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At least 847 records · Page 47Linked to original sources
PubMed1992

Diagnostic value of the lymphocyte proliferation test in nickel contact allergy and provocation in occupational coin dermatitis.

The lymphocyte proliferation test (LPT) was compared with the patch test in the diagnosis of nickel contact sensitivity. Of the 21 subjects with nickel contact allergy, the patch test detected 20 (95%). The subject remaining negative in the patch test was positive in the intradermal test. 18/21 subjects with nickel contact sensitivity were positive in the LPT, whereas in the control group 2/23 subjects were false positive. These results were obtained at nickel sulfate concentrations of less than 10 micrograms/ml, higher concentrations led to nonspecific lymphocyte stimulation. 3 nickel-sensitive cashiers with suspected coin contact-induced deterioration of their hand eczema were challenged by having them count nickel-containing coins daily for 15 min. 2 of them developed vesicular eczema on their palms and fingers in 2 to 3 days. The present results show that the LPT is a reliable additional test in the diagnosis of nickel contact sensitivity. Furthermore, provocation is a valuable procedure when assessing the relevance of nickel contact in occupational hand eczema in certain occupations.

Adult↗
PubMed1997

Baboon syndrome.

An 18-month-old patient developed Baboon syndrome after oral treatment with erythromycin syrup for a sore throat. The lymphoblastic transformation test was positive for erythromycin. Prick tests were negative although the intradermal test was positive at a concentration of erythromycin of 1:10,000. The biopsy showed a perivascular lymphocytic dermatitis. Local treatment with a potent corticoid improved the lesions after 3 days. The Baboon syndrome is uncommon among children. It has a pattern similar to systemic contact dermatitis with particular features (erythema in flexural areas). In our case, the role of erythromycin was documented. However, this antibiotic remains a relatively rare allergen.

Anti-Bacterial Agents↗
PubMedDate not supplied

Localized pustulosis induced by betalactams.

Localized forms of pustular drug eruptions related to antibiotics are uncommon and their mechanism is still unknown. We describe herein a patient who developed numerous pin-head pustules without erythema in the peribuccal area after ingestion of ceftibuten and amoxicillin. The relationship with these drugs was confirmed by single-blind oral challenges. The following tests were performed: prick and intradermal tests with benzylpenicilloyl polylysine, minor determinant mixture, benzylpenicillin and amoxicillin; patch tests were also carried out with benzylpenicillin, amoxicillin, cloxacillin, cefuroxime, ceftriaxone, cefazolin, ceftibuten and cefaclor. All cutaneous tests were negative. Controlled single-blind challenge tests were performed with amoxicillin, cefadroxil, ceftibuten, cefuroxime, cefaclor, erythromycin and ciprofloxacin. All betalactam antibiotics tested gave a positive reaction, with good tolerance of other antibiotics; this would appear to indicate a specific mechanism of hypersensitivity and not an unspecific reaction to wide spectrum antibiotics.

Adult↗
PubMed2003

Demonstration of an IgE-mediated immunological pathogenesis of a severe adverse reaction to gadopentetate dimeglumine.

In this case report, the authors, after reviewing the literature data about contrast agents in Magnetic Resonance Imaging (MRI) and correlated problems, investigate the immunological mechanism of an adverse reaction to gadopentetate dimeglumine (Gd-DTPA), in order to demonstrate an IgE-mediated immunological pathogenesis. The case of a patient who underwent MR imaging in our hospital was studied. During, and after, the MR examination with Gd-DTPA the patient showed local warmth/pain to the external genitalia and to the face, tachycardia, nausea, vomiting, diarrhea, uterine cramps, and diffuse cutaneous rash. Skin tests (intradermal) and the passive transfer test according to Prausnitz and Küstner were positive, suggesting the involvement of an I-type allergy (IgE-mediated) mechanism. In this paper, we demonstrate that the adverse reactions to Gd-DTPA can be supported by an immunological mechanism.

Adult↗
PubMedDate not supplied

[Evaluation of the activities and value of allergo-anesthetic consultation at the University Hospital Center of Nice 1985-1991].

