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PubMed1982

[Timing of sensitization and appearance of skin allergic reaction in infectious bovine rhinotracheitis--infectious pustular vulvovaginitis].

Allergic and serologic investigations were carried out on infectious bovine rhinotracheitis--infectious pustular vulvovaginitis with cattle artificially and spontaneously affected with the causative agent of the disease as well as with cattle that were treated with a live attenuated vaccine. It was found that in the case of experimental infection the allergization of the body and the positive skin allergic reaction set in as early as the 7th day of the disease while in the case of vaccination they developed two weeks later. In the course of a natural development of the disease (spontaneous abortions) allergization likewise set in more rapidly than in animals that were vaccinated. In all three groups of cattle the results of the serologic investigation corresponded in general terms to those obtained by the skin allergic reaction. Discussed are the factors that substantiate the differences in the time of allergization of the body and the development of a positive skin reaction.

Abortion, Veterinary↗
PubMed2000

Effect of Vitex rotundifolia on immediate-type allergic reaction.

We investigated the effect of aqueous extract of Vitex rotundifolia (L.) (Verbenaceae) fruits (VRFE) on the immediate-type allergic reactions in vivo and in vitro. VRFE (10(-4)-1.0 g/kg) dose-dependently inhibited systemic allergic reaction induced by compound 48/80. When VRFE was employed in a systemic allergic reaction test, the plasma histamine levels were reduced in a dose-dependent manner. VRFE (5x10(-1) and 1.0 g/kg) inhibited passive cutaneous anaphylaxis activated by anti-dinitrophenyl (DNP) IgE. VRFE (10(-3)-1.0 mg/ml) also dose-dependently inhibited the histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80 or anti-DNP IgE. Moreover, VRFE (10(-3) mg/ml) had a significant inhibitory effect on anti-DNP IgE-induced tumor necrosis factor-alpha production from RPMC. These results suggest that VRFE may be beneficial in the regulation of immediate-type allergic reaction.

Animals↗
PubMed1989

Immunopharmacological studies on TBX, a new antiallergic drug (4). Effects on type II to IV allergic reactions and immunological functions in animal models.

The effects of 9-methyl-3-(1H-tetrazol-5-yl)-4H-pyrido[1,2-a]pyrimidin-4-one potassium salt (TBX) on type II to IV allergic reactions and immunological functions were investigated in animal models. Types II to IV allergic reactions in rodents were unaffected in vivo by TBX, even at higher doses than those capable of completely inhibiting the type I allergic reaction. However, both complement-mediated hemolysis via the classical pathway and hypotonic shock-induced hemolysis were slightly inhibited in vitro only by a high concentration of the drug (10(-4) g/ml). In the mouse system, TBX had no ability to suppress anti-hapten IgE antibody formation as well as hemagglutinin formation and to inhibit the proliferation of spleen cells induced by non-specific T and B cell mitogens. The results obtained indicate that TBX is an antiallergic drug essentially devoid of inhibitory actions on types II to IV allergic reactions and immunological functions, thus indicating that it is a specific inhibitor of type I allergic reactions.

Animals↗
PubMed2001

Allergic reactions to measles-mumps-rubella vaccination.

OBJECTIVE: Immunization of egg-allergic children against measles, mumps, and rubella (MMR) is often deferred or even denied, although the safety of this vaccination has been clearly shown. Moreover, the majority of severe allergic reactions have occurred in egg-tolerant vaccinees. Other allergenic vaccine components have been sought, and gelatin has been suggested as one cause of allergic adverse events. The aim of this study was to further characterize the actual allergenic vaccine components. METHODS: Serum samples from 36 recipients of MMR vaccine with anaphylaxis, urticaria with or without angioedema, asthmatic symptoms, or Henoch-Schönlein purpura were analyzed by CAP System radioallergosorbent test (RAST) and immunospot methods to detect the allergenic vaccine component. To evaluate the correspondence between the findings in the CAP System RAST or the immunospot and clinical symptoms, histories of allergies and present hypersensitivity symptoms were assessed. RESULTS: Of the 36 participants, 10 were demonstrated to be allergic to gelatin. Seven of them had persistent allergic symptoms, possibly attributable to foods containing gelatin or cross-reactive allergens. The results of the immunospot suggested concomitant allergy to gelatin and egg, chicken, and feathers, as well as cow's milk, or they reflected allergen cross-reactivity. CONCLUSIONS: Although severe allergic adverse events attributable to MMR vaccination are extremely rare, all serious allergic reactions should be further assessed to detect the likely causative vaccine component, including gelatin. The current recommendation for immunization of egg-allergic persons according to standard MMR vaccination schedules is reinforced. measles, mumps, and rubella vaccine, immunization, adverse effects, allergic reactions, gelatin allergy, CAP System, radioallergosorbent test, immunospot, immunoglobulin E.

