Anaphylaxis triggered by prick test with latex extract: a case report

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.

Evaluation of dental material series from patients with dental prostheses and suspicion of delayed hypersensitivity

Abstract: BACKGROUND: Patients with oral sensitivity are common in our practice. Allergic contact dermatitis is one of the most frequent etiologies. OBJECTIVES: Evaluate oral contact dermatitis using the Brazilian standard series and complementary dental series in patients using dental prostheses, with or without oral complaints. Determine specific dental Brazilian series. METHODS: Patients using dental prostheses with or without oral complaints realized patch tests. Brazilian standard series and complementary dental series were used according to ICDRG recommendations. The results were analysed according to age, sex, race, atopic conditions and symptoms associated. RESULTS: From 54 patients tested, 34 (63%) were positive at least to one substance. Nineteen had oral complaints, such as burning mouth, itch or oral erythema. There was no association between atopic condition and tests results. Without the oral series, just 23(42,6%) patients had a positive result. Using the Brazilian standard series with the complementary dental series we improved the positivity of the patch test to 47%. CONCLUSION: In patients using prostheses and with oral complaints, patch tests with Brazilian standard series with complementary dental series improve the tests positivity.

Avaliação do teste de contato com aeroalérgenos em pacientes com dermatite atópica / Evaluation of patch test with airbone allergic agents in patients with atopic dermatitis

FUNDAMENTOS: a dermatite atópica é uma doença inflamatória cutânea que apresenta múltiplos fatores desencadeantes. Há vários relatos de autores que confirmaram os aeroalérgenos como fatores agravantes ou desencadeantes. O teste de contato com aeroalérgenos ou teste de contato atópico foi proposto para avaliar a participação destes alérgenos na dermatite atópica. OBJETIVO: objetivo deste estudo foi avaliar a positividade do teste de contato atópico em pacientes com dermatite atópica. MÉTODOS: Avaliamos 50 pacientes com dermatite atópica e 45 do grupo com rinite alérgica, nos quais realizamos teste de contato atópico com extratos de Dermatophagoides pteronissynus, Dermatophagoides farinae e Blomia tropicalis, além de testes cutâneos de leitura imediata para os mesmos alérgenos, acrescidos de epitélio de cão e gato e fungos. RESULTADOS: verificamos que o teste de contato atópico com ácaros apresentou maior positividade nos indivíduos do grupo de dermatite atópica quando comparado ao grupo de rinite alérgica. CONCLUSÕES: o teste de contato atópico apresenta resultados estatisticamente significativos quando realizado com ácaros, em pacientes com dermatite atópica, com p=0,035, OR (odds ratio) = 3,35 e IC(95 por cento) = [ 1,18; 9,47].

BACKGROUND: Atopic dermatitis is an inflammatory skin disease that can be triggered by many factors. Several reports confirm the role of airborne allergic agents as aggravating or triggering factors. The patch test with airborne allergic agents or the atopy patch test was suggested to evaluate the role of these allergens in atopic dermatitis. OBJECTIVE: This study aimed at evaluating the positivity of the atopy patch test in patients with atopic dermatitis. METHODS: We evaluated 50 patients with atopic dermatitis and 45 with allergic rhinitis, the atopy patch test was performed in these patiennts with extracts of Dermatophagoides pteronissynus, Dermatophagoides farinae and Blomia tropicalis, as well as immediate skin prick tests for the same allergens with cat and dog epithelia and fungi. RESULTS: It was found that the atopy patch test with dust mites showed higher positivity in individuals with atopic dermatitis when compared to those with allergic rhinitis. CONCLUSIONS: The atopy patch test shows statistically significant results when performed with dust mites in patients with atopic dermatitis, p = 0.035, odds ratio (OR) = 3.35 and CI (95 percent) = [1.18, 9, 47].

Anafilaxia induzida por farinha de trigocontaminada por ácaros / Dust mite-contaminated wheat tiour induced anaphylaxis

Objetivo: Documentar o segundo caso brasileiro de alergia oral acarina com anafilaxia e o primeiro relato envolvendo farinha de trigo contaminada, neste caso com o ácaro de estocagem Aleuroglyphus ovatus.Métodos: Análise investigativa para ácaros através da microscopia ótica, utilizando características taxonômicas, de amostras da farinha de trigo contaminada, utilizada na preparaçãode empadas, associada ao quadro de anafilaxia apresentado.Resultados: Presença do ácaro de estocagem Aleuroglyphus ovatus na farinha de trigo (300 ácaros por grama de farinha), associada ao quadro de anafilaxia.Conclusões: É apresentado um caso grave de anafilaxia oral acarina após a ingestão de empada preparada com farinha de trigo contaminada com o ácaro de estocagem Aleuroglyphusovatus. A paciente apresentava alergia respiratória (asma e rinite) aos ácaros da poeira de casa (Dermatophagoides farinae, Dermatophagoides pteronyssinus, Blomia tropicalis e Lépidoglyphus destructor), desenvolvendo anafilaxia imediatamenteapós a primeira mordida desta empada de elaboração caseira. Apresentava também idiossincrasia com aspirina, antiinflamatórios não-esteroidais e pirazolonas (angioedema facial e edemade glote). Reações antigênicas cruzadas entre os vários ácaros domésticos estão muito bem documentadas. Toda farinhade trigo ou de outros grãos deverá ser sempre armazenada congelada, e depois constantemente refrigerada, para evitara proliferação de ácaros.

Objective: To document the second Brazilian case of oral mite allergy with anaphylaxis and the first report involving contaminated wheat flour, in this particular case with the storagemite Aleuroglyphus ovatus.Methods: Analysis for mites of the wheat flour samples, used to prepare pancakes, associated with the anaphylactic reaction through light microscopy using taxonomic keys.Results: Presence of the storage mite Aleuroglyphus ovatus in the wheat flour (total of 300 Aleuroglyphus ovatus mites per gram of flour), that triggered the anaphylactic reaction.Conclusions: It is presented a case of severe oral mite anaphylaxis following the ingestion of a pancake made ofwheat flour contaminated with the storage mite Aleuroglyphus ovatus. This patient has house dust mite allergic asthma and rhinitis (Dermatophagoides farinae, Dermatophagoides pteronyssinus, Blomia tropicalis and Lepidoglyphus destructor), anddeveloped anaphylaxis immediately after the first bite of this home made pancake. 5he also presented intolerance to aspírin, non steroidal anti-inflammatory drugs and pyrazolones(facial angioedema and laryngeal edema). Antigenic cross reactions among several domestic mites are well documented. Ali grain flours including the ones obtained from wheat shouldalways be stored frozen followed by constant refrigeration, in order to prevent mite proliferation.