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1.
Arch. argent. pediatr ; 120(1): 21-29, feb 2022. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1353407

ABSTRACT

Introducción. La alergia a las proteínas de la leche de vaca es la alergia alimentaria más frecuente en los niños y para su diagnóstico se emplean historia clínica dirigida y prueba de provocación oral (PPO), el dosaje sérico de inmunoglobulina E específica (sIgE) y pruebas cutáneas de puntura (SPT, por su sigla en inglés). Sin embargo, su utilidad diagnóstica es difícil de establecer en la población local. El objetivo fue evaluar la utilidad de las pruebas para el diagnóstico de alergia a las proteínas de la leche de vaca (PLV) en la población estudiada. Población y métodos. Análisis retrospectivo de datos de pacientes atendidos en la Unidad de Alergia del Hospital Elizalde entre 2015 y 2018. Se evaluaron SPT y sIgE para leche, alfa-lactoalbúmina, beta-lactoglobulina y caseína, seguidos de PPO y se determinó la utilidad diagnóstica para cada prueba, y sus combinaciones. Resultados. Se evaluaron las pruebas de 239 pacientes. La PPO fue hospitalaria en el 54,8 % de los casos, por reexposición domiciliara en el 35,5 % y en el 9,6 % por incorporación de PLV a la madre. La mayor especificidad fue la de SPT con caseína (96,7 %; intervalo de confianza [IC95%]: 90,8-99,3) y la mayor sensibilidad, la de la combinación de SPT y sIgE con los 4 alérgenos (55,3 %; IC95%: 45,7-64,6). Conclusiones. El trabajo estableció la utilidad diagnóstica de las SPT y el sIgE en la población estudiada.


Introduction. Cow's milk protein allergy is the most common food allergy among children. It can be diagnosed based on a guided history taking and using an oral food challenge (OFC), serum specific immunoglobulin E levels (sIgE), and skin prick tests (SPT). However, it is difficult to establish their diagnostic performance in the local population. Our objective was to assess the usefulness of tests used to diagnose cow's milk protein (CMP) allergy in the studied population. Population and methods. Retrospective analysis of data from patients seen at the Unit of Allergy of a tertiary care pediatric hospital between 2015 and 2018. SPT and sIgE tests were done for milk, alpha-lactalbumin, beta-lactoglobulin, and casein, followed by an OFC, and the diagnostic usefulness of each test, as well as their combination, was established. Results. The tests of 239 patients were assessed. OFC was performed at the hospital in 54.8 % of cases, via a rechallenge test at home in 35.5 %, and through CMP intake by the mother in 9.6 %. The highest specificity was observed with the casein SPT (96.7 %; 95 % confidence interval [CI]: 90.8-99.3) and the highest sensitivity, with the 4-allergen SPT and sIgE combination (55.3 %; 95 % CI: 45.7-64.6). Conclusions. The study established the diagnostic usefulness of SPT and sIgE in the studied population.


Subject(s)
Humans , Animals , Infant , Milk Hypersensitivity/diagnosis , Immunoglobulin E , Cattle , Skin Tests , Allergens , Cross-Sectional Studies , Retrospective Studies
2.
Article in English | WPRIM | ID: wpr-922573

ABSTRACT

OBJECTIVE@#To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections (CHIs).@*METHODS@#The skin tests including skin prick tests (SPT), intradermal tests (IDT) and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs, including ginkgolide injection, diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection. The results of the provocation tests were used as the "gold standard" to determine the sensitivity and specificity of the skin tests.@*RESULTS@#The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests (P>0.05). The specificities of SPT and IDT were 0.976 and 0.797, respectively, and the sensitivities of both SPT and IDT were 0.@*CONCLUSION@#Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs. (ChiCTR-CPC-15006921).


Subject(s)
China , Humans , Hypersensitivity , Intradermal Tests , Sensitivity and Specificity , Skin Tests
3.
Arq. bras. med. vet. zootec. (Online) ; 73(4): 821-826, Jul.-Aug. 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1285277

ABSTRACT

Canine atopic dermatitis is an inflammatory, genetic, pruritic and chronic dermatosis that affects between 10 and 30% of dogs and one of the most important allergens is grass pollen. The objective of this study was to evaluate the sensitization to grass pollen allergens in dogs with canine atopic dermatitis and to compare intradermal skin test (IDT) with percutaneous test (PT). For this study, ten healthy dogs and 39 dogs with atopic dermatitis were tested. Dogs were submitted to IDT and PT for Lolium multiflorum, Cynodon dactylon and Paspalum notatum. The IDT and PT tests were compared using the Proportion Test. All healthy dogs were negative to both tests. Ten atopic dogs (25.6%) responded positively to the PT and none were positive in IDT. C. dactylon, L. multiflorum and P. notatum were responsible for positive reactions in 70%, 70% and 30% of positive dogs, respectively. The number of positive reactions in PT were statistically higher than IDT (P<0.05). In conclusion, grass pollen can be important source of allergens for dogs in Paraná state (Brazil) and the PT showed higher sensitization to grass pollen in dogs with atopic dermatitis than IDT.(AU)


