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At least 865 records · Page 48Linked to original sources
PubMed2003

Erythema multiforme due to contact with weeds: a recurrence after patch testing.

Erythema multiforme (EM) as a complication of patch testing (PT) is rare. A 52-year-old woman with a 13-year history of episodes of EM, after contact with weeds during home gardening, had had no recent history of herpes simplex, other infection, drug ingestion or vaccination. On examination, EM lesions were distributed on the exposed skin. 5 weeks after complete resolution, PT and photopatch testing (PPT) were done with fresh plants she brought in. She was PT with a standard series and the Hermal-Trolab plants, woods, tars, balsams and flavors series. Intradermal testing, with a 3 + reaction to mixed weed pollens, was done 3 weeks later. Specific IgE to weed pollens class 1 (CAP-Pharmacia) was detected. Eczematous PT reactions were obtained with fresh leaves: common chickweed (Stellaria media Caryophyllaceae), dandelion (Taraxacum officinale Compositae), field-milk thistle (Sonchus arvensis Compositae) and white clover (Trifolium repens Leguminosae). Photoaggravation was seen to common chickweed and dandelion. Positive PT was also seen with alantolactone. By the 4-day reading, a typical EM had commenced, coming up to quite the same extent as seen on admission. There was no photosensitivity (UV skin tester, K. Waldmann). In the essential oil obtained from common chickweed, thin layer chromatography (TLC) revealed the well-known contact allergens borneol, menthol, linalool, 1,8-cineole, and other terpenes such as epoxy-dehydro-caryophyllene, monoterpene alcohol-ester and caryophyllene. Up to now, no data on essential oil in Stellaria media (common chickweed) have been reported. It can be concluded that EM developed due to contact with weeds, and recurred after patch testing. Neither blistering nor eczematous lesions have been seen on her skin, making this case very unusual. As far as the world literature is concerned, this is only the 4th report of EM developing in association with patch testing.

Dermatitis, Occupational↗
PubMed2000

Detection of mycobacterial DNA in papulonecrotic tuberculid lesions by polymerase chain reaction.

Tuberculids are a heterogeneous group of cutaneous lesions. Recent discoveries of M. Tuberculosis DNA in these lesions by PCR suggest that M. tuberculosis could play a role in their pathogenesis. The aim of this study was to demonstrate the presence of M. tuberculosis DNA by polymerase chain reaction in papulonecrotic tuberculid lesions. Skin biopsy specimens from ten patients with papulonecrotic tuberculid lesions (histopathologic features) were studied. All of them tested solidly positive in a tuberculin intradermal test. A gene-amplification PCR, using primers capable of amplifying DNA in the M. tuberculosis complex, was performed to detect M. tuberculosis DNA in the lesions. A 285-bp sequence specific of M. tuberculosis complex was amplified and confirmed by Southern-blot hybridation with a 32 p 5'-labelled internal probe. No inhibitors were detected in the negative PCR samples. The PCR technique makes the detection of mycobacterial DNA in tuberculids a possibility, and therefore provides a rational basis for antituberculous therapy and for the clinical management of these disorders.

Biopsy↗
PubMed1992

Anaesthesia and the patient with latex allergy.

Reports of severe life-threatening anaphylaxis to latex are increasing. A case of latex anaphylaxis occurring during surgery is reported. Sudden cardiorespiratory collapse 25 min after the start of surgery was treated with oxygen, fluid, epinephrine, hydrocortisone, and benadryl. Two months later, skin testing to latex was positive but intradermal testing to the drugs used during anaesthesia was negative. Anaesthetists should be aware of this clinical entity. Latex allergy should be considered in the differential diagnosis of intraoperative anaphylaxis. Fortunately, it is usually preventable by obtaining a positive history, recognising that it occurs in particular subsets of patients and by avoiding latex products. Skin testing to latex is available and may assist in the recognition of latex sensitivity.

Anaphylaxis↗
PubMed1999

Cockroach allergens and asthma in Brazil: identification of tropomyosin as a major allergen with potential cross-reactivity with mite and shrimp allergens.