Life-threatening accident during anesthesia scarcely happen but the consequences may be dramatic. We report our experience of an allergo-anesthesia consultation created since 1985 in Nice hospital. 452 patients have been investigated: 1) 109 for life-threatening anaphylactic and anaphylactoid drug reactions. They have been investigated by: skin tests intradermal reactions (IDR) and prick tests with substances used during anesthesia (drugs and latex) and for all the muscle relaxants; the radioabsorbent test (RAST) for the muscles relaxants, propofol and latex; the human basophilic degranulation test (HBDT) for all the other drugs. We used the imputability decision table to classify the reactions. When anaphylaxis diagnosis was established (14) an "allergy card" was given to patients which identified the drugs to which they had a positive reaction. 62 patients have presented an anaphylaxis: 57 due to muscle relaxants (37 due to suxamethonium), 4 to latex and 1 to a gelatin. Patients were subsequently contacted and 50 of the 58 have responded. 18 of these patients have received 22 new anesthesias. Without exception, the advises to avoid a drug have been followed, 17 patients have a positive reaction to a muscle relaxant. In four of these, another muscle relaxant (skin test negative) was used without any trouble. For the other 13 who had shown a cross reactivity, all the muscle relaxants had been rejected and another anesthetic technique have been used: local anesthesia (3 cases), epidural (2 cases) associated or not with narcotics (propofol, midazolam), general anesthesia (propofol, midazolam, droperidol, phenoperidine). These drugs were all skin test negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaphylaxis↗
PubMed2002

Anaphylaxis to muscle relaxants: rational for skin tests.

IgE-dependent allergy to muscle relaxants (MR) has an estimated prevalence of 1 out of 6500 General Anesthesias (GA). 62% of anaphylaxis during surgery are due to MR anaphylaxis. All the molecules are divalent, carrying two NH4+ epitopes (quaternary ammonium ions), either structurally or after rapid in vivo protonization (vecuronium). The excellent overall performance of skin test makes them the golden standard for the diagnosis of anaphylactoid reactions. Techniques include intradermal tests and prick-tests. The current localizations are the forearm and the back. Positivity criteria are 3 mm for prick-tests. For IDTs, the criterium is the doubling of the size of the injection papula, when 0.02 to 0.04 ml is injected: 8 mm. The recommended concentrations are not falsely negative. Commercial concentrations can be tested by prick tests, except for mivacurium and atracurium tested of 1:10 dilution. A scale of concentrations is advised for IDT starting with 1:10,000, up to a normally non reactive concentration that is: 100 micrograms/ml (succinylcholine), 200 micrograms/ml (gallamine), 10 micrograms/ml (atracurium), 2 micrograms/ml (mivacurium), 200 micrograms/ml (pancuronium), 400 micrograms/ml (vecuronium), 1,000 micrograms/ml (rocuronium), 200 micrograms/ml (cis atracurium). The specificity and sensitivity of the skin tests to MRs are greater than 95%. The reproducibility over years is 88%. The overall concordance of PT and IDR is 97%. Both types of tests can be used for the diagnosis. IDT have to be carried out for the search of the cross sensitization. 84% of patients do have cross sensitization to MRs but only 16% react to all MRs. The further use of MRs selected by negative IDTs has been proved to be safe.

Anaphylaxis↗
PubMedDate not supplied

Allergy to cloxacillin with normal tolerance to amoxicillin and cefuroxime.

BACKGROUND: Cloxacillin is a semisynthetic penicillin widely used in nonmethicillin resistant Staphylococcus aureus infections. Several hypersensitivity reactions to cloxacillin have been reported, although IgE-mediated allergic reactions to the drug are rare and there is little information about possible tolerance to other semisynthetic penicillins or cephalosporins in patients with cloxacillin allergy. We present 2 patients with demonstrated IgE-mediated allergy to cloxacillin and tolerance to amoxicillin and cefuroxime. CASE REPORTS: Case 1. A 47-year-old woman began treatment with cloxacillin due to acute cellulitis. After ingesting 500 mg of the drug, she experience generalized maculopapular eruption and facial angioedema. Case 2. A 55-year-old woman presented an episode of acute urticaria and labial angioedema 60 minutes after ingesting 500 mg of cloxacillin for a skin abscess. METHODS AND RESULTS: Skin prick tests were positive to cloxacillin in case 1 and negative in case 2. However, an intradermal test was positive to cloxacillin (2 mg/ml) in case 2. Simple-blind oral challenge tests with amoxicillin (1 g) and cefuroxime (500 mg) were well-tolerated by both patients. CONCLUSIONS: We present 2 patients allergic to cloxacillin with normal tolerance to other betalactam antibiotics, confirming that cross-reactivity among these antibiotics seems to be uncommon. Complete allergy study, including an oral challenge test, should be considered in these patients.