A dermatite atópica canina é uma dermatose inflamatória, genética, prurítica e crônica que afeta entre 10% e 30% dos cães, e um dos alérgenos mais importantes são os polens de gramíneas. O objetivo deste estudo é avaliar a sensibilização a alérgenos de polens de gramíneas em cães com dermatite atópica e comparar o teste intradérmico (TID) com o teste percutâneo (TP). Para o estudo, 10 cães hígidos e 39 cães com dermatite atópica foram testados. Estes foram submetidos ao TID e ao TP para Lolium multiflorum, Cynodon dactylon e Paspalum notatum. TID e TP foram comparados usando-se o teste de proporção. Todos os cães hígidos foram negativos em ambos os testes. Dez cães atópicos (25,6%) responderam positivamente ao TP e nenhum ao TID. C. dactylon, L. multiflorum e P. notatum foram responsáveis por reações positivas de 70%, 70% e 30% dos cães positivos, respectivamente. O número de reações positivas no TP foi estatisticamente maior que no TID (P<0,05). Foi concluído que os polens de gramíneas podem ser importantes fontes de alérgenos para cães no estado do Paraná (Brasil) e que o TP mostrou maior sensibilização a polens em cães com dermatite atópica que o TID.(AU)


Subject(s)
Animals , Dogs , Pollen/adverse effects , Allergens/analysis , Dermatitis, Atopic/veterinary , Lolium , Skin Tests/veterinary , Cynodon , Paspalum , Poaceae/adverse effects
4.
An. bras. dermatol ; 96(2): 148-154, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248734

ABSTRACT

Abstract Background: The pathophysiology of urticaria is still poorly understood. Recent studies demonstrate that the activation of coagulation is correlated with the clinical activity of Chronic Spontaneous Urticaria. Coagulation and inflammation are strongly linked. Objectives: To correlate the severity and activity of Chronic Spontaneous Urticaria with the levels of D-dimer, C-reactive protein, and autologous serum test in patients with Chronic Spontaneous Urticaria. Methods: The study included 55 patients diagnosed with chronic spontaneous urticaria. D-dimer levels were measured using enzyme-linked fluorescent assay and C-reactive protein levels were measured using the nephelometric method; autologous serum testing was performed on patients who discontinued antihistamine therapy. The severity of the disease was assessed using the urticaria activity score. Results: patients with severe, spontaneous, and difficult-to-control chronic urticaria had elevated serum levels of D-dimer, as well as a positive autologous serum test. Little correlation was demonstrated between the severity of chronic spontaneous urticaria and the levels of C-reactive protein. Conclusion: The authors concluded that patients with severe Chronic Spontaneous Urticaria showed signs of activated fibrinolysis. Most patients with high clinical scores had high D-dimer values. Patients with positive results for the autologous serum test also had more severe Chronic Spontaneous Urticaria and needed more drugs to control the disease. Finally, little correlation was found between C-reactive protein levels and disease severity. Study limitations: The main limitation was the small sample of patients. In the present patients, it was demonstrated that serum D-dimer levels and the autologous serum test can act as predictive markers of severity and activity of Chronic Spontaneous Urticaria.


Subject(s)
Humans , Urticaria , Pharmaceutical Preparations , Chronic Urticaria , Brazil , C-Reactive Protein/analysis , Fibrin Fibrinogen Degradation Products , Skin Tests , Chronic Disease , Cross-Sectional Studies
5.
Rev. bras. anestesiol ; 70(6): 642-661, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155771

ABSTRACT

Abstract This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after an episode of anaphylaxis. As anaphylaxis assessment is extensive, the identification of medications, antiseptics and other substances used at each setting, the comprehensive data documentation, and the use of standardized nomenclature are key points for obtaining more consistent epidemiological information on perioperative anaphylaxis.


Resumo Este segundo documento, escrito por especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória, tem por objetivo revisar os mecanismos fisiopatológicos, agentes desencadeantes (em adultos e crianças), assim como a abordagem diagnóstica durante e após o episódio. Por se tratar de uma avaliação abrangente, a identificação das medicações, antissépticos e outras substâncias usadas em cada região, registros detalhados, e nomenclatura padronizada são pontos fundamentais para a obtenção de dados epidemiológicos mais fidedignos sobre a anafilaxia perioperatória.


Subject(s)
Humans , Child , Adult , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Perioperative Period , Anaphylaxis/diagnosis , Anaphylaxis/etiology , Societies, Medical , Vasodilator Agents/adverse effects , In Vitro Techniques , Mastocytosis/complications , Brazil , Preoperative Care , Immunoglobulin E/immunology , Bradykinin/adverse effects , Skin Tests/methods , Risk Factors , IgA Deficiency/complications , Drug Hypersensitivity/physiopathology , Allergy and Immunology , Symptom Assessment , Anaphylaxis/physiopathology , Anesthesiology , Angioedema/chemically induced , Terminology as Topic
6.
Vaccimonitor (La Habana, Print) ; 29(3)sept.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139853

