ABSTRACT
BACKGROUND: Immunotherapy in elderly patients is controversial, and there is still no evidence supporting this treatment's safety and efficacy in this population. This study was performed to evaluate the safety and efficacy of specific sublingual immunotherapy for house dust mite (HDM) allergens in patients over 60 years of age with allergic rhinitis and a confirmed allergy to HDM. OBJECTIVE: This study sought to assess nasal symptoms during HDM season, reduce medication use and monitor for adverse reactions during immunotherapy. METHODS: One hundred and eleven 60- to 75-year-old patients with allergic rhinitis and a confirmed Dermatophagoides pteronyssinus and Dermatophagoides farinae allergy were included in the study. The patients were individually randomized to active or placebo groups using a double-blind method (NCTO01605760 ClinicalTrials.gov). A total of 51 subjects in the sublingual allergen-specific immunotherapy (SLIT) group (Staloral 300R, Stallergenes, France) and 57 subjects in the placebo group were monitored for 3 years. RESULTS: Forty-seven patients completed 3 years of SLIT, and 48 subjects finished the placebo treatment in the same time period. The total nasal symptom score decreased by 44% in the active group and 6% in the placebo group after 3 years of SLIT. This difference was only significant in the active group (P < 0.05). At the end of therapy, the total medication score of the active group decreased significantly by a maximum of 51% (P < 0.05), whereas the total medication score of the placebo control group showed an insignificant decrease (P = 0.56). There were no systemic adverse reactions during the study. CONCLUSIONS & CLINICAL RELEVANCE: Sublingual allergen-specific immunotherapy in elderly patients with a HDM allergy to D. pteronyssinus and D. farinae generated a significant clinical improvement in the active group compared with the placebo group, particularly during the heating season. This therapy was well tolerated.
Subject(s)
Antigens, Dermatophagoