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PubMed1980

[Change of immunity during pregnancy (author's transl)].

Determination of antibody to toxoplasmosis, on the basis of DT, CF, and ST, has shown that antibody quantities may vary, in the course of pregnancy, but are characterised by defined behaviour.--Antibody levels are shown to be at their maximum in early gravidity, that is before the 18th week of pregnancy, followed by relative decline and widely constant values beyond the 25th week.--The author, in a comprehensive discussion, points at the similarity between curves and titres of HCG excretion in urine, and he consideres that similarity a possible approach to further studies in greater detail.--Reference is also made to the importance of the above findings to diagnosis of acute infection by Toxoplasma gondii.

Antibody Formation↗
PubMed1993

[Asthma screening with a standardized running test].

Exercise induced asthma is a common feature of asthma in childhood. We performed a standardized free running test in 1461 primary schoolchildren in first grade (mean age: 7.3 years). A decrease of peak expiratory flow of at least 15% after a 6 minutes exercise period was considered a positive response. For a lifetime prevalence of a physician's diagnosis of asthma the sensitivity of the test was 35.4% and the specificity 94.3%. A positive response was associated with atopy (defined as a positive skin prick test) and with the clinical severity of asthma.

Asthma↗
PubMed1995

Long-term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics.

A variety of adverse reactions to local anesthetics has been described, some of which are thought to be allergic. Different protocols of prick and intradermal skin tests as well as subcutaneous challenge tests are used to select a local anesthetic which can safely be used. Their long-term effectiveness has not yet been assessed. Twenty-eight patients with a history of adverse reaction to local anesthetics were evaluated over a 3-year period. Loss of consciousness occurred in eight patients, skin reaction in nine, and vagal symptoms in eight. Various reactions were recorded in the remaining three patients. Rapid spontaneous recovery was the rule, suggesting that immediate allergic reaction and, in particular, anaphylactic reaction were unlikely. Investigation allowed the selection of a tolerated anesthetic in all cases. Reexposure occurred in 19 patients 16-50 months after evaluation and 6.8 +/- 5.5 years after the first reaction. No patient presented a second reaction. In conclusion, adverse reactions to local anesthetics seem to be, in most cases, not allergic in nature. Evaluation protocols are effective in selecting an agent susceptible to tolerance, but are time consuming. However, they probably contribute to an important reassurance effect that is likely to increase tolerance to subsequent local anesthetic administration. Simplification of the protocols and better patient selection are proposed.

Adult↗
PubMed1985

Hypersensitivity reaction to a metabolite of cyclophosphamide.

Generalized urticaria and fever were noted in a patient with IgA (kappa) myeloma after intravenous cyclophosphamide. Intradermal skin testing revealed no reaction to cyclophosphamide and its analog, isophosphamide. However, phosphoramide mustard, a principle metabolite of cyclophosphamide, evoked an immediate wheal-and-flare response. Subsequent therapy with isophosphamide was well tolerated. These findings suggest that acute hypersensitivity reactions to cyclophosphamide are due to its metabolites and can be delineated with skin testing.

Cyclophosphamide↗
PubMed1994

Latex-induced dermal and pulmonary hypersensitivity in rabbits.

BACKGROUND: Natural rubber latex (NRL) causes immediate, IgE-mast cell-mediated reactions in sensitized individuals, especially among health care workers and children with spina bifida. The immunopathogenesis of the reaction is obscure. METHODS: To study the immunologic mechanisms of NRL allergy, rabbits were sensitized with two nonammoniated and one ammoniated NRL antigens. Subcutaneous and intratracheal injections were used to immunize rabbits. Intradermal skin tests, IgG antibodies against NRL in serum and lung lavage fluid, and pulmonary histologic features were evaluated. RESULTS: One of nine sensitized rabbits died of anaphylaxis immediately after the third intratracheal injection with nonammoniated NRL. All sensitized rabbits, but not the controls, showed an immediate wheal and flare reaction in intradermal skin testing with NRL antigens. A positive skin reaction was detected 6 and 48 hours after the intradermal injections in four of five sensitized rabbits. A significant increase in NRL-specific IgG antibodies was detected in serum and lung lavage fluid of immunized rabbits. Lung histologic evaluation of NRL-sensitized rabbits showed a granulomatous interstitial and bronchial inflammation with a predominance of eosinophils and histiocytes in both intratracheally and subcutaneously sensitized rabbits. Vasculitis, hypertrophia, and contraction of pulmonary arteries could be detected in sensitized animals. CONCLUSION: The results of the first NRL rabbit model study indicate that eosinophils and IgE antibodies play a major role in the immunopathogenesis of NRL-induced allergy and anaphylaxis. A wide range of inflammatory responses detected in rabbits injected by subcutaneous route without intratracheal exposure suggests that NRL exposure may pose a risk for a subsequent systemic reaction.