BACKGROUND: Cockroaches produce several proteins that induce IgE antibody responses. Although cockroaches are abundant in warm and humid areas, sensitization to cockroach allergens has not been investigated in Brazil. OBJECTIVE: The aims of this study were to investigate the frequency of cockroach allergy among patients with asthma, rhinitis, or both in Brazil and to identify American cockroach allergens. METHODS: Skin tests using cockroach extracts were performed on children and young adults with asthma, rhinitis, or both. A Periplaneta americana complementary (c)DNA library was screened by using IgE antibodies from Brazilian patients allergic to cockroaches. Reactivity of an mAb directed to Dermatophagoides pteronyssinus tropomyosin against cockroach tissue was examined by immunofluorescence. RESULTS: Cockroach allergy was present in 55% and 79% of the patients, as determined by using skin prick tests alone or combined prick and intradermal tests, respectively. Five cDNA clones reacted with IgE antibody and contained the same sequence. A representative clone (1300 bp), pa 12, coded for a protein that reacted with 50% of the sera from patients allergic to cockroaches on plaque immunoassay and showed a high degree of homology to tropomyosins, particularly those from invertebrates. P americana tropomyosin showed 80%, 81%, and 82% sequence identity to tropomyosins from D pteronyssinus, D farinae, and shrimp, respectively, which have been previously defined as important allergens. An mAb directed against D pteronyssinus tropomyosin, which also recognizes shrimp tropomyosin, showed binding to cockroach striated muscle. CONCLUSION: Our results support the recommendation that cockroach extracts should be routinely used for the evaluation of patients with asthma, rhinitis, or both in Brazil. The identification of P americana tropomyosin as an important allergen will make it possible to investigate cross-reactivity among cockroaches, mites, and food derived from invertebrates.

Adolescent↗
PubMed2002

Cross-reactivity patterns to budesonide.

Allergic contact dermatitis from topical corticosteroids is not uncommon. Budesonide has been included in the European standard series as a marker for corticosteroid allergy, though little is known of its cross-reactivity with other corticosteroids. Twelve patients previously positive to budesonide on patch testing were given further patch and intradermal tests to a range of corticosteroids. Six patients previously negative to budesonide on patch testing were used as a control group. Budesonide cross-reacts with hydrocortisone-21-sodium phosphate and triamcinolone acetonide. Patients positive to budesonide should therefore avoid hydrocortisone and triamcinolone acetonide. Patch testing, unfortunately, is an inaccurate method of determining cross-reactivity patterns among corticosteroids.

Administration, Topical↗
PubMed1987

Common occurrence in Toyama of bronchial asthma induced by chironomid midges.

A total of 119 asthmatic children were investigated by prick tests for the hypersensitivity against chironomid antigens. The percentages of cases who showed positive prick tests to the antigens of the adults of Polypedilum kyotoense, Chironomus yoshimatsui and Tokunagayusurika akamusi, that of the larvae of Tokunagayusurika akamusi and of Dermatophagoides farinae were 23.5%, 17.6%, 7.6%, 16.0% and 94.2%, respectively. The correlations among the wheal size in prick test, the threshold dilution in the intradermal test, the RAST score, and the result of the provocation test were significant. The specific IgE antibodies against two additional midge species were measured with the Phadezyme RAST test in a total of 27 asthmatic cases who were positive to either of the 3 adult midge antigens previously tested. RAST was positive in 59.3% with Chironomus plumosus and 100% with Tanytarusus oyamai. In the RAST inhibition tests, the Polypedilum kyotoense antigen causing allergic reaction was shown to be quite independent from Dermatophagoides farinae. These results suggest that the extracts of chironomid midges have strong allergenicity, and are one of the important inhalant antigens causing asthma in Toyama.

Adolescent↗
PubMed2003

Injection by various routes of melanoma antigen-associated macrophages: biodistribution and clinical effects.

Patients' autologous macrophages (AM) were used as antigen-presenting cells (APC) in a vaccination protocol against malignant melanoma. AM were administered by various routes, including intralymphatic, since these cells did not express CCR7, a molecule required for APC migration to lymph nodes. Seven HLA-A2 patients with metastatic melanoma-two classified as M1 and five as M3-were included in the study. AM were produced from leukapheresis-separated mononuclear cells by 7-day culture with granulocyte-macrophage colony-stimulating factor. After separation by elutriation, AM were frozen in aliquots and subsequently thawed at monthly intervals, exposed to MAGE-3(271-279) peptide and injected subcutaneously into lymph nodes or into one peripheral lymph vessel. Intradermal tests were performed before and after treatment to determine peptide reactivity. No acute toxicity was observed following injection. One M1 patient had a 7-mm induration intradermal reaction response and was stabilized for 64 weeks. The M3 patients did not show any immunological or clinical response. In 11 patients, the biodistribution of 111In-labeled AM was investigated. There was no clear evidence that AM injected intradermally or subcutaneously left the site of injection. After injection into a lymph vessel of the foot region, scintigraphs showed five to ten popliteal and inguinocrural lymph nodes. This appeared to be the most efficient way to administer rapidly and safely large amounts of peptide-loaded APC into lymph nodes.