Abscess↗
PubMed1987

Experimental Brucella abortus infection in pigs.

Sixteen pigs inoculated by the intra-conjunctival, intravenous or subcutaneous routes with Brucella abortus Strain 544 developed a short-lived infection usually accompanied by conjunctival and vaginal excretion of the organism for up to 99 days post-inoculation. Serological tests performed by the agglutination, complement fixation, Rose Bengal plate, antiglobulin, immunodiffusion or ELISA procedures with B. abortus antigens disclosed wide variations in the antibody responses of individual animals. In some cases the serological tests were negative even though the animal was shown to be excreting B. abortus. The intradermal test for delayed hypersensitivity to Brucella antigens gave more consistent results, especially when supported by histological evaluation of the skin reactions.

Animals↗
PubMed2001

Relevance of skin tests with drugs in investigating cutaneous adverse drug reactions.

Skin tests with drugs can be of value in investigating patients who have developed cutaneous adverse drug reactions (CADR), but their specificity and relevance remain to be determined. A false-positive result on skin testing can happen if it is not compared to results in control subjects. When performing intradermal tests (IDT), we have determined the lowest concentrations that induce false-positive results for many drugs, including betalactam antibiotics, cephalosporins, other antibiotics or non-steroidal anti-inflammatory drugs. Some drugs in their commercialized form contain sodium lauryl sulfate and can induce irritation when patch tested as such. When patch tested with colchicine at 10% in pet. or with a Cytotec pill (containing misoprostol) at 30% in pet., respectively, 80% of the 29 and 9 of the 10 negative controls developed false-positive results. Lastly, positive results of patch tests with drugs can be related to contact allergy to one of the components of the commercialized form of the drug, without any relevance to the investigation of a CADR, as observed in 2 cases with iodine or avocado oil.

Dermatitis, Irritant↗
PubMedDate not supplied

[Occupational hypersensitivity to spiramycin. Report of a case].

A case report of occupational hypersensitivity to Spiramycin. Rhinoconjunctivitis and spasmodic cough are reported in a 34 year-old female handling spiramycin powder in a pharmaceutical factory. The symptoms appeared within the first few hours of coming into contact with the drug and continued for several hours after leaving her place of work. The patient had no personal case history of atopy. Results for prick-test with extracts using a concentration of 1/100 (w/v) were positive, as were results por intradermical tests with a solution using a concentration of 1/10.000 (w/v). The diagnostic was confirmed with the application of a nasal provocation test. Our criteria to determine positivity to this test was according to Bachman (1) and the European Committee of Rhinomanometry. On our suggestion the patient was transferred to another section of the pharmaceutical company whereupon all symptoms disappeared immediately and no further allergic reactions to drugs were registered. This case suggest that reactions to a chemical product may involve immunological mechanisms.

Adult↗
PubMed1991

[Simple allergen skin test device Multi skit (tentative name)].

We have developed a device tentatively named Multi Skit (Mu), a simple allergen test device, in order to conduct the skin test safely, accurately and conveniently. The utility of this device was evaluated by determining how the results obtained by the intradermal test (In) and Mu were correlated with those obtained by IgE RAST (RA) in 65 AD patients. RA values concerning nine antigens were compared to results obtained by the In and Mu in terms of the positive and negative response coincidence rates, overall coincidence rates, and false-positive and false-negative response rates. The correlation between RA data obtained from the literature and the results of the scratch test (Sc) was also evaluated. The results of In and RAST values showed no correlation regardless of the food antigen used. Mu and RAST values showed correlation with respect to all 4 food antigens except soy-bean, resulting in overall coincidence rates of 66.2 to 87.7%, which were higher than those concerning the Sc. With respect to false-positive responses to environmental antigens, the rate obtained by Mu was higher than that by the Sc, but it was lower than that by the In. However, Mu was the most excellent test with respect to the other indices, i.e., positive and negative response coincidence rates, overall coincidence rates (73.9-89.2%) and false-negative responses. The mechanism of Mu makers it possible to minimize variations from one investigator to another, and the major drawback of all other skin tests. Mu is a safe and convenient screening skin test device which provides accurate and specific test results.

Adolescent↗
PubMed1985

Skin testing in the preoperative diagnosis of anaesthetic allergy.

Intradermal testing is a valid manoeuvre for the determination of the drug responsible for an anaphylactoid reaction during anaesthesia. It does not fill criteria for a screening test and will have limited use in the preoperative diagnosis of anaesthetic allergy unless a high risk group is selected.

Anesthesia↗
PubMed1986

Bronchospasm following the use of vecuronium.

A case history is presented which records bronchospasm due to vecuronium. Immunological investigations, including basophil degranulation tests, indicated that the bronchospasm was not caused by direct histamine release and was not IgE mediated. It was of interest that intradermal testing gave a positive wheal response against neuromuscular agents other than those involved in the anaesthetic procedure under investigation. A positive reaction to vecuronium was only obtained when given in a high concentration and accords with the general belief that vecuronium has extremely low potential for histamine release.

Aged↗
PubMed1997

Changing patterns of Clonorchis sinensis infections in Kyongbuk, Korea.

Studies were conducted from May, 1993 to April, 1995 to determine the changing patterns of infection by the liver fluke, Clonorchis sinensis, among residents and fish hosts in Kyongbuk Province. The infection rate among residents was 7.7% by stool examination. The rate in males (11.3%) was significantly higher than females (4.1%). Positive rate of intradermal test was 27.6% in the same population. The special type of a simple catalytic model was applied for the analysis of intradermal positive reactors by age and sex, and the equation was y = 0.4776 (1 - e-0.0375t) for males and, y = 0.2085 (1 - e-0.0138t) for females. Analysis of stool examination data by two-stage catalytic model revealed y = 0.025 (e-0.00471 - e-0.0235t). The annual Clonorchis infection rate was 4.7 per 1,000 susceptibles and the annual loss rate was 23.5 per 1,000 infected. The frequency distribution by the eggs per gram (EPG) was calculated as well as the cumulative percentages of positives. The regression equations were y = 0.929 + 1.506 log x for males and, y = 0.473 + 1.767 log x for females. Of the 25 fish species, 7 species were infected with Clonorchis metacercariae. Infection rates varied by the species, and ranged from 2.8% in Puntungia herzi to 30.0% in Pseudorasbora parva. Average number of the matacercariae per gram of flesh was 58.1 in P. parva, followed by 10.2 in Gnathopogon atromaculatus, 7.0 in Saurogobio dabryi, and 3.0 in Paracheilognathus rhombea. The present study indicates that clonorchiasis in Kyongbuk Province is less prevalent than that of several decades ago.

Adolescent↗
PubMed1982

Control of schistosomiasis japonica in the Nagatoishi area of Kurume, Japan.

A pilot experiment using NaPCP as a molluscicide to control schistosomiasis japonica was initiated in 1950--51 in Nagatoishi-cho, Kurume, Japan, where 1,050 persons lived behind dikes built to prevent flooding from the Chikugo River. They farmed 60 ha of rice, and 72.9% of them were infected with schistosomiasis. At the end of 2 years, 99.5% of the snails (Oncomelania h. nosophora) were controlled and new cases dropped from 30--35 per year to 5 and 0 at the end of the 1st and 2nd year, respectively. Mollusciciding was continued by Japanese, and paddy irrigation ditches were lined with concrete by 1958. Land reclamation, involving conversion of cultivated land in the river bottom to a golf course, resulted in virtual elimination of infected snails from this area and, when found, snails were uninfected. Using immunologic tests (intradermal, complement fixation, and circumoval precipitation) plus multiple stool examinations in 1972 and 1978, it was possible to demonstrate a marked decrease in cases of schistosomiasis in children 15 years of age or younger. These results were significantly different (P less than 0.001) from those found in similar tests run in 1940 and 1966. By 1978 all children in the Nagatoishi area of Kurume, Japan, were negative for Schistosoma japonicum infection.