ABSTRACT

Para confirmar la presencia de apneea obstructiva del sueño (OSA) en rinitis alérgica (RA), se realizó poligrafía cardiorrespiratoria (CRP) y para tratar ambas condiciones, inmunoterapia alérgeno específica (ITAE). El diseño fue descriptivo en el universo de pacientes del servicio de Alergología del policlínico Previsora en Camagüey, Cuba, desde diciembre 2018 a marzo 2020. Se seleccionaron 326 pacientes en orden consecutivo de asistencia a la consulta, teniendo en cuenta los criterios: ≥5 años con RA, sospecha de OSA y prueba cutánea con ácaros: Dermatophagoides pteronyssinus, Dermatophagoides siboney y Blomia tropicalis, producidos en: Centro Nacional de Biopreparados de Cuba. Todos recibieron ASIT por ≥10 meses y se realizó CRP antes y después de la ASIT. La CRP se realizó utilizando el marcaje automático de eventos de ApneaLink AirTM (Resmed Corp., RFA), validado para estudiar los trastornos del sueño en el hogar. Los resultados de la prueba cutánea y de CRP se evaluaron antes y después de la ASIT; también la eficacia de la ASIT según criterios de pacientes y profesionales. De la muestra, 152 fueron del sexo femenino y 174 del sexo masculino para un 46,6 por ciento y 53,4 por ciento respectivamente; aquellos con habón de 5 a 6 mm fueron los más representados (p=0,04). Hubo descenso en los niveles de gravedad de OSA después de la ASIT (p=0,025). En la valoración de la eficacia de la ASIT, hubo un número significativo de mejorados (p=0,012). La CRP proporciona el diagnóstico de OSA en RA, y la ASIT cambia el curso de ambas condiciones(AU)


To confirm the presence of obstructive sleep apnea (OSA) in allergic rhinitis (AR), cardiorespiratory polygraphy (CRP) was performed, and to treat both conditions, the allergen specific immunotherapy (ASIT) was used in order to change their course. Descriptive study in the universe of patients from Previsora polyclinic Allergology service, Camagüey, Cuba was carried-out from December 2018 to March 2020. 326 patients were selected in consecutive order of attendance at the consultation, taking into account the criteria: ≥5 years with AR, suspicion of OSA and positive skin test to: Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis, supplied by the National Center for Biopreparations in Cuba. All patients received ASIT for ≥10 months and CRP was performed before and after ASIT. The CRP results were taken from the automatic scoring of the ApneaLink AirTM device (Resmed Corp., Australia), validated to study OSA at home. The skin test and CRP results were evaluated before and after the ASIT. In addition, the assessment of the ASIT efficacy according to criteria of patients and professionals was performed. The sample was made-up of 152 female patients (46.6 percent) and 174 males (53.4 percent); those with 5 to 6 mm wheal were the most represented (p=0.04). There was decrease in OSA severity levels after ASIT (p=0.025). The ASIT efficacy was proved with a significant number of improvements (p=0.012). CRP provides the diagnosis of OSA in AR, and ASIT changes the course of both conditions(AU)


Subject(s)
Humans , Male , Female , Skin Tests/methods , Sleep Apnea, Obstructive/therapy , Rhinitis, Allergic/therapy , Mites , Epidemiology, Descriptive , Observational Study
7.
Rev. bras. anestesiol ; 70(5): 534-548, Sept.-Oct. 2020. tab
Article in English | LILACS | ID: biblio-1143957

ABSTRACT

Abstract Experts from the Brazilian Association of Allergy and Immunology (ASBAI) and the Brazilian Society of Anesthesiology (SBA) interested in the issue of perioperative anaphylaxis, and aiming to strengthen the collaboration between the two societies, combined efforts to study the topic and to prepare a joint document to guide specialists in both areas. The purpose of the present series of two articles was to report the most recent evidence based on the collaborative assessment between both societies. This first article will consider the updated definitions, treatment and guidelines after a perioperative crisis. The following article will discuss the major etiologic agents, how to proceed with the investigation, and the appropriate tests.


Resumo Especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória reuniram-se com o objetivo de intensificar a colaboração entre as duas sociedades no estudo desse tema e elaborar um documento conjunto que possa guiar os especialistas de ambas as áreas. O objetivo desta série de dois artigos foi mostrar as evidências mais recentes alicerçadas na visão colaborativa entre as sociedades. Este primeiro artigo versará sobre as definições mais atuais, formas de tratamento e as orientações após a crise no perioperatório. No próximo artigo serão discutidos os principais agentes causais e a condução da investigação com testes apropriados.


Subject(s)
Humans , Child , Adult , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Perioperative Period , Anaphylaxis/diagnosis , Anaphylaxis/etiology , Societies, Medical , Vasodilator Agents/adverse effects , In Vitro Techniques , Mastocytosis/complications , Brazil , Preoperative Care , Immunoglobulin E/immunology , Bradykinin/adverse effects , Skin Tests/methods , Risk Factors , IgA Deficiency/complications , Drug Hypersensitivity/physiopathology , Allergy and Immunology , Symptom Assessment , Anaphylaxis/physiopathology , Anesthesiology , Angioedema/chemically induced , Terminology as Topic
8.
Arch. argent. pediatr ; 118(5): 337-342, oct 2020. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1122034

