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PubMed2004

Immediate hypersensitivity to chlorhexidine: literature review.

Chlorhexidine, an antiseptic belonging to family of biguanides, is used extensively in the medical and surgical environment. Late onset hypersensitivity and eczema occur regularly and are well documented events. Conversely, immediate hypersensitivity, sometimes taking the form of acute urticaria that can result in anaphylactic shock, is rarer. These manifestations can occur during contact of the skin or mucosa with chlorhexidine. Out of the fifty case reports of chlorhexidine-related anaphylaxis published worldwide over the past ten years, fifteen occurred during surgery. Signs generally appear from 15 to 45 minutes after the start of anesthesia. If there is any suspicion of immediate allergy to chlorhexidine, prick-tests or even intradermal reaction (IDR) techniques are highly recommended. In the event of confirmed allergy to chlorhexidine, strict eviction is required, bearing in mind that over a hundred medicinal products currently on the French market contain chlorhexidine.

Anaphylaxis↗
PubMed1990

[A case of asthma exacerbated by sulfite contained in betamethasone].

Adverse reactions to preservatives contained in food and medications have been recognized with increasing frequency. We have recently seen an asthmatic patient in whom wheezing and dyspnea increased after injection of betamethasone. The patient was a 26-year-old woman who had had bronchial asthma since 1980. She was treated at another hospital for moderate wheezing and betamethasone injections were given in May 1988. After this treatment her condition deteriorated acutely and she was transferred to our hospital. To confirm the possible relationship between betamethasone (sulfite) and asthmatic attack, provocation challenge tests were conducted. Intradermal skin test revealed an immediate positive reaction to sodium bisulfite at a concentration of 100 mg/L. Challenge test with increasing amounts of sodium bisulfite showed a 52% decrease in FEV1, 50 min after inhalation of 5 mg/ml solution. In addition, another inhalation challenge was conducted by use of an Astograph. Rrs immediately increased during inhalation of 10 mg/ml solution. These results suggested that sulfite contained in betamethasone preparation provoked exaggerated bronchospasm in this patient.

Adult↗
PubMed1989

The study of house dust mites in Taiwan.

By using a radioallergosorbent test (RAST) and intradermal skin testing, our previous studies strongly suggested that house dust mites are the most important allergen in Taiwan, especially in asthmatic children. This study was conducted to determine the distribution of house dust mites in houses of mite-sensitive asthmatic children and normals, the species of mites in various house dust samples, the seasonal prevalence, and the relation between the content of mite allergen and the mite density in dusts. Serial samples were collected every month between February 1986 and January 1987 from 61 houses of mite-allergic patients and nine normals. About 1 m2 surface area each of (A) family couch, (B) TV room floor carpet, (C) mattress, and (D) bed room floor carpet was vacuumed for one minute. The flotation method was used to collect mites in dusts and mites were counted under an inverted phase contrast microscope. Identification of house dust mite species was also performed. The RAST inhibition method was used for assay of mite allergen in dust extracts. The results showed the following six points. (1) Dermatophagoides pteronyssinus (DP) was the dominant species found in house dust in the Taipei area (78.8%). (2) The mean number of mites was greater in August through November and lowest in July. (3) The content of mite allergen did not correlate with the number of mites in dust sample. (4) The average number of mites in patients' houses was not different from that in normals' houses.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMedDate not supplied

[Skin test with aeroallergens untested in Mexico].

This study was carried out to prove that some molds even not studied in Mexico can be able to incit a positive skin test. We tested 43 adults (15-45 years old), 34 of them suffering respiratory allergy verified by roentgenography and laboratory tests including traditional intradermic allergic test. 9 subjects served as control group. We used manual scarification to Ustilago maydis, Rhodotorula rubra, Puccinia graminis, Cunhigamella sp and Zyncephalastrum sp. Our patients showed a positive skin test in 26, 12, 12, 9 and 6% respectively. This Fisher exact test do not detects significative differences. We conclude this molds can be able to incit an immune reaction IgE mediated and the must be tested in allergic patients from farmer communities.

Adolescent↗
PubMed2000

Positive reactions to common allergens in 42 atopic dogs in Japan.