Adult↗
PubMed1993

Case report: recurrent anaphylactic shock to radiographic contrast media. Evidence supporting an exceptional IgE-mediated reaction.

A rare case of anaphylaxis to iodinated contrast media is reported. The patient underwent two anaphylactic shocks to intravenous administration of radiocontrast agents. Specific IgE were suspected on the basis of positivity of intradermal tests and human basophil degranulation tests. The passive sensitization of basophils from donors was performed, comparing native and heated serum. Results agreed with the hypothesis of IgE antibodies, since heating 56 degrees C during two hours prevented the degranulation. Considering the chemical structure, iopamidol was thought to be innocuous. Two opacification procedures were further performed with iopamidol without any incident.

Aged↗
PubMed1992

Anaphylactoid reaction to propofol.

A case of an anaphylactoid reaction following the induction of anaesthesia is reported. Subsequent intradermal testing suggested propofol to be the causative agent.

Anaphylaxis↗
PubMed1997

Lispro analog for treatment of generalized allergy to human insulin.

OBJECTIVE: To evaluate the clinical usefulness of the human insulin analog lispro in a patient with generalized allergy to human insulin. RESEARCH DESIGN AND METHODS: A 34-year-old obese female patient developed systemic allergic reactions to human insulin but tolerated insulin lispro. Sequential analyses of the anti-insulin IgE and IgG immunoglobulins were performed. RESULTS: On intradermal test, the lispro insulin produced a 50% less intense wheal-flare response, compared with human insulin, which was presumed to be due to lispro's molecular form. The intradermal reactivity to both human and lispro insulins decreased with time and disappeared by week 25. 125I-labeled lispro and human insulin binding antibody titers of both the IgE and IgG immunoglobulins were high initially, but decreased progressively, becoming very low by the end of 1 year. In in vitro immunoassay, the lispro and human insulins show a complete cross-reactivity. CONCLUSIONS: Lispro may be useful for the management of allergy to human insulin. This analog of human insulin appears to have a reduced immunogenic potency.

Adult↗
PubMed2002

[Methods for the control of quality in mass tuberculin tests].

It is possible to achieve a qualitative annual intradermal testing of children and adolescents by the Mantoux test with 2 TE PPD-L and to form Dispensary Registration Group 6 completely only when there is a combination of a mass tuberculin diagnosis, team's well organized work and systematic control methods for its work quality. Standards have been developed for the quality of registration of Group 6 patients and for that of registration of positive Mantoux tests with 2 TE PPD-L, for the completeness of formation of the above group of patients, for organization of controlled chemoprophylaxis in children's collective bodies.

Adolescent↗
PubMed1999

Mold testing by RAST and skin test methods in patients with allergic fungal sinusitis.

RAST tests have traditionally been considered less sensitive than skin tests during investigation of atopy involving molds. This has been attributed to technical problems such as difficulty in binding the mold antigen to the carrier substrate. Ten patients with proven allergic fungal sinusitis were evaluated for sensitivity to 11 important molds by both RAST and dilutional intradermal testing. A predictable correlation between RAST and skin test scores was observed in many, but not all, cases. Most often this disparity was in the form of greater sensitivity indicated by skin testing than by RAST, sometimes differing by as many as 3 classes. The lack of concordance was not confined to testing for the fungi cultured from the sinuses, nor was it more or less pronounced in the case of dematiaceous fungi. The most likely causes for the disparity noted in this series are subtle differences in antigens used in skin test material and for RAST standards. Skin tests allow for evaluation of delayed and late-phase reactions, a measurement not possible by specific IgE testing with RAST. Delayed skin test reactions were not noted in this series of patients. An additional important finding was the sensitivity of patients with allergic fungal sinusitis to virtually every fungal antigen to which they were tested.

Allergens↗
PubMed1999

Cutaneous allergic reaction to intramuscular vitamin K1.