Adolescent↗
PubMed1985

[Cellular and humoral bases of allergic reactions].

The inflammatory symptoms of allergic reactions are caused by complex interactions of mediator substances. They are either split from humoral precursor molecules by proteolytic enzymes or released from various cells. Mediators may cause the allergic symptoms directly or act on other mediators and mediator systems. New activities may be generated by mediator cooperation. Mediator systems can be activated by immunological antigen-specific and nonimmunological nonspecific mechanisms. In a given reaction both types of induction mechanisms are involved. It is not possible to relate a certain allergic symptom to a certain mediator or a set of mediators.

Anaphylaxis↗
PubMed2005

Does severity of low-dose, double-blind, placebo-controlled food challenges reflect severity of allergic reactions to peanut in the community?

BACKGROUND: The severity of allergic reactions to food appears to be affected by many interacting factors. It is uncertain whether challenge-based reactions reflect the severity of past reactions or can predict future risk. OBJECTIVE: To explore the relationship of a subject's clinical history of past reactions to the severity of reaction elicited by a low-dose, double-blind, placebo-controlled food challenge (DBPCFC) with peanut. METHOD: Cross-sectional questionnaire assessment of community-based allergic reactions and low-dose DBPCFC in self-selected peanut-allergic subjects. Reaction severity was assessed using a novel scoring system, taking account of the dose of allergen ingested. RESULTS: Forty subjects (15 males, 23 children, 23 asthmatics by history) were studied. Only the most recent community reaction predicted the severity of reaction in the DBPCFC, but even this association was weak (r=0.37, P=0.03). Peanut-specific IgE (PsIgE) and skin prick test (SPT) weal size were not associated with community score but PsIgE level correlated well with the challenge score (r=0.6, P=0.001). Asthma did not affect the eliciting dose or challenge score directly but the association of PsIgE and challenge score was stronger in those without asthma (r=0.72, P=0.001) than in those with asthma (r=0.48, P=0.02). CONCLUSIONS: The scoring system developed appears to improve the sensitivity of assessment of reactions induced by DBPCFC. This is the first prospective study showing an association between PsIgE levels and clinical reactivity in DBPCFC, an effect that is more pronounced in non-asthmatics. This finding has important implications for the clinical care of subjects with food allergy. There is a poor correlation between the severity of reported reactions in the community and the severity of reaction elicited during low-dose DBPCFC with peanut.

Administration, Oral↗
PubMedDate not supplied

Understanding allergic reactions to local anesthetics.

OBJECTIVE: To review the pharmacology and mechanisms by which local anesthetics cause allergic reactions. Recommendations concerning appropriate use of local anesthetics and alternative therapies in patients with documented local anesthetic allergies are given. DATA SOURCE: A MEDLINE search of English-language literature identified pertinent clinical studies, case reports, and reviews. The periods of review were Med1, 1990-present, and Med2, 1985-1989, using the MeSH terms drug hypersensitivity and anesthetics. References from the selected studies, case reports, and reviews were reviewed. STUDY SELECTION: Controlled and uncontrolled prospective studies and case reports pertaining to local anaesthetic allergies were reviewed. The selection focused on information pertaining to the etiology and diagnosis of allergic reactions to local anesthetics and alternative therapies for patients with local anesthetic allergies. DATA SYNTHESIS: Local anesthetics are classified as either ester or amide compounds. Esters are associated with a higher incidence of allergic reactions, due to a p-aminobenzoic acid (PABA) metabolite. Amide agents do not undergo such metabolism. However, preservative compounds (methylparaben) used in the preparation of amide-type agents are metabolized to PABA. Patients who are allergic to ester local anesthetics should be treated with a preservative-free amide local anesthetic. If the patient is not allergic to ester local anesthetics, these agents may be used in amide-sensitive patients. In the rare instance that hypersensitivity to both ester and amide local anesthetics occurs, or if skin testing cannot be performed, than alternative therapies including diphenhydramine, opioids, general analgesia, or hypnosis can be used. CONCLUSIONS: A true immunologic reaction to a local anesthetic is rare. Intradermal skin testing of local anesthetic compounds, methylparaben, and metabisulfite should be performed in patients when a thorough history does not rule out a possible allergic reaction to local anesthetics and future local anesthesia is necessary. Skin testing enables the clinician to identify autonomic responses to minor surgical procedures and toxic reactions to anesthetics so that patients are not incorrectly labeled as "caine" allergic. Diphenhydramine can be used as an alternative to ester and amide local anesthetics in minor procedures of short duration.

Anesthesia, Local↗
PubMed2002

The distribution of individual threshold doses eliciting allergic reactions in a population with peanut allergy.

BACKGROUND: Hidden peanut in consumer products can endanger patients with peanut allergy. Individual threshold doses for eliciting allergic reactions need to be elucidated to assess the risks for development of allergic reactions after accidental ingestion of peanut in a population with peanut allergy. OBJECTIVE: We sought to determine the distribution of individual threshold doses in a population with peanut allergy and to correlate these thresholds to the severity of peanut-induced symptoms. METHODS: Twenty-six adult patients with a convincing history of peanut-related symptoms, a specific IgE level of 0.7 kU/L or greater, or a positive skin prick test response of 2+ or greater to peanut were included. These patients underwent double-blind, placebo-controlled food challenges with increasing doses of peanut. A threshold dose could be established when objective or repetitive subjective reactions occurred after active doses. RESULTS: All patients had subjective oral symptoms (n = 26), prior subjective gastrointestinal symptoms (n = 14), or objective symptoms (n = 5). Reactions started within 30 minutes after ingestion of peanut, but in 2 patients additional symptoms were delayed by 1 to 2 hours. Threshold doses for allergic reactions ranged from a dose as low as 100 microg up to 1 g of peanut protein. Fifty percent of the study population (95% CI, 30%-70%) already had an allergic reaction after ingestion of 3 mg of peanut protein. Patients with severe symptoms had lower threshold doses compared with those of patients with mild symptoms (P =.027). CONCLUSIONS: A substantial part of a population with peanut allergy will react to very low amounts of peanut, requiring accurate declaration of peanut content in consumer products. This is even more important because patients with severe reactions react to lower doses than patients with mild symptoms.

Adolescent↗
PubMed2005

Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing?

BACKGROUND: The aim of this retrospective survey of possible allergic reactions during anaesthesia was to investigate whether the cause suspected by anaesthetists involved corresponded with the cause found on subsequent investigation in the Danish Anaesthesia Allergy Centre (DAAC). METHODS: Case notes and anaesthetic charts from 111 reactions in 107 patients investigated in the DAAC were scrutinized for either suspicions of or warnings against specific substances stated to be the cause of the supposed allergic reaction. RESULTS: In 67 cases, one or more substances were suspected. In 49 of these (73%) the suspected cause did not match the results of subsequent investigation, either a different substance being the cause or no cause being found. Only five cases (7%) showed a complete match between suspected cause and investigation result. In the remaining 13 cases (19%) there was a partial match, the right substance being suspected, but investigations showed an additional allergen or several substances, including the right substance being suspected. CONCLUSIONS: An informed guess is not a reliable way of determining the cause of a supposed allergic reaction during anaesthesia and may put a significant number of patients at unnecessary risk. Some patients may be labelled with a wrong allergy, leading to unnecessary warnings against harmless substances, and some patients may be put at risk of subsequent re-exposure to the real allergen. Patients with suspected allergic reactions during anaesthesia should be referred for investigation in specialist centres whenever possible.

