anesthesia is a constant source of concern for anesthesiologists, given that the rates of death and serious complications are high and predicting which patients will be susceptible is impossible. All substances used in the perioperative period carry a certain risk of releasing histamine and triggering an allergic reaction, though muscle relaxants are the drugs usually implicated. The incidence of serious anaphylaxis ranges between 1:4,000 and 1:23,000 anesthetic procedures, with mortality set at 3-9% and morbidity 10 times higher. Clinical signs vary from mild symptoms to anaphylactic shock and cardiac arrest. The diagnostic procedure to follow upon observing an allergic reaction is to first identify the responsible mechanism and later the responsible agent, as well as drugs that can be used safely. Prophylaxis is based mainly on recognizing predisposed patients before surgery and following recommendations and pharmacological protocols based on better understanding of the pathophysiological mechanisms that cause anaphylactic reaction and on experience in managing them.

Analgesics↗