Anaphylaxis to Agaricus bisporus ingestion / Anafilaxia por ingestão de Agaricus bisporus

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.

A experiência em grupo: buscando formas alternativas à punição / A group experiment: searching for alternatives to punishment

Based on data collection from the research entitled "Psychosocial analysis of children living on the streets of Ipatinga", (unpublished), together with the project at the "Community Garden" was perceived the emerging demand to study about the different forms of family violence. Gathering information with project monitors as well as with the children about their abuse, this speculation was confirmed. The children were being target of many forms of abuse, including physical punishment by the family members, mainly by their mothers, under the influence of drug abuse. In relation to physical punishment, the situation aggravates when mothers see no other alternatives to deal with quotidian pressures and education methods to deal with their children. Thinking about this problem, professionals of this program decided to develop simultaneous study to evaluate the different forms of conflict between mothers and children. Through the formation of mothers' group meeting every two weeks, the authors proposed discussions of problems to enable them find other methods of correcting their children as well as encourage them to talk about ways to solve their socialûeconomic problems. The results show that violence can not be analyzed only by the physical action, but rather by interrelating the mothers' life history and the ways society produces mechanisms of controlling coercive activities...

A história de vida como precursora da violência doméstica / Personal background as a precursor of domestic violence

This work relates the experience of therapeutic group with twelve mothers between 28 to 60 years of age, living in the periphery of Ipatinga, Minas Gerais, working part time or in prostitution. The result of this study reveals a history of actual family violence, similar to their past family situation. Even though these data correspond to past situations, they are useful to develop ideas and alternatives for therapeutic interventions and promote to this group awareness about their life history and present situations...