Allergens↗
PubMed2002

[Aseptic meningitis as a complication caused by an allergic reaction after microvascular decompression: two case reports].

We report here two cases of patients complicated with aseptic meningitis after microvascular decompression (MVD). The first case, a 56-year-old female complained of headache with high fever 18 days after the MVD for right trigeminal neuralgia. The amount of cells in cerebrospinal fluid (CSF) had so much increased that bacterial meningitis was suspected. However, there was no improvement after antibiotics therapy, so immune globulin was injected and the meningitis gradually improved. Eosinophilia remained in peripheral blood and the symptoms improved rapidly after the steroid therapy. Because of this, we suspected that meningitis was caused by an abnormal allergic reaction. The second case, a 30-year-old male complained of headache with mild fever 15 days after MVD for left hemifacial spasm. The amount of cells in CSF increased, so bacterial meningitis was suspected. Eosinophilia remained in peripheral blood and the steroid therapy proved very effective for the meningitis. Because of this, we suspected that meningitis was caused by an abnormal allergic reaction. We suspected that the two patients suffered from aseptic meningitis caused by allergic reaction, and the antigen for this abnormal allergic reaction was the foreign materials used for MVD. The materials were Dacron for prostesis, Goatex or Lyodula for dural plasty, fibrin glue for preventing CSF leakage. We ascertained that the abnormal allergic reaction was caused by human fibrinogen in the second case. It is important to be aware of such allergic reaction to fibrin glue in the post-operative stage after MVD.

Adult↗
PubMed1995

Dysfunction of muscarinic M2 receptors after the early allergic reaction: possible contribution to bronchial hyperresponsiveness in allergic guinea-pigs.

1. Using a guinea-pig model of allergic asthma, in which the animals display early (0-5 h) and late phase (8-23 h after antigen challenge) bronchoconstrictor reactions, the function of prejunctional inhibitory M2 and postjunctional M3 receptors in isolated tracheal preparations have been investigated. In addition, cardiac M2 receptor function in vitro and bronchial responsiveness to histamine in vivo were evaluated. 2. Sensitivity to inhaled histamine was increased 3.1 fold and 1.6 fold after the early and late allergic reactions (i.e. at 5 h and 23 h after a single ovalbumin challenge), respectively. At 23 h after the last of four allergen challenges, executed on four consecutive days, bronchial hyperresponsiveness to histamine was diminished to 1.3 fold. 3. After the early response, there was no change in cardiac muscarinic M2 receptor function, since in left atria pD2 (-log EC50) and Emax values of pilocarpine and pKB values of AQ-RA 741, a selective M2 receptor antagonist, were not significantly different from controls (unchallenged sensitized animals), and this also applied to methacholine pD2 values for muscarinic M3 receptors in tracheal smooth muscle. 4. Prejunctional inhibitory muscarinic M2 autoreceptors in airway smooth muscle were markedly dysfunctional after the early allergic response, since potentiation of electrically evoked twitch contractions of tracheal preparations by low concentrations of the M2-selective muscarinic receptor antagonists, gallamine, methoctramine, AQ-RA 741 and AF-DX 116, which is the result of M2 receptor blockade, was clearly and significantly diminished compared to controls. However, after the late response, both in single and repeatedly challenged animals, twitch potentiation was not significantly different from and similar to controls, indicating restoration of M2 receptor function during the late allergic reaction.5. It is concluded that dysfunction of muscarinic M2 autoreceptors in the airways of sensitized and challenged guinea-pigs is already present after the early allergic reaction, and that it has recovered after the late response. Since histamine-induced bronchoconstriction involves vagal pathways, the present results suggest that bronchial hyperresponsiveness to histamine is partly due to M2 auto receptor dysfunction, leading to increased release of acetylcholine.

