Anaphylaxis: lesson learned from five cases.

Anaphylaxis is a severe hypersensitivity reaction. Its clinical manifestations vary, affecting several organs at once. Skin symptom is the most frequent manifestation; however, diagnosis of anaphylaxis will only be established when involving one or both vital organs, which are cardiovascular and respiratory system. Other symptom, such as that involving central nervous system or gastrointestinal tract, may accompany. We present five cases of anaphylaxis which vary in onset of symptoms, allergen, degree of severity, therapeutic response and clinical manifestation. Anaphylactic reaction to drugs in these cases is mainly manifested as anaphylactic shock and reaction to food allergen causing obstruction of respiratory tract. Four anaphylactic events occurred at home and only one occurred in a hospital, thus education on anaphylaxis to general community is very important, especially for the patients and their families. Prompt medical assistance in patients with anaphylactic symptoms determines their therapeutic response. Skin test prior to administration of cephalosporin does not give negative predictive value toward anaphylactic event.

House dust mite allergen level and allergen sensitization as risk factors for asthma among student in Central Jakarta.

This study is a community-based study to get an overview about House Dust Mite (HDM) allergen level, allergen sensitization as risk factors of asthma. This is a cross-sectional study on 3,840 students from 19 junior high schools, aged 13-14 years. All of the respondents filled out the International Study on Asthma and Allergy in Children (ISAAC) questionnaire. Of 3840 respondents, 288 (7.5%) were assigned to asthma group (experience wheezing during the last 12 months). The skin prick test was performed on 207 respondents and the house dust mite was collected from 135 respondents. Of 2601 respondents in non-asthma group, the skin prick test was randomly performed on 274 respondents and the house dust mite was collected from 165 respondents. There is no significant difference on HDM allergen concentration for Der p1, Der f1 or Group I between asthma and control group. The risk of asthma was caused especially by sen D.pteronyssinus (crude odds ration (OR): 12.68, 95% confidence interval (CI): 7.50-21.44), D.farinae (OR: 10.50, CI: 6.35-17.34) and cockroach allergen (OR:5.57, CI:3.44-9.01). The risk for asthma was not correlated with the level of house dust mite allergens but its sensitization. In conclusion, sensitization to HDM and cockroach allergen should be concerned in order to reduce risk and prevalence of asthma.

Latex allergen sensitization due to glove use among hospital staff in Jakarta and related factors.

AIM: To know whether latex sensitization risk among nurses is higher than among administration staff and whether latex sensitization risk among operating room nurses is higher than among ward room nurses and also whether there is a correlation between sensitization and sex, age, duration-frequency of exposure, smoking, or atopic status. METHODS: A cross-sectional study has been conducted in 830 persons from 6 hospitals in Jakarta consisting of 271 operating room nurses, 287 ward room nurses, and 272 administration staff. Subjects completed a guided questionnaire to determine the subject's age, sex, work setting, duration and frequency of exposure or smoking habits and then the subjects underwent an allergy skin prick test with allergens Der p, Der f, Fel d and latex to determine atopic status and latex sensitization. RESULTS: The proportion of latex sensitization among nurses was 6.1% and among administration staff 1.5%; there was a significant difference (p=0.002). The proportion between operating room nurses was 6.3% and among ward room nurses 5.9%; there was no significant difference (p=0.974). There was a significant correlation between sensitization and mild or severe exposure or atopic status, but no significant correlation between sensitization and sex, age, duration of exposure, or smoking. CONCLUSION: The risk of latex sensitization among nurses is higher than among administration staff, but the risk among operating room nurses was similar to ward room nurses. Atopic status and frequency of exposure were both associated with latex sensitization.