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PubMed1997

Performance of the single intradermal comparative tuberculin test in identifying cattle with tuberculous lesions in Irish herds.

The sensitivity of the single intradermal comparative tuberculin test, as applied in the Republic of Ireland, was estimated in 353 cattle with tuberculous lesions. These cattle had been removed from 47 herds which were depopulated owing to chronic or extensive infection with Mycobacterium bovis. The test had a sensitivity of 90.9 per cent, because 321 (90.9 per cent) of the 353 cattle with tuberculous lesions gave a positive or inconclusive result, and 32 gave a negative result. These 32 negative cattle came from 17 (36 per cent) of the 47 depopulated herds.

Animals↗
PubMed1998

Anaphylaxis to intravenous cyclosporine and tolerance to oral cyclosporine: case report and review.

BACKGROUND: Hypersensitivity reactions to cyclosporine are rare. The mechanism of the reaction and guidelines for subsequent use of cyclosporine are not well defined. OBJECTIVE: To investigate the mechanisms involved in hypersensitivity reactions to cyclosporine and determine the feasibility of future cyclosporine use. METHODS: We report a patient who had an anaphylactic reaction during the intravenous infusion of cyclosporine. Skin-prick tests were performed for the antibiotics he received earlier in the day and the cyclosporine. A MEDLINE search identified all the reported cases of hypersensitivity reactions to cyclosporine. Each was analyzed to determine a mechanism of the hypersensitivity reaction and subsequent management outcomes. RESULTS: Intradermal tests to intravenous cyclosporine formulation (1 mg/mL) were positive in the patient and negative in two controls. There was no reaction to the antibiotics. The literature search revealed 22 cases of hypersensitivity reaction to cyclosporine. The clinical setting and diagnostic evaluation suggest multiple mechanisms for the hypersensitivity response. All seven patients who were given an oral formulation of cyclosporine tolerated it well after a reaction to the intravenous infusion. Two patients who initially reacted to an oral solution formulation subsequently tolerated the corn oil-based soft gelatin capsule. CONCLUSIONS: Hypersensitivity reactions to cyclosporine are due to Cremophor EL. There is direct and indirect evidence for various immunologic and nonimmunologic pathways precipitating the reaction. This case suggests a role for IgE in the hypersensitivity reaction. Fortunately, a hypersensitivity reaction to one formulation of cyclosporine does not preclude use of a different formulation. The corn oil-based soft gelatin capsule appears to be the safest formulation.

Administration, Oral↗
PubMed1993

An anaphylactoid reaction following local anesthesia: a case report.

A case report of an adverse reaction to a preparation of an amide local anesthetic, prilocaine with epinephrine, is presented. Signs and symptoms were consistent with an anaphylactic reaction and the patient responded positively to treatment based on this assumption. Treatment included administration of epinephrine injected sublingually and oxygen by inhalation. However, subsequent skin testing failed to confirm this diagnosis. A number of explanations are possible and a final diagnosis of an anaphylactoid reaction was made. Local anesthetic allergies and their management are reviewed. The literature demonstrates that an allergic reaction to amide local anesthetics can occur and a thorough history, intradermal testing, and subcutaneous challenge are reasonable approaches to determine a safe agent for subsequent use.

Adult↗
PubMed1983

Severe delayed inflammatory reactions from injected insulin. Association with cell-mediated immunity.

A diabetic patient had severe, delayed cutaneous reactions to insulin accompanied by fever, leukocytosis, and elevated erythrocyte sedimentation rate. Replacement of isophane beef-pork insulin suspension with other commercially available lente beef-pork, single-component beef and pork insulin preparations brought about no improvement. Intradermal testing demonstrated biphasic reactions to a wide variety of insulin preparations except for two recently available purified single-component (less than 1 ppm proinsulin) insulins. Immunologic studies showed increased incorporation of tritiated thymidine by the patient's peripheral blood lymphocytes after incubation with these insulin preparations that incited subcutaneous and intradermal reactions. Additionally, there was significant elaboration of the lymphokine, migration inhibitory factor, in response only to isophane beef-pork insulin. Control lymphocytes from a normal subject, from a patient with non-insulin-dependent diabetes, and from a patient with insulin-dependent diabetes without delayed allergy demonstrated no response to insulin preparations. The data suggest these delayed reactions were associated with a cellular immune response to one or more contaminants in the less purified insulin preparations.

Diabetes Mellitus↗
PubMed1988

Zinc effects on nickel dermatitis in the guinea pig.