Administration, Inhalation↗
PubMed1975

[Allergic reactions following dextrane infusions (author's transl)].

14 allergic reactions to dextran 60 and dextran 75 are reported. In 8 patients the peripheral pulse became impalpable; Medical history and clinical examination did not reveal any predisposition. Histamine liberation is to be discussed. Antihistamines did not protect against allergic reactions of colloid plasma expanders. All the patients were treated with prednisolone and fluids. After rapid infusion of Ringer-lactate and plasma protein solution to an amount of 2000-2775 ml adequate circulation was restored.

Adult↗
PubMedDate not supplied

Bronchial provocation with cat allergen: long-term outcome of the late allergic reaction and the individual IgE CRIE pattern.

In bronchial provocation tests with allergen, about 50% of the patients experienced a late allergic reaction (LAR), which has been associated with a specific IgE pattern as determined by crossed radioimmunoelectrophoresis (CRIE). Long-term outcome of this LAR is still unknown. Six patients allergic to cat, with documented LAR and specific IgE CRIE patterns were rechallenged in the same conditions after a mean interval of 2.5 years. Forced expiratory volume in one second (FEV1) and resistance results of the bronchial provocation tests (BPT) were compared, as well as specific IgE level and IgE CRIE patterns. All six patients were still suffering from asthma when exposed to a cat, although they were not being treated for asthma. Three patients (50%) had lost their LAR without specific treatment. They were older, with a longer history of asthma, but presented a very similar early allergic reaction to similar allergen doses. The other 3 were more reactive to the allergen but presented similar LAR after a slightly worse early allergic reaction (EAR). Specific IgE levels had decreased and the IgE CRIE pattern showed a diminished intensity of staining in the three patients who had lost their LAR, as opposed to the other three. These data suggest that asthmatic patients can lose their LAR over time without treatment. The occurrence of a LAR seems to be associated with a specific IgE CRIE pattern and IgE level. Further analysis of the individual antigen fractions might help to understand the mechanism of allergic reactions.

Adult↗
PubMed1981

[Granulomatous allergic reaction of the delayed type to surfen].

In the last five years, a distinct increase of allergic reactions to surfen, a constituent of various insulin preparations, was observed. The allergic reactions were tuberculoid granulomas of the delayed type (type IV of Gell and Coombs). Intracutaneous tests with surfen or surfen-containing insulin preparations confirmed the diagnosis. Dermal infiltrates and mild erythema developed 24 to 96 hours after the injection of insulin. In some patients a post-inflammatory pigmentation was noted. Histological examination of the lesions and the intracutaneous test sites revealed a granulomatous inflammation without signs of foreign body reaction. At present, the cause of the increased incidence of allergic reactions to surfen remains hypothetical.

Chemical Phenomena↗
PubMed1997

Systemic allergic reaction following ingestion of undeclared peanut flour in a peanut-sensitive woman.

BACKGROUND: Although peanuts and peanut butter are well recognized as food allergens, few reports describe allergic reactions associated with eating peanut flour. OBJECTIVE: To describe an allergic reaction that occurred in a peanut-sensitive woman who ate undeclared peanut flour that was part of a flavor ingredient contained in a dry soup mixture, and to estimate the amount of peanut protein the patient ingested. METHODS: The patient was interviewed, medical records from her emergency room visit were reviewed, and the manufacturer of the soup mix was investigated to ascertain the proportion of the soup mix constituted by the undeclared peanut flour. RESULTS: Minutes after ingesting the soup, a 33-year-old woman experienced a systemic allergic reaction. She was treated successfully in the emergency room with intravenous fluids, corticosteroids, and diphenhydramine. Investigation of the soup manufacturer revealed that undeclared peanut flour was a component of a flavoring ingredient in the soup. Based on the concentration of peanut flour in the flavoring, we estimated the patient ate approximately 45 mg of peanut protein. CONCLUSIONS: Inadvertent ingestion of peanut flour by peanut-sensitive individuals may lead to systemic allergic reactions.