ABSTRACT

Introducción. Publicaciones internacionales estiman una prevalencia de sensibilización al látex (SL) en el personal de salud del 7 % al 17 %, y se desconocen los valores en la Argentina.Objetivos. Estimar la prevalencia de sensibilización y alergia al látex en médicos residentes de un hospital pediátrico mediante la prueba epicutánea de lectura inmediata y evaluar factores de riesgo asociados en dicha población.Población y métodos. Estudio de corte transversal. Se incluyeron los residentes, jefes e instructores de Pediatría, Ortopedia, Cirugía y Terapia Intensiva entre junio y octubre de 2017. En todos, se realizó un cuestionario (que evaluó enfermedades atópicas y otros factores de riesgo) y la prueba epicutánea de lectura inmediata. En un subgrupo (residentes de 1ero, 4to año, especialidades quirúrgicas y terapia) se dosó inmunoglobulina E total y específica para látex.Resultados. Se incluyeron 113 participantes. La prevalencia de SL fue del 7,96 % (intervalo de confianza del 95 %: 3,70-14,58); 4 participantes resultaron alérgicos al látex. El antecedente de síntomas relacionados con el látex se asoció significativamente con prueba epicutánea de lectura inmediata + (p = 0,0196; odds ratio 6,13; intervalo de confianza del 95 %: 1,44-26,04). No hubo asociación entre SL y año de residencia.Conclusiones. La prevalencia de SL hallada fue del 7,9 %. Se evidenció una relación significativa entre el antecedente de SRL y un resultado de prueba epicutánea de lectura inmediata positiva


Introduction. International publications estimate a 7 %-17 % latex sensitization (LS) prevalence among health care workers, but values in Argentina are unknown.Objectives. To estimate the prevalence of latex sensitization and allergy among residents of a children's hospital using the immediate-reading prick test and to assess associated risk factors in this population.Population and methods. Cross-sectional study. Residents, trainers, and Chief residents of the Departments of Pediatrics, Orthopedics, Surgery and Intensive Care were included between June and October 2017. All of them were administered a questionnaire (assessing atopic diseases and other risk factors) and underwent the immediate-reading prick test. Total and latex-specific immunoglobulin E levels were determined in a subgroup of individuals (first- and fourth-year residents, surgical specialties, and intensive care).Results. A total of 113 participants were included. LS prevalence was 7.96 % (95 % confidence interval: 3.70-14.58); 4 participants were allergic to latex. A history of latex-related symptoms (LRS) was significantly associated with a positive result in the immediate-reading prick test (p = 0.0196; odds ratio: 6.13; 95 % confidence interval: 1.44-26.04). There was no association between LS and the year of the residency program.Conclusions. The observed LS prevalence was 7.9 %. There was a significant relation between a history of LRS and a positive result in the immediate-reading prick tes


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Latex Hypersensitivity , Physicians , Skin Tests , Epidemiology, Descriptive , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Internship and Residency
9.
Vaccimonitor (La Habana, Print) ; 29(2)mayo.-ago. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1127515

ABSTRACT

Las enfermedades alérgicas van en aumento importante en todo el mundo. La rinitis alérgica es una enfermedad inflamatoria crónica de la mucosa nasal IgE mediada, alérgeno-específica con participación de diversas células. Nos propusimos caracterizar la rinitis alérgica en pacientes atendidos en el Hospital Universitario General Calixto García. Se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, entre octubre 2016 y octubre 2017. En una muestra de 100 pacientes que cumplieron los criterios de inclusión, se realizó historia clínica alergológica empleando variables como: edad, sexo, antecedentes patológicos personales y familiares, procedencia, manifestaciones clínicas, y prueba cutánea por punción. Predominó el sexo femenino entre 30 y 39 años de edad, de área urbana, antecedentes patológicos familiares y personales de asma y conjuntivitis. La rinitis intermitente leve prevaleció en nuestro estudio, así como la sensibilidad a Dermatophagoides pteronyssinus. La tercera década de la vida fue la edad promedio de los pacientes. Se concluye que los pacientes presentaron una alta sensibilidad a Dermatophagoides pteronyssinus. La rinitis persistente leve, con la mitad de los casos, obtuvo mayor predominio por la duración de los síntomas(AU)


Allergic diseases are increasing significantly worldwide. Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, IgE-mediated, allergen-specific with the participation of various cells. The aims of this study was to characterize allergic rhinitis in patients treated at the General Calixto García University Hospital. Descriptive cross-sectional non-randomized observational study was carried out between October 2016 and October 2017. A sample of 100 patients who meet the inclusion criteria was studied. Allergological medical history was performed using variables such as age, sex, personal and family pathological history, origin, clinical manifestations, and puncture skin test. Female sex predominated between 30 and 39 years old, urban area, family and personal pathological history of asthma and conjunctivitis. Mild intermittent rhinitis predominated in our study. Sensitivity to Dermatophagoides pteronyssinus. The third decade of life was the average age of the patients in this study. We summarize that patients had presented a high sensitivity to Dermatophagoides pteronyssinus. Mild persistent rhinitis with half of the cases had a greater predominance for the duration of symptoms(AU)


Subject(s)
Humans , Male , Female , Skin Tests/methods , Rhinitis, Allergic/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study
10.
Arch. argent. pediatr ; 118(1): S1-S11, 2020-02-00. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1096405

ABSTRACT

Los antiinflamatorios no esteroideos son ampliamente recetados en niños. Constituyen la segunda causa de reacciones a medicamentos en pediatría después de los antibióticos betalactámicos; sin embargo, solo una parte de estas son reacciones de hipersensibilidad. La prevalencia de dichas reacciones a antiinflamatorios no esteroideos en niños es del 0,3 % y aumenta al 5 % en asmáticos.Los mecanismos fisiopatológicos involucrados (inhibición de la ciclooxigenasa, hipersensibilidad mediada por inmunoglobulina E, linfocitos T reactivos y/o afectación de la inmunidad innata) darán lugar a diferentes entidades clínicas con sintomatología dispar.La confusión con síntomas propios de procesos virales y la variabilidad clínica hacen del diagnóstico de certeza un verdadero desafío. Una historia clínica detallada, análisis de laboratorio, pruebas cutáneas y de provocación controlada permitirán definir estrategias para cada paciente en particular sin etiquetar como alérgico a un niño que no lo es ni exponer a riesgos innecesarios a quien está sensibilizado.