A 40-year-old woman with no pre-existing hepatic disease developed a cutaneous allergic reaction to intramuscular vitamin K1. She received this medication prophylactically prior to surgery, developed severe localized, and subsequently generalized, dermatitis, beginning 5 days after administration of the Konakion Cremophor-EL form of vitamin K1 by intramuscular injection at four sites on her thighs. Investigation by patch and intradermal testing revealed delayed-type hypersensitivity to Konakion Cremophor-EL, Konakion Mixed Micelles and pure vitamin K1, but not Cremophor-EL vehicle alone. This case is unusual because the patient was also shown to be patch test positive to vitamin K3 sodium bisulfite.

Adult↗
PubMed1984

[Immunodiagnosis of gasterophilosis].

Research into the immunological diagnosis of gasterophilosis. So far there have been no reliable methods of diagnosing equine gasterophilosis intra vitam. Horses from the G.D.R. and the M.P.R. spontaneously infected with Gasterophilus spp. were tested for antibodies by the immunotechniques of counterimmunoelectrophoresis after Pesendorfer, passive haemagglutination and the intradermal test using antigen made from larvae of all 6 Gasterophilus spp. present in the palaearctis. All 3 techniques produced positive results. The intradermal injection produced an immediate reaction. A correlation between the infestation degree of Gasterophilus larvae and the intensity of the immunoreaction tested has not been found so far.

Animals↗
PubMed1981

The duration of the response of cattle to inoculation with atypical mycobacteria.

Each of 4 strains of atypical mycobacteria was inoculated into 2 cattle and the responses of the cattle were studied over the following 52 weeks. Each strain was injected subcutaneously into one animal and into a mesenteric lymph node of another. Within 7 days palpable lesions were produced at the sites of subcutaneous inoculation in response to all the strains. After intervals varying from 3 to 26 weeks, lesions due to 3 of the strains were no longer palpable. The lesion produced in response to the fourth strain, a non-agglutinable serotype of Mycobacterium intracellulare, was still palpable at necropsy, 52 weeks post-inoculation (PI). Of the 8 cattle inoculated with mycobacteria, the latter was the only animal that had a lesion with features consistent with a mycobacterial infection and from which mycobacteria were isolated. The inoculated cattle and 4 uninoculated control cattle were tuberculin tested on 8 occasions during the post-inoculation period. Bovine purified protein derivative (PPD), avian PPD and PPD tuberculins prepared from each of the atypical mycobacteria were used. In inoculated cattle, sensitivity to both avian and bovine PPD was short lived, significant levels not persisting in any animal beyond 16 weeks PI. From the results of intradermal tests on the control cattle, a 95% confidence interval for their response to any of the 6 tuberculins used, was found to be +/- 1.36mm. On this basis all inoculated cattle developed sensitivity to the homologous tuberculin. The animal with mycobacterial granuloma at the subcutaneous inoculation site at necropsy had never developed significant levels of sensitivity to bovine PPD, had not shown significant levels of avian sensitivity after week 16 PI nor had it shown homologous sensitivity after 22 PI. In all animals the level of sensitivity to bovine PPD decreased between successive tests. This fact could be used to clarify the status of a reactor if non-specific bovine sensitivity was suspected. Alternatively, the comparative intradermal tuberculin test using both bovine and avian PPD may be employed.

Animals↗
PubMed1991

Anaphylactoid reaction to intravenous hydrocortisone sodium succinate: a case report and literature review.

Reports of corticosteroid sensitivity reactions are rare in the medical literature. We report an anaphylactoid reaction to hydrocortisone sodium succinate given intravenously which occurred on two occasions during treatment of a patient for asthma. Intradermal testing with a wide range of steroid preparations gave positive results with hydrocortisone sodium succinate, methylprednisolone sodium succinate, methylprednisolone sodium succinate and methylprednisolone acetate. No reactions occurred to dexamethasone sodium phosphate administered intravenously, prednisolone given orally or beclomethasone dipropionate by inhalation. Results of a radioallergosorbent test (RAST) were negative for hydrocortisone sodium succinate.

Administration, Inhalation↗
PubMed2006

Erythroderma due to aztreonam and clindamycin.

A 73-year-old woman developed erythroderma with intense pruritus, malaise, and chills 7 days after treatment with intravenous clindamycin. Two years later she experienced a similar reaction with more rapid onset (48 hours) after treatment with aztreonam. Resolution followed withdrawal of treatment in both instances, and intradermal tests proved positive at delayed reading for both drugs.

Aged↗