Prevention of NiSO4 induced allergic contact dermatitis (ACD) using ZnSO4 in drinking water was studied in a guinea pig model. Without ZnSO4 interventions, nickel (Ni)-exposure resulted in significantly higher (p less than 0.05) stimulation indices (SIs) as compared to non-exposed controls, using NiSO4 as an allergen in the lymphocyte transformation test (LTT). Oral intake of ZnSO4 at both 250 micrograms/ml double-distilled deionized water (DDD) and 500 micrograms/ml DDD resulted in lower SIs than those of control guinea pigs drinking only DDD; the 250 micrograms/ml group had significantly lower SIs (p = 0.025) than controls. There was no significant correlation between intradermal test responses and the SI values of individual guinea pigs exposed to NiSO4. Mean zinc (Zn) concentrations in skin and in whole blood were not statistically different between the NiSO4 exposed control and Zn supplemented groups, nor between Ni-sensitive and non-sensitive animals within groups. The rôle of Zn homeostasis, rôle of the Langerhans cell, effect of Zn supplementation on Ni ACD in other species, and possible blocking effects of other metals should be investigated in future studies.

Administration, Oral↗
PubMed2003

Occupational asthma due to exposure to iroko wood dust.

BACKGROUND: Occupational asthma (OA) from iroko wood has been reported primarily in case reports. OBJECTIVE: To improve understanding of the pathogenesis of OA induced by iroko wood dust. METHODS: Three groups of woodworkers were included in this study: 9 workers who had clinically proven OA from iroko; 10 asymptomatic woodworkers; and 10 woodworkers with asthma. All patients underwent the following tests: a skin test with an iroko aqueous extract, specific IgE determination, and an iroko bronchial provocation test (IBPT). An eosinophil count was determined before and after the IBPT, and a methacholine inhalation test was performed after avoidance of exposure to iroko. Patients were asked to monitor their peak expiratory flow rates during a week at work followed by a week's vacation. RESULTS: In all patients with a personal history predictive of OA from iroko, a reduction of the peak expiratory flow rate and positivity to the IBPT while working with iroko were present. The latter test result showed a dual response, with a decrease in forced expiratory volume in 1 second from 25% to 32% at 10 minutes and a further decrease from 35% to 43% at 8 hours; at 24 hours, the eosinophil count was higher (P = .046). In 4 patients, the intradermal test results with iroko extract were positive, whereas the skin prick test result and the specific IgE determination were negative in all patients. The methacholine test result was also positive. In the control groups, all the test results with iroko extract were negative. CONCLUSIONS: Our data suggest that OA due to iroko wood may be induced by immunologic mechanisms other than IgE-mediated immediate hypersensitivity reactions.

Adult↗
PubMed1979

Predictive evaluation in animals of the contact allergenic potential of medically important substances. II. Comparison of different methods of cutaneous sensitization with "weak" allergens.

Results of the optimization method and of other methods used to assess contact allergy in laboratory animals were compared with known epidemiological data on the occurrence of hypersensitivity reactions in man. Tests were performed with preservatives (formalin, ethylenediamine and sorbic acid), drugs (penicillin G, Benzocaine and sulphathiazole) and other contactants belonging to widely different chemical classes (p-phenylenediamine, triclosan, pyrazole derivatives, nickel and chrome salts, eugenol, isoeugenol and mercaptobenzothiazole). The degree of sensitization achieved in guinea pigs by the optimized procedure (intradermal test with adjuvant combination) and the maximization procedure was invariably superior to that produced by the epidermal method using prior irritation of the site of application. Both the optimized procedure and the maximization test seem to be capable of identifying contact allergens that cause hypersensitivity reactions in as few as 1 in 10,000 of the human population as a whole. The optimization test merits consideration as a standardized and efficiently predictive procedure.

Adjuvants, Immunologic↗
PubMed1995

[Chronic urticaria caused by penicillin. Results of monitoring cases of acute penicillin urticaria which developed into chronic urticaria].

Penicillin is known to cause allergic reactions with different clinical manifestations and possible immunologic mechanisms. The purpose of this study was to follow cases of established hypersensitivity to penicillin and its possible development into chronic urticaria. 35 patients with a clinical picture of acute urticaria and with or without angioedema were examined. Three kinds of tests to penicillin were performed: patch test, scarification test and PPL test. Hypersensitivity to penicillin was confirmed in 12 (34.27%) patients with positive PPL test. Seven (58.33%) out of these 12 developed the clinical picture of chronic urticaria. As food was assumed to be the hidden source of penicillin, eliminatory diet was included. In 4 (57.14%) patients there was a complete remission of the disease during the course of diet without milk and milk products (intradermal test to milk and specific IgE antibodies were negative). The gathered results show that acute urticaria caused by penicillin can get a chronic character. It is the consequence of prolonged penicillin's activity in some so called "hidden sources of penicillin".