Nonsteroidal anti-inflammatory drugs are widely prescribed in children. They are the second cause of drug ́s reactions in pediatrics after beta-lactam antibiotics, however only a part of them are hypersensitivity reactions. The prevalence of these reactions to nonsteroidal anti-inflammatory drugs in children is 0.3 %, increasing to 5 % in asthmatics.The different physiopathological mechanisms involved (inhibition of cyclooxygenase, immunoglobulin E-mediated hypersensitivity, reactive T lymphocytes and/or disturbance of innate immunity) will cause different clinical entities with diverse symptoms.The confusion between the common symptoms of a viral infection and a hypersensitivity reaction, and the variability of the clinical presentations make diagnosis a real challenge.A detailed clinical history, laboratory, skin and controlled provocation tests will provide strategies for each patient, without labeling a child who is not an allergic one, or taking unnecessary risks with those who are sensitized.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Anti-Inflammatory Agents, Non-Steroidal , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/drug therapy , Skin Tests , Cross Reactions , Drug Hypersensitivity/prevention & control
11.
Mem. Inst. Oswaldo Cruz ; 115: e190361, 2020. tab, graf
Article in English | LILACS | ID: biblio-1091244

ABSTRACT

Genes associated with wound healing have been shown to be risk factors for cutaneous leishmaniasis (CL) which is caused by Leishmania braziliensis. In this study, we examined whether the genes previously associated with CL influenced the clinical outcome. Patients were genotyped and retrospectively classified as responders, who were cured with a single course of pentavalent antimony (Sbv), or as refractories, who did not respond to Sbv. Patients characterised as responders showed a stronger response to the leishmanin skin test (LST) when compared to the refractory subjects (p = 0.0003). Furthermore, we observed an association between the FLI1 CC genotype and an increased size of ulcers (p = 0.0170). We suggest that the leishmanin skin test may be a predictive tool for therapeutic outcome and reinforce FLI1 as a potential influencer of susceptibility and lesion size in CL.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Wound Healing/genetics , Leishmaniasis, Cutaneous/genetics , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Skin Tests , Case-Control Studies , Retrospective Studies , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Cutaneous/drug therapy , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Genotype , Middle Aged
12.
Einstein (Säo Paulo) ; 18: eRC5478, 2020. graf
Article in English | LILACS | ID: biblio-1142868

ABSTRACT

ABSTRACT A 33-year-old male with house dust mite allergic rhinitis and asthma reported an episode of facial and lip angioedema, dyspnea, cough and dysphagia at the age of 25, minutes after eating a mushroom ( Agaricus bisporus ) pizza. He denied any drug intake, hymenoptera stings or other possible triggers, and no identifiable cofactors were present. Since then he avoided all types of mushrooms, however an accidental contact occurred with mushroom sauce that resulted in angioedema of the lip within minutes. The allergy workup included measurements of total IgE and specific IgE to mushroom, and skin prick test to aeroallergens sources, possible food allergen sources and mushroom extract, a prick to prick test with raw and cooked A. bisporus , in addition to a SDS-PAGE and immunoblotting assay. The study revealed a specific IgE to mushroom of 0.76kUA/L positive skin prick test to mushroom extract, and prick to prick test positive to white and brown A. bisporus (raw and cooked). The immunoblotting identified two IgE binding proteins with 10kDa and 27kDa. We report a case of A. bisporus anaphylaxis probably due to primary mushroom sensitization. We detected two IgE-reactive proteins with 10kDa and 27kDa as possible culprit allergens.


RESUMO Paciente do sexo masculino, 33 anos, com asma e rinite alérgica desencadeadas por ácaros, relatou episódio de angioedema facial e labial, dispneia, tosse e disfagia aos 25 anos, minutos após a ingestão de uma pizza de cogumelo ( Agaricus bisporus ). O paciente negou consumo de medicamentos, picadas de himenópteros, ou quaisquer outros possíveis desencadeadores ou cofatores que pudessem estar presentes. Desde então, evita todos os tipos de cogumelos, até a ocorrência de um contato acidental com molho de cogumelo, que resultou em angioedema labial minutos após. O estudo imunoalergológico incluiu doseamento de IgE total e específica para cogumelos, testes cutâneos para aeroalérgenos, possíveis alérgenos alimentares e extrato de cogumelos, teste prick to prick com A. bisporus cru e cozido e teste de SDS-PAGE immunoblotting . O estudo revelou IgE específica para cogumelos de 0,76kUA/L, teste cutâneo positivo para extrato de cogumelos e teste prick to prick positivo para A. bisporus branco e castanho (cru e cozido). O immunoblotting identificou duas proteínas de ligação de IgE, de 10kDa e 27kDa. Relatamos, assim, um caso de anafilaxia por ingestão de A. bisporus , provavelmente explicado por sensibilização primária a cogumelos. Detectamos duas proteínas IgE-reativas de 10kDa e 27kDa como os possíveis alérgenos responsáveis.