Adult↗
PubMed1976

A comparison of several intradermal tuberculins in Macaca mulatta during an epizootic of tuberculosis.

During an epizootic of tuberculosis in rhesus monkeys, several intradermal test reagents were compared for accuracy in detecting tuberculosis and for strength of reaction elicited. A purified protein derivative of Mycobacterium bovis, similar to one which will probably be approved for official veterinary testing and thus eliminate tuberculin-mammalian intradermic from commercial production, was among those evaluated. None of the reagents was found to be superior to tuberculin-mammalian intradermic. Significant difference were not found in reaction strength between abdominal and palpebral test sites, but both together were about 10 per cent more sensitive than either alone. Mycobacterium bovis and Mycobacterium tuberculosis were both cultured and identified from this epizootic.

Abdomen↗
PubMed1999

Anaphylaxis to omeprazole.

BACKGROUND: Omeprazole is a non-competitive inhibitor of the parietal cell enzyme H+-K--adenosine triphosphatase. To date, two cases of angioedema and urticaria and two cases of anaphylaxis from omeprazole have been published. OBJECTIVE: To report a new patient with omeprazole-induced anaphylaxis demonstrated by skin tests and increased serum tryptase levels. METHODS AND RESULTS: Elevated serum tryptase levels (5.1 U/L) were detected 6 hours after the onset of the anaphylaxis. Skin intradermal tests were positive with omeprazole i.v. (4 mg/mL), omeprazole capsules diluted in saline serum (20 mg/ mL), and lansoprazole (30 mg/mL). Serum specific IgE anti-omeprazole was negative. CONCLUSIONS: According to the elevated serum tryptase levels and the positive skin test results, anaphylaxis was due to use of omeprazole. We think the adverse reaction to omeprazole was induced by an IgE-mediated hypersensitivity mechanism to omeprazole itself and not to a metabolite. We have also demonstrated crossreactivity, at least by skin tests, between omeprazole and lansoprazole.

Adult↗
PubMed1997

Role of delayed cellular hypersensitivity and adhesion molecules in amoxicillin-induced morbilliform rashes.

BACKGROUND: Morbilliform rashes induced by amoxicillin are though to be caused by a delayed cell-mediated immune reaction. The importance of amoxicillin skin tests is not well defined. A better understanding of the mechanisms of amoxicillin-induced morbilliform rashes can be obtained by performing cutaneous immunohistological studies on specimens from amoxicillin-induced morbilliform rashes and positive amoxicillin skin test results. OBSERVATIONS: Skin biopsy specimens were obtained from 5 patients who had developed an amoxicillin-induced morbilliform rash. All patients underwent amoxicillin prick, patch, and intradermal tests. Similar immunohistological investigations were performed on amoxicillin-induced morbilliform rashes and positive skin test biopsy specimens, with a special focus on the expression of adhesion molecules. Three of the 5 patients developed delayed positive results to intradermal and patch tests and 2 patients developed delayed positive results to prick tests. Amoxicillin-induced morbilliform rashes were well reproduced by skin tests, with similar immunohistological results in amoxicillin-induced morbilliform rashes and skin test biopsy specimens. Keratinocytes were activated and expressed CD54 (intercellular adhesion molecule 1); perivascular lymphocytes were mostly CD2+, CD3+, and CD4+ and exhibited CD11a through CD18 (leukocyte function-associated antigen 1) and often HLA-DR and/or CD62L (leukocyte endothelial cell adhesion molecule 1); and endothelial cells were activated with a strong expression of CD54 (intercellular adhesion molecule 1), CD62E (endothelial leukocyte adhesion molecule 1), and CD31 (platelet endothelial cell adhesion molecule 1) in lesser amounts. CONCLUSIONS: Findings of this clinical and immunohistochemical study support the theory of a T-cell-mediated immune reaction in patients with amoxicillin-induced morbilliform rashes, with a strong involvement of adhesion molecules both on endothelial and infiltrating cells. Our findings emphasize the importance of delayed readings of amoxicillin prick, intradermal, and patch tests.

Amoxicillin↗