Acute Disease↗
PubMed2001

Nonpigmenting solitary fixed drug eruption after skin testing and intra-articular injection of triamcinolone acetonide.

BACKGROUND: Although several medications have been reported to cause fixed drug eruption (FDE) reactions, triamcinolone acetonide has not been previously described as an offending agent. OBJECTIVE: To emphasize both an unprecedented causative agent and the extraordinary development of a FDE, we describe this response in a 42-year-old female patient. METHODS: Because her history included a questionable reaction to corticosteroid preparations, prick and intradermal testing with triamcinolone acetonide was done to determine whether she could safely receive a triamcinolone acetonide injection. RESULTS: Both skin test procedures and the intra-articular administration of triamcinolone acetonide caused FDEs on her right retroauricular area. CONCLUSIONS: Because any drug may induce a FDE by any administration route, physicians should be aware of this delayed skin reaction when skin testing drugs.

Adult↗
PubMed2000

[Alpha interferon-induced eczema in atopic patients infected by hepatitis C virus: 4 case reports].

OBJECTIVES: We report four cases of eczema induced by alpha interferon in atopic patients treated for chronic hepatitis C. CASE REPORTS: Eczema developed in 4 patients with certain (3 cases) or possible (1 case) atopy treated by subcutaneous injections of alpha interferon for hepatitis C virus infections. Delay to onset was 3 weeks to 6 months. Interferon was highly likely the causal agent: lesions started at site of interferon injection, followed the rhythm of interferon injections (three cases), disappeared at interferon withdrawal. In two patients, the lesions diffused to other sites. Both Introna and Roféron were used. Three patients also took ribavirine. The possible role of a contact factor (antiseptic.) was ruled out. Skin tests (patch tests, prick tests, intradermal reactions) were negative for interferon alpha and for a standard battery. DISCUSSION: The role of interferon in the induction of skin diseases or its influence on the course of certain dermatoses is well known. In atopic patients, interferon might induce eczema via an immunomodulator rather than an allergic mechanism since skin tests (performed in one patient) were negative. This observation is similar to that in psoriasis induced by interferon in predisposed subjects who develop skin lesions at injection sites which sometimes diffuse to distant localizations. The role of other factors (hepatitis C virus infection, ribavirine) remains unknown; they might participate in this mechanism by aggravating skin dryness.

Adrenal Cortex Hormones↗
PubMed1989

Wheal and flare responses to opioids in humans.

Certain opioids release histamine from cutaneous mast cells to produce local wheal and flare responses and adverse hemodynamic effects. In vivo responses to opioids suggest that cutaneous responses result from the interaction of opioids with opioid receptors on human mast cells. There are no data evaluating or comparing the opioids currently used in anesthesia. Volunteers were injected intradermally with different opioids as well as with naloxone and antihistamines to evaluate their effects on cutaneous mast cell reactivity and cutaneous vascular responses. Fentanyl and morphine produced concentration-dependent wheal and flare responses in the range of 5 X 10(-6) M to 1.5 X 10(-3) M. Volunteers were then tested intradermally with different opioids and histamine at a 5 X 10(-4) M concentration to determine their relative cutaneous effects. Morphine, meperidine, fentanyl, and sufentanil produced both wheal and flare responses that were significantly greater than those due to saline (P less than 0.05). Naloxone, alfentanil, and nalbuphine did not produce significant wheal or flare responses. Butorphenol was followed by a significant wheal but no flare. Naloxone attentuated cutaneous wheal and flare responses to fentanyl and the flare response to morphine. Intradermal antihistamines (diphenhydramine and cimetidine) produced significant wheal and flare responses. Electron micrographs of biopsies from fentanyl-induced wheals demonstrated normal mast cell architecture with no evidence of mast cell degranulation. Opioid effects on wheal and flare responses and mast cell degranulation appear independent of opioid analgesic potency. Opioids produce cutaneous vascular responses dependent on both histamine release from mast cells and direct effects on the vasculature.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗
PubMed1976

An evaluation of delayed hypersensitivity in guinea pigs to various trichophytin preparations.