Subject(s)
Humans , Animals , Male , Adult , Cats , Agaricus , Deglutition Disorders/etiology , Cough/etiology , Dyspnea/etiology , Food Hypersensitivity/immunology , Anaphylaxis/etiology , Angioedema/etiology , Immunoglobulin E/blood , Skin Tests , Allergens , Alternaria , Flour , Anaphylaxis/chemically induced
13.
Article in Korean | WPRIM | ID: wpr-811298

ABSTRACT

Hypersensitivity reaction to iodinated contrast media (ICM) is a persistent clinical issue owing to widespread use of computed tomography (CT) examinations. The question of whether routine performance of skin tests can predict hypersensitivity reactions to contrast media remains unresolved. Recently, a prospective study was performed to evaluate the role of an intradermal skin test as a prescreening test for hypersensitivity reactions to ICM. Fifteen (0.5%) of the 2,843 patients had positive skin test results prior to scheduled CT scans. However, none of the patients experienced a hypersensitivity reaction after administration of full-dose ICM. Meanwhile, 19 patients who experienced hypersensitivity reactions to an ICM challenge showed negative skin test results. The sensitivity and positive predictive value of skin tests for hypersensitivity reaction to ICM were both 0%. More studies should be conducted to confirm the uselessness of prescreening skin tests. In conclusion, a prescreening intradermal skin test prior to a CT scan has no significant clinical value as a tool for predicting hypersensitivity reactions to ICM. Therefore, prescreening skin tests should not be routinely performed.


Subject(s)
Contrast Media , Humans , Hypersensitivity , Predictive Value of Tests , Prospective Studies , Skin Tests , Skin , Tomography, X-Ray Computed
14.
Asia Pacific Allergy ; (4): 4-2020.
Article in English | WPRIM | ID: wpr-785461

ABSTRACT

BACKGROUND: Banana fruit has been recognized as an important food allergen source. Nowadays banana hypersensitivity had been reported more frequently with various presentations from oral allergy syndrome to anaphylaxis.OBJECTIVE: This study aims to describe the pattern of banana hypersensitivity and the sensitivity of diagnostic test.METHODS: Six patients who experienced banana hypersensitivity were recruited from adult allergy clinic, Ramathibodi Hospital, Mahidol University between 2015–2018. Demographic data, pattern of banana allergy consisted of the onset of reaction, symptoms, severity, cross-reactivity to kiwi, avocado, latex including type and amount of banana were collected. Skin test, serum specific IgE to banana and open-label food challenge test had been applied.RESULTS: All patients experienced multiple episodes of banana anaphylaxis. Regarding the diagnostic investigation, prick-to-prick skin test had higher sensitivity (sensitivity, 100%; 95% confidence interval [CI], 54.07%–100%) than the commercial banana extract (sensitivity, 83.33%; 95% CI, 35.88%–99.58%) and serum specific IgE to banana (sensitivity, 50%; 95% CI, 11.81%–88.19%). The discordance between skin prick test using commercial banana extract and skin test was reported. The cross-reactivity between the species of banana, kiwi, the avocado was documented in all patients. Latex skin prick test and application test were applied with negative results. From the oral food challenge test, a case of banana anaphylaxis patient can tolerate heated banana.CONCLUSION: The various phenotypes of banana hypersensitivity were identified. The prick-to-prick test showed the highest sensitivity for diagnosis of banana allergy. However, component resolved diagnostics might be needed for conclusive diagnosis.


Subject(s)
Adult , Anaphylaxis , Diagnosis , Diagnostic Tests, Routine , Food Hypersensitivity , Fruit , Hot Temperature , Humans , Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulin E , Latex , Musa , Persea , Phenotype , Skin , Skin Tests , Thailand
15.
Asia Pacific Allergy ; (4): 8-2020.
Article in English | WPRIM | ID: wpr-785457

ABSTRACT

There are geographical, regional, and ethnic differences in the phenotypes and endotypes of patients with drug hypersensitivity reactions (DHRs) in different parts of the world. In Asia, aspects of drug hypersensitivity of regional importance include IgE-mediated allergies and T-cell-mediated reactions, including severe cutaneous adverse reactions (SCARs), to beta-lactam antibiotics, antituberculous drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) and radiocontrast agents. Delabeling of low-risk penicillin allergy using direct oral provocation tests without skin tests have been found to be useful where the drug plausibility of the index reaction is low. Genetic risk associations of relevance to Asia include human leucocyte antigen (HLA)-B*1502 with carbamazepine SCAR, and HLA-B*5801 with allopurinol SCAR in some Asian ethnic groups. There remains a lack of safe and accurate diagnostic tests for antituberculous drug allergy, other than relatively high-risk desensitization regimes to first-line antituberculous therapy. NSAID hypersensitivity is common among both adults and children in Asia, with regional differences in phenotype especially among adults. Low dose aspirin desensitization is an important therapeutic modality in individuals with cross-reactive NSAID hypersensitivity and coronary artery disease following percutaneous coronary intervention. Skin testing allows patients with radiocontrast media hypersensitivity to confirm the suspected agent and test for alternatives, especially when contrasted scans are needed for future monitoring of disease relapse or progression, especially cancers.