Adult↗
PubMed2006

[Allergic reaction to components of bone cement after total knee arthroplasty].

There are many reports about allergic reactions in association with total hip or knee arthroplasty. While most studies focus on allergic reactions to metallic components, only few reports exist about reactions to bone cement or its ingredients. We report about a patient who developed eczema at the knee and the lower leg one year after cemented TKR. Patch testing showed as potential causes contact allergic reactions to nickel and benzoylperoxide, an ingredient of the here used bone cement. The local and temporal association between onset of eczema and knee arthroplasty suggests a causal link. Benzoylperoxide as potential contact allergen in bone cement is so far almost neglected. The development of extended testing procedures and data collection should provide further information and better care of these patients. The development of special bone cements for patients with allergic diathesis is requested.

Arthroplasty, Replacement, Knee↗
PubMed1997

Inhibitory mechanisms of beta-adrenoceptor agonists for immunoglobulin E-mediated experimental allergic reactions in rats.

Inhibitory mechanisms of isoproterenol and clenbuterol for immunoglobulin E (IgE)-mediated experimental allergic reactions in rats were studied. IgE-mediated passive cutaneous anaphylaxis, histamine-induced cutaneous reaction and serotonin-induced cutaneous reaction were evoked at the same time in the same rats. Isoproterenol administered intravenously immediately before challenge inhibited all these reactions significantly. Clenbuterol administered intravenously 0-3 h before challenge also significantly inhibited the three cutaneous reactions. The inhibition was maximum when the drug was given 1 h before challenge. Passive cutaneous anaphylaxis was always inhibited more potently than histamine-induced cutaneous reaction and serotonin-induced cutaneous reaction by these beta-adrenoceptor agonists. Passive peritoneal anaphylaxis was caused by injecting an antigen intravenously. Isoproterenol administered intravenously immediately before challenge inhibited the reaction significantly. Clenbuterol administered intravenously 0-3 h before challenge also significantly inhibited passive peritoneal anaphylaxis, maximally so when given 1 h before challenge. In vitro IgE-dependent histamine release from sensitized peritoneal mast cells or mesenteric mast cells was not affected by isoproterenol and clenbuterol. Mouse monoclonal IgE, a foreign protein, administered intravenously decreased rapidly in the circulation. About 50% of the mouse IgE given disappeared in 20 min. The decrease of mouse IgE was partly but significantly inhibited by the beta-adrenoceptor agonists, and the inhibition was abolished by simultaneous treatment with propranolol. These results indicate that direct inhibition of mast cell activation does not contribute to the potent inhibition of in vivo allergic reactions in rats by beta-adrenoceptor agonists, and that inhibition of the allergic cutaneous reaction is partially explained by the inhibition of vascular permeability increases caused by mast cell mediators. Penetration of intravenously administered antigen from blood vessels to peripheral tissues to cause mast cell activation might be inhibited by beta-adrenoceptor agonists, and this could play some role in inhibiting intravenous antigen-induced allergic reactions in rats. Clenbuterol exhibited its maximum action with some latency in vivo, suggesting that some time-requiring process may be involved in the manifestation of its action.

Adrenergic beta-Agonists↗
PubMed1991

Systemic allergic reactions to corticosteroids.

Allergic anaphylactic (type I) reactions to corticosteroid medications are uncommon; however, a number of well-documented cases have been reported. We present a review of the literature, and report on two patients who suffered anaphylaxis after injections of corticosteroids. The first patient, a registered nurse, was finally found to be sensitive to all corticosteroid preparations containing carboxymethylcellulose, as well as the pure carboxymethylcellulose. The second patient had positive skin tests to hydrocortisone, hydrocortisone sodium succinate, methylprednisolone sodium succinate, and suxamethonium. Both patients were tested on two occasions; four normal subjects were tested in parallel, and did not elicit any positive skin reaction. In patients with systemic severe reactions to injectable corticosteroids, we recommend careful and comprehensive skin testing with most available corticosteroids, as well as the components of the injectables.

Adult↗