Guinea pigs immunized with mycelium from Trichophyton mentagrophytes in Freund's complete adjuvant were tested intradermally with the following trichophytin preparations: TrI extracted by ethylene glycol, TrII extracted by phenol and TrII, a commercially obtained preparation fromSächsisches Serumverk KG. In our experience, TrI was found to be superior to the other preparations. It showed signifiicant delayed skin reactions in all sensitized animals and none in the controls. Lymphocyte stimulation test with this preparation (TrI) gave positive results.

Animals↗
PubMed1975

Skin irritancy and sensitivity to laundry detergents containing proteolytic enzymes. Part II.

The late type contact sensitizing effect of alkaline protease enzymes (PE) on the intact human skin has been investigated in the present study. The immune process of sensitisation was induced with "Tenzym prilled" (TP, Grindstedvoerket) and with "Maxatase" (M, Gist-Brocades) protease enzymes in the epicutaneous test (ET), using concentration series and various durations of application. The ETs were made on the intact (symptom-free) skin, as well as under conditions promoting the subcorneal penetration of PE. Challenge was carried out at 21 to 30 days following induction of 2092 subjects, and at 2 to 5 months on 1624 subjects. Despite the large number of subjects tested, contact sensitisation developed in none of the cases, although the inducing exposure took place under conditions promoting the immune process of sensitisation. In 60 individuals suffereing from occupational dermatitis on regular contact with PE and having no symptoms of early type inhalative allergy (mucous membrane changes, bronchial asthma-like symptoms) were challenged also by the intradermal test. No reaction was noted in any of them at 10 and 30 minutes, as well as at 24 and 48 hours following the test. Next the influence of PE is analysed in the induction or increased severity of the irritation caused by bioactive laundry detergents. The studies involved the use of serial dilutions of "Biopon" (Bn) laundry detergent containing TP or M, or not containing PE, respectively, by means of the ET. A total of 740 series (5220 tests) of the three variants were applied in dilution series to intact skin surface, as well as to pathologically and arteficially lsioned skin areas. The Bn variants containing and not containing PE increased the number of irratative reactions in essentially the same degree. This suggests that the irritative effect is not due to the presence of PE, but to the laundry-active detergents (WAS) of Bn in the first place, and to a lesser extent to its other ingredients.

Chemical Industry↗
PubMed1994

Measles, mumps, rubella vaccine administration in egg-sensitive children: systemic reactions during vaccine desensitization.

In egg-sensitive children, measles-mumps-rubella (MMR) vaccination may cause acute allergic reactions; therefore, current recommendations are to perform skin testing with the commercial vaccine before administration to egg-allergic children. In children with positive skin tests, desensitization with the measles-mumps-rubella vaccine should be done in order to administer a full dose of the vaccine. Twelve egg-allergic children, aged 12 months to 5 years of age, were referred to our pediatric allergy clinic for MMR administration over a 20-month period. Three children had positive skin prick or intradermal tests to the MMR vaccine. Two of these three patients experienced systemic hypersensitivity reactions while undergoing desensitization to the MMR. All reactions occurred with injections of the undiluted vaccine. Based upon this experience, we recommend that egg-allergic children should continue to have cutaneous tests done to the MMR vaccine and careful observation during desensitization in those children with positive skin tests.

Child, Preschool↗
PubMed1994

Epidemiological study of sporotrichosis and histoplasmosis in captive Latin American wild mammals, São Paulo, Brazil.

Sporotrichosis and histoplasmosis are deep mycosis with a high incidence in human beings in Brazil. In domestic animals histoplasmosis has been described only in dogs, but the occurrence of sporotrichosis among domestic animals in Brazil has been described in dogs, cats, mules and asses. There is also a case of this disease reported in a chimpanzee (Pan troglodites). The purpose of this research was to perform an epidomiological study of these mycoses using delayed hypersensitivity tests (histoplasmin and sporotrichin) in Latin American wild mammals. This research was assayed using 96 healthy animals at Parque Zoológico de São Paulo, Brazil: Primates: 33 Cebus apella--weeping-capuchin and 16 Callithrix jacchus--marmoset; Procyonidae: 37 Nasua nasua--coatimundi and 10 Felidae (Panthera onca--jaguar; Felis pardalis--ocelot Felis wiedii--margay; Felis tigrina--wild cat). For intradermic tests, the following antigens were used: Sporothrix schenkii cell suspension (sporotrichin, histoplasmin-filtrate), Histoplasma capsulatum cell suspension (histoplasmin), and Histoplasma capsulatum (polysaccharide). The positivity to histoplasmin was 44.79% (Cebidae 15.15%; Callithricidae 6.25%; Procyonidae 86.49% and Felidae 50.00%, respectively). With respect to sporotrichin, 30.21% (Cebidae 6.06%, Callithricidae 0.0%; Procyonidae 64.86% and Felidae 30.00% respectively). The pattern of infection is similar to that shown by human beings and this may suggest that these animals could be involved in the epidemiologic chain of sporotrichosis and histoplasmosis, the second most prevalent human deep mycoses in Brazil. It is important to point out the absence of similar studies in Latin American wild animals.