Subject(s)
Adult , Allopurinol , Anaphylaxis , Anti-Bacterial Agents , Asia , Asian Continental Ancestry Group , Aspirin , Asthma , Carbamazepine , Child , Cicatrix , Contrast Media , Coronary Artery Disease , Diagnostic Tests, Routine , Drug Hypersensitivity , Ethnic Groups , Humans , Hypersensitivity , Penicillins , Percutaneous Coronary Intervention , Phenotype , Recurrence , Skin Tests
16.
Vaccimonitor (La Habana, Print) ; 28(3)sept.-dic. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094631

ABSTRACT

Los ácaros Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) y Blomia tropicalis (Bt), constituyen la herramienta fundamental para diagnóstico e inmunoterapia de rinitis alérgica (RA), que en muchas ocasiones se asocia al síndrome apnea-hipopnea obstructiva del sueño (SAHOS). Para diagnosticar SAHOS se seleccionaron 465 individuos del registro de alergia del Policlínico Previsora, Camagüey, Cuba, con diagnóstico presuntivo de RA. Se descartaron aquellos con prueba cutánea Prick test negativa a Dp, Ds y Bt y sin poligrafía cardio-respiratoria (PCR), quedando para estudio 236 pacientes entre 8 y 70 años de edad: 102 casos (43,2 por ciento) definidos como aquellos con respiración oral y ronquidos y 134 controles (56,7 por ciento) sin respiración oral ni ronquidos. La PCR se realizó utilizando el marcaje automático de eventos del dispositivo ApneaLink AirTM (Resmed Corp., RFA). La media del tamaño del habón fue de 5,9 mm en los casos (p=0,02). El índice de apnea e hipopnea (IAH) fue positivo en 129 pacientes (54,6 por ciento); de ellos, 97 casos (41,1 por ciento) y 32 controles (13,5 por ciento). Los pacientes con IAH˃20/h predominaron en los casos con 21 individuos (8,8 por ciento) (p꞊0,048). La sensibilidad del PCR fue del 95,10 por ciento, su especificidad del 76,12 por ciento. Los valores predictivos positivos y negativos del 75,19 por ciento y 95,33 por ciento respectivamente. Se estimó en 3,98 la razón de verosimilitud positiva y de 0,06 la negativa. Los pacientes con SAHOS en los casos y controles presentan incremento con predominio para casos (p=0,002). La PCR con el dispositivo ApneaLink permite hacer el diagnóstico de SAHOS en RA(AU)


The mites Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) and Blomia tropicalis (Bt) are the primary tool for the diagnosis and immunotherapy of Allergic Rhinitis (AR), which is often associated with the Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). To diagnose OSAHS, 465 individuals were selected from the allergy registry of the Previsora Polyclinic, Camagüey, Cuba, with presumptive diagnosis of AR. Those with a skin test (Prick test) negative to Dp, Ds and Bt, and without a previous Cardiorespiratory Polygraphy (CRP) were discarded, leaving 236 patients between 8 and 70 years old: 102 cases (43.2 percent) those with oral breathing and snoring and 134 controls (56.7 percent) without oral breathing or snoring. The CRP data analysis was performed using the automatic algorithm of the ApneaLink AirTM device (Resmed Corp., Germany). The average size of the wheal was 5.9 mm in cases (p = 0.02). The Apnea Hypopnea Index (AHI) was greater than 5 events/hour in 129 patients (54.6 percent); of those, 97 cases (41.1 percent) and 32 controls (13.5 percent). Patients with AHI˃20/h predominated in cases with 21 individuals (8.8 percent) (p꞊0.048). The sensitivity of the PCR was 95.10 percent, its specificity 76.12 percent. The positive and negative predictive values were 75.19 percent and 95.33 percent respectively. The positive likelihood ratio was 3.98 and the negative one was 0.06. The prevalence of OSAHS was significantly higher in cases compared to controls (p =0.002). The CRP with the ApneaLink device allows the diagnosis of SAHOS in AR(AU)


Subject(s)
Skin Tests/methods , Sleep Apnea, Obstructive/diagnosis , Pyroglyphidae , Rhinitis, Allergic/diagnosis , Cuba
17.
Rev. fac. cienc. méd. (Impr.) ; 16(1): 12-18, ene.-jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1023772

ABSTRACT

La atopia es un fenómeno biogenético y ambiental, un estado de hipersensibilidad anómala que presentan ciertos individuos ante la presencia de sustancias o condiciones que para el resto de la población son inocuas, con diversas manifestaciones clínicas de alergia aguda o crónica, sistémica u órgano- específica. En el país existe poca información sobre enfermedades alérgicas. Objetivo: describir las manifestaciones clínicas frecuentes y la condición atópica, definida a través de datos clínicos y pruebas cutáneas de alergia. Material y Métodos: se realizó un estudio observacional, descriptivo, transversal, con muestreo por conveniencia, de 50 de los 62 empleados del Centro de Salud Integral Zoé de Tegucigalpa, Honduras, de octubre 2015 a febrero 2016. A cada participante, previo consentimiento informado, se le aplicó un instrumento clínico-epidemiológico y un prick test de aero alérgenos inhalados y de alimentos frecuentes. Resultados: La población femenina fue mayoritaria (66%), con una relación mujer/varón de 2:1, 38 personas (76%) ubicadas entre los 20 y 40 años de edad. Se encontró que 23 (46%) tuvieron antecedentes familiares de atopia, 28 (56%) manifestaron el antecedente personal de rinitis, asma bronquial o dermatosis, 6 (12%) expresaron antecedente de alergia a medicamentos y 35 (70%) identificaron el polvo como principal alérgeno. La prevalencia general de atopia, medida por una prueba de prick positiva fue de 76%. Los alérgenos identificados fueron principalmente los ácaros del polvo doméstico (48%), hongos (50%) y cucaracha (polvo casero) (32%); en menor frecuencia chocolate (6%), mariscos (6%) y maíz (6%). Conclusiones: Se encontró un elevado porcentaje (76%) de enfermedad alérgica, con mayor frecuencia de hipersensibilidad a polvo, ácaros y mohos. La detección oportuna y adecuada de los alérgenos desencadenantes de enfermedades alérgicas, es necesaria para tomar medidas terapéuticas óptimas y ofrecer mejor calidad de vida a las personas que las padecen...(AU)