Clinically important allergens for the diagnosis and treatment of atopic dermatitis vary geographically. In order to identify the most prevalent allergens in atopic dogs in Japan, 42 dogs with a clinical diagnosis of atopy were tested using both in vivo (intradermal skin test (IDST)) and in vitro (antigen-specific IgE assay) allergy tests. Allergens used for IDST included 26 allergen extracts from eight allergen groups: trees, weeds, grasses, house dust mites (HDM), molds, foods, epithelia, and arthropods. Immunodot assay was used to measure antigen-specific IgE against 24 allergens from these eight groups and against fish such as cod and sole. In the 42 dogs, the most common positive allergen reaction was to HDM on both IDST (29/42 dogs or 69%) and in vitro testing (23/42 or 54.8%). The second most frequent positive allergen reaction was to Japanese cedar pollen (21/42 or 50.0% for IDST and 7/42 or 16.7% for in vitro testing). In both tests, less than 20% of dogs had positive reactions to molds or foods. Positive reactions to cat epithelia were frequently found on IDST, but rarely found on in vitro testing. Agreement between the two tests was found in 26 instances: HDM (21 dogs), Japanese cedar pollen (five dogs) and wheat (one dog). In this study, the two most common allergens involved in atopic dermatitis in dogs in Japan were HDM and Japanese cedar pollen.

Allergens↗
PubMed1976

Delayed hypersensitivity to fungal antigens in mice. I. Use of the intradermal skin and footpad swelling tests as assays of active and passive sensitization.

Mice were sensitized to Coccidioides immitis and Candida albicans antigens and tested for sensitivity by the intradermal and footpad swelling methods. In mice actively sensitized with killed antigen, antigen-specific intradermal and footpad induration responses occurred 24 and 48 hr after sensitization. Antigen-specific intradermal and footpad responses were transferred to normal mice with spleen cells from immune animals. Such responses were also transferred with normal spleen cells that had been incubated in vitro with immune RNA preparations. Histologic studies of intradermal reactions showed a mixed response of neutrophilic and mononuclear leukocytes, with slight vascular involvement compatible with delayed hypersensitivity. No intradermal or footpad responses were observed 4, 24, or 48 hr after injection in recipients of serum from actively sensitized mice. Histologic examination of skin sites in these mice revealed only a polymorphonuclear response. It is concluded that these intradermal and footpad responses are the result of delayed hypersensitivity and can be used as assays for this type of immunity in mice.

Animals↗
PubMed1985

[Role of atypical mycobacteria in the occurrence of nonspecific tuberculin reactions in cattle].

Bacteriologic investigations were carried out with a total of 295 cattle of the Holstein-Zebu breed that responded positively to tuberculin. Mycobacterium bovis was isolated from 66 animals, and 12 species of atypical mycobacteria were isolated from 94 animals. Parallel studies were comparatively made of the intradermal reaction test and the bacterial findings. Three groups of calves were infected with various atypical mycobacteria, and their response was followed up with the use of the avian and the bovine type of tuberculin on the 100 th day of infection. It was found that the unspecific tuberculin response of cattle in Cuba were not uncommon, and the best proportion of such reactions were shown to be due to the involvement of atypical mycobacteria. The investigated cattle with a positive response to bovine tuberculin at a single intradermal test were harbouring M. bovis in 66 cases (22.3 per cent), atypical mycobacteria in 94 cases (32.1 per cent), and Actinomyces bovis in 7 cases (2.3 per cent). In 128 of the cases (43.3 per cent) both the morphologic and the bacteriologic findings were negative. The cases with a stronger response at the single intradermal tuberculin test in which the skin fold enlarged over 6.5 mm corresponded to a larger extent to the actual specific infection in the animals than to an infection caused by atypical mycobacteria, however, this could not be absolutely stated for all animals. Following a muscular as well as an oral infection of calves with atypical mycobacteria the allergic response was enhanced from the 40 th up to the 100 th day, the positive reaction to avian tuberculin becoming stronger than to bovine tuberculin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1981

Allergy to aminophylline: lack of predictability by skin testing.

Problems with determining hypersensitivity to aminophylline, ethylenediamine, and theophylline with intradermal skin tests and patch tests are reported in three patients. Three patients were tested with intradermal injections of 0.9% sodium chloride, 1% aminophylline, 1% ethylenediamine, and 0.5% theophylline following apparent allergic reactions to aminophylline. Patch testing using hydrophilic ointment base, 1% aminophylline, 1% ethylenediamine, and 0.5% theophylline was also done. All three patients had no reaction to intradermal sodium chloride or theophylline; all patch tests were negative. The first patient reacted to ethylenediamine strongly and to aminophylline more weakly; punch biopsy of the ethylenediamine reaction site showed a direct toxic effect with no allergic component. Punch biopsy of the aminophylline site showed a typical hypersensitivity reaction. Two concentrations (0.5% and 1.0%) of ethylenediamine injection were used to test the second patient, and he reacted to both concentrations but not to any other injections. His positive reactions contained blisters rather than the typical wheal-and-flare reaction of hypersensitivity. The third patient had similar responses including reactions to 0.5% and 0.1% ethylenediamine (he was not tested with 1% ethylenediamine). Skin testing may be of value in predicting aminophylline or ethylenediamine allergy, but the nonspecific toxic effect of ethylenediamine makes interpretation difficult.

Aged↗