Anaphylaxis↗
PubMed1980

Cimetidine as an immunomodulator: chronic mucocutaneous candidiasis as a model.

Four adult patients with chronic mucocutaneous candidiasis were studied to establish a possible role for cimetidine as an immunomodulator. These patients had negative baseline in-vivo and in-vitro cell-mediated immune response to candida antigen as measured by intradermal skin tests, lymphocyte transformation, and leukocyte migration inhibitory factor production to cimetidine, 300 mg by mouth, four times daily. Subsequently four of four patients developed strong (greater than 15 mm) intradermal skin test reactions, and two of four patients produced leukocyte migration inhibitory factor to candida antigen. Skin tests and leukocyte migration inhibitory factor production reverted to baseline negative values when repeated 4 weeks after discontinuation of therapy. After 4 additional weeks on cimetidine, four of four patients showed strong positive skin tests and leukocyte migration inhibitory factor production to candida antigen. Lymphocyte transformation was not affected by therapy.

Adult↗
PubMed2001

Feline atopy in three littermates.

This case report describes the history, clinical signs and diagnosis of a pruritic skin disease in three sibling cats living the same household. Clinical signs consistent with pruritus (i.e. hair pulling, hair loss, excessive grooming and face rubbing) were first noted when the cats were 6 months of age. The cats were treated for a possible ear mite and/or flea infestation; there was no response to treatment and clinical signs progressed. Although the presence of pruritus in a multiple cat household suggested an infectious or contagious aetiology, none could be identified. There was no improvement in clinical signs after a 60-day flea control trial, three treatments of ivermectin, an 8-week restricted diet or removal from the home for 10 days. A diagnosis of feline atopy was made on the basis of elimination of other causes of pruritus, consistent history and clinical signs, a positive intradermal skin test and response to therapy.

Animals↗
PubMed1987

[The significance of mite antigens in Kawasaki disease].

House dust mites have been suspected as a causative agent in Kawasaki disease. To assess the role of mite in children with Kawasaki disease, we studied 20 cases of Kawasaki disease from September 1985 through May 1986. Their ages ranged from 2 months to 4 years with a mean of 2.1 years, we assessed intradermal skin test reactivity to mite antigens (Dermatophagoides pteronyssinus and Dermatophagoides farinae) and anti-mites specific IgE (RAST) levels in 20 Kawasaki disease patients, 10 children for control, and 30 asthmatic patients for comparison. Intradermal skin test reactivity to mite antigens was not significantly increased in the 20 Kawasaki disease patients than in pediatric controls (p greater than 0.05), there was a more significantly reactivity in asthmatic patients than in Kawasaki disease and pediatric control (p less than 0.001). There was a correlation between serum IgE and anti-D. pteronyssinus specific IgE (r = 0.65, p less than 0.001) or anti-D. farinae specific IgE (r = 0.73, p less than 0.001) in Kawasaki disease. The anti-mite specific IgE's expressed as RAST score or mean values were not more significantly raised in Kawasaki disease than in pediatric controls (p greater than 0.05), there was a more significantly raised in asthmatic patients than in Kawasaki disease patients and in pediatric control. Coronary artery involvement was not significantly related to anti-mite specific IgE's in Kawasaki disease (p greater than 0.05). According to this study, the role of house dust mites is undetermined to Kawasaki disease.

Antigens↗
PubMed1978

BCG as active immunotherapy in children with acute lymphoblastic leukemia in longstanding remission: positive effects on remission duration and immunologic parameters.