Subject(s)
Humans , Male , Female , Adult , Skin Tests/methods , Allergens , Hypersensitivity , Informed Consent/ethics
18.
Säo Paulo med. j ; 137(3): 295-297, May-June 2019. tab
Article in English | LILACS | ID: biblio-1020953

ABSTRACT

ABSTRACT CONTEXT: Adverse reactions associated with prick tests are rare but may be present as serious systemic reactions. CASE REPORT: A 38-year-old female nursing technician complained of three episodes of anaphylaxis in one year, all in the workplace. To investigate latex allergy, the patient underwent the prick test with latex, and immediately developed a rash, itchy skin, hoarseness, dyspnea and dry cough. Her condition improved promptly after appropriate measures were established for controlling her anaphylaxis. CONCLUSION: The skin test must be performed under medical supervision, since complications that can lead to life-threatening reactions, if support measures are not readily implemented, have been attributed to this test.


Subject(s)
Humans , Female , Adult , Skin Tests/methods , Latex Hypersensitivity/diagnosis , Anaphylaxis/etiology , Occupational Diseases/etiology , Latex Hypersensitivity/complications , Anaphylaxis/diagnosis , Occupational Diseases/diagnosis
19.
Rev. bras. ginecol. obstet ; 41(3): 203-205, Mar. 2019. graf
Article in English | LILACS | ID: biblio-1003537

ABSTRACT

Abstract Introduction Autoimmune progesterone dermatitis (APD) is a rare autoimmune dermatosis characterized by recurrent cutaneous and mucosal lesions during the luteal phase of the menstrual cycle that disappear some days after the menses. Case Report A 34-year-old primipara woman with no significant past medical history and no prior exogenous hormone use, who presented with cyclic skin eruptions starting 1 year after the delivery. The lesions occurred 6 days before the menses and disappeared in between 1 and 2 days after the menstruation ceased. The patient was diagnosed after a positive response to an intradermal test with progesterone and was successfully treated with combined oral contraceptives. The skin eruptions have not returned since the initiation of this therapy. Conclusion Dermatologists, gynecologists, and obstetricians should be aware of this rare entity. Furthermore, if this condition is suspected, a thorough history taking on the menstrual cycle and results of the intradermal progesterone test are mandatory.


Subject(s)
Humans , Female , Adult , Progesterone/adverse effects , Autoimmune Diseases/drug therapy , Contraceptives, Oral, Combined/administration & dosage , Dermatitis/drug therapy , Menstruation Disturbances/drug therapy , Recurrence , Autoimmune Diseases/diagnosis , Skin Tests , Treatment Outcome , Dermatitis/diagnosis , Ethinyl Estradiol/administration & dosage , Androstenes/administration & dosage , Menstruation Disturbances/diagnosis
20.
Korean Journal of Medicine ; : 353-357, 2019.
Article in Korean | WPRIM | ID: wpr-759948

ABSTRACT

Urticaria is a common cutaneous disease characterized by recurrent and transient wheals and pruritus, sometimes accompanied angioedema. The classification of urticaria is based on the duration of the disease and whether extrinsic triggers are identified or not. Acute urticaria is usually occurred by specific causes, such as drug, food, and infection, etc. Therefore, acute urticaria can be remitted within 6 weeks just by avoiding the exposure to the causes. However, chronic urticaria defined as repeatedly occurred itchy wheals and/or angioedema for at least 6 weeks, has a significant effect on patients' quality of life. Chronic inducible urticaria can be triggered by various physical stimuli including dermographism, delayed pressure, cold, heat, cholinergic stimuli, sunlight, and exercise. Chronic spontaneous urticaria (CSU) is diagnosed when no specific extrinsic cause is identified in the patients. CSU due to autoimmune mechanism accounts for 30–50%, autologous serum skin test and anti-thyroid autoantibody can be evaluated. However, various physical stimuli, emotional or physical stress, drugs, particularly aspirin and non-steroidal anti-inflammatory drugs can exacerbate urticaria in 30–75% of patients with CSU. Allergic diseases and autoimmune diseases are more common in CSU patients than in general populations. To assess the severity of urticaria and to adjust treatment step, urticaria activity score over 7 days, calculated by the number of wheals and the severity of pruritus, is recommended by recent international guidelines.


Subject(s)
Angioedema , Aspirin , Autoimmune Diseases , Classification , Diagnosis , Hot Temperature , Humans , Pruritus , Quality of Life , Skin Tests , Sunlight , Urticaria
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