Animals↗
PubMed1999

Evaluation of an ELISA-PPD for the diagnosis of bovine tuberculosis in field trials in Brazil.

Bovine tuberculosis is a major health problem in Brazil. The intradermal tuberculin test is the standard test for its detection, but it can lack both sensitivity and specificity. The purpose of this study was to evaluate a bovine enzyme-linked immunosorbent assay- (ELISA - PPD) under field conditions in Brazil. A total of 1632 animals from 13 dairy farms were tested with the intradermal tuberculin test (ITT). Two hundred and seven cows gave a positive reaction, which represents 12.7 per cent of the cattle studied. The sensitivity and specificity rates to ITT were 87.7 per cent and 95.2 per cent, respectively. From the 1632 animals 15 per cent of each herd (220 in total) were selected to be tested by the ELISA. Differences between mean optical density (OD) of the control group, ITT -positive and ITT -negative groups were all significant (P<0.01). The sensitivity rates to ELISA - PPD were 86.7 per cent, while specificity was 90.6 per cent. The use of ELISA - PPD is suggested for situations where the investigation of the whole herd is more important than the individual testing of each cow. In addition, the ELISA - PPD can also be helpful when a collective diagnosis is desired to elucidate clinical suspicions of disease, or in the first steps of a control program, for identification of foci.

Animals↗
PubMedDate not supplied

Anaphylactic histamine release from human gastric and duodenal mast cells.

Mast cells from human gastric and duodenal walls were isolated using a collagenase dispersion technique. The reactivity of both mast cell populations with anti-human IgE antibodies and specific antigens was tested in an in vitro model of anaphylactic reaction. Mast cell populations were sensitive to the action of anti-IgE, and histamine release was 17.4-27.4% (duodenal) and 19.3-29.3% (gastric mast cells). No significant differences between both mast cell populations of the same individuals were observed. Gastric and duodenal mast cells obtained from patients with peptic ulcer and positive intradermal test with allergens (grass pollen, tomato, cocoa) released histamine after challenge with adequate antigens. The reaction was dose-dependent. Gastric mast cells were more reactive than duodenal cells to challenge with antigen.

Anaphylaxis↗
PubMed1995

The effect of cetirizine on sulfidoleukotriene production by blood leukocytes in children with allergic rhinitis.

Twelve children with allergic rhinitis due to monosensitivity to Dermatophagoides pteronyssinus (Dp) took part in a placebo-controlled, double-blind, crossover study to evaluate the effect of cetirizine, a second-generation, nonsedating H1-blocker-type antihistamine, on sulfidoleukotriene releasability by blood leukocytes and to determine its correlation with clinical findings and nasal challenge scores. Sulfidoleukotriene release by blood leukocytes was determined by the cellular allergen stimulation test (CAST), which measures leukotriene (LT)C4, LTD4, and LTE4, all in one assay. Compared to placebo, cetirizine significantly (P < 0.05) decreased daily symptom scores of nasal discharge, nasal itching, and sneezing, as well as the number of sneezings after nasal challenge with the antigen, without alleviating nasal obstruction (P > 0.05). It also suppressed both early (P < 0.05) and late skin reactions to intradermal tests. Although cetirizine did not influence in vitro sulfidoleukotriene production by blood leukocytes with buffer or anti-IgE (P > 0.05), it substantially reduced the release of these mediators upon challenge with Dp antigen. Furthermore, there was a high correlation between the number of sneezes after challenge and the amount of sulfidoleukotriene released in nine patients (r = 0.78; P < 0.01). It is concluded that the amount of sulfidoleukotrienes produced by blood leukocytes in vitro may reflect the nasal hyperreactivity of the patient, and that cetirizine, which is highly effective in the treatment of allergic rhinitis, owes part of its effect to inhibition of sulfidoleukotriene releasability by blood leukocytes in children.

Adolescent↗