Currently at the University of Florida, 22/45 children and adolescents are long-term survivors in complete sustained remission of standard chemotherapy regimens and central nervous system prophylaxis. All such therapy was discontinued in these survivors at 36 months after diagnosis and they were given monthly inoculations of BCG of the Tice strain by tine technique. 19/22 of BCG-treated patients remain in remission for 12 to 44 + months after cessation of chemotherapy. 1/22 has suffered relapse. Immunological function tests have shown statistically significant increased lymphocyte responses to PPD in contrast to age-matched controls and normal siblings. A trend to earlier than expected return to normal in other immunological parameters, including absolute lymphocyte counts, intradermal skin tests, phagocytosis indices, PHA transformation, and E-rosette forming cells was also observed, coincident with the BCG treatment. Further study of the role of BCG in acute lymphoblastic leukemia patients after cessation of chemotherapy is encouraged.

Adolescent↗
PubMed2001

Nontuberculous mycobacterial adenitis of the head and neck in children: experience from a tertiary care pediatric center.

OBJECTIVE: To describe our experience with the diagnosis, surgical treatment, and outcome of nontuberculous mycobacterial (NTM) adenitis of the head and neck in children, and to present a preliminary report about the use of NTM skin tests in our institution. STUDY DESIGN: Retrospective study. METHODS: The medical records of all children diagnosed with cervicofacial NTM adenitis were retrospectively reviewed for the period from January 1, 1995, through December 31, 2000. We also examined the use of intradermal skin tests for the diagnosis of NTM infection. RESULTS: Fifty patients were diagnosed with NTM cervicofacial adenitis. Pertinent demographic information, clinical presentation, investigation, and type of diagnostic procedures were documented. Surgical procedures, complications, and relapses were also noted. One unusual case of retropharyngeal adenitis is illustrated. All patients were treated with complete excision of their lesion at the first operation. No major complications were noted. Only one patient relapsed and required a second operation. Forty-one children were skin-tested with NTM antigens. Of these, 30 patients were dual-tested with Purified Protein Derivative (PPD) also. No adverse reactions were noted with the use of skin tests. Sensitivity of NTM antigens alone is 87%. Sensitivity of dual testing is 78%. No patient had a PPD-dominant reaction. CONCLUSION: Surgical excision is the treatment of choice of NTM adenitis because of the high cure rate with a single procedure, the excellent cosmetic result, and the low complication rate. NTM skin tests are safe and could be useful in early diagnosis of the infection but further investigation is needed.

Biopsy↗
PubMed1999

[Importance of the benzylpenicillin nucleus and the side chain of the beta-lactams. Demonstration by skin tests and RAST in penicillin allergic patients].

We studied 30 patients with beta-Lactams allergy demonstrated by clinical findings. The aim of this work was to determine the capacity of the beta-Lactams nucleus and the side chain in the induction of specific IgE to BPO, Ax, Amp, performed by intradermal skin test and RAST. The patients were divided by clinical manifestations in: 1-Accelerated reactions (n:19); and 2-Immediate reactions (n:11). The Prick tests were performed with BPO-PL, Ax-PL, Amp-PL, MDM-BP, MDM-Ax, MDM-Amp. The accelerated group presented BPO-PL (+) in 2 cases, Ax-PL & Amp-PL (+) in 4 cases, and all of the reactives were (+) in 13 out of 19 cases. The immediate group presented MDM-BP (+) in 10 out of 11 cases and MDM-Amp was (+) in 1 out of 11 cases. The RAST's were performed in all patients(n:30). In accelerated group were (+) to BPO-PL in 13 out of 19 cases, to Ax-PL in 3 out of 19 cases, to Amp-PL in 1 out 19 cases, to BPO-PL and Ax-PL on overlap in 1 out of 19 cases, and 1 case was negative to all reactives. The immediate group presented RAST's negatives in 11 out of 11 cases. The control group(n:20) presented Prick (+) to Ax-PL in 1 out of 20 cases, and the others reactives were negatives in all cases. The RAST's to all reactives were (-) in 20 out of 20 subjects. These results indicate that BPO was the most important determinant, and the side chain of the Ax or Amp were others determinants of the beta-Lactams drugs. These determinants induced specific IgE, and in rare occasions appears specific IgE for two different determinants on overlap in the same patient. The intradermal skin testing is the method of choice to study the penicillin allergies, because non satisfactory RAST's have yet been developed for minor determinant-specific IgE antibodies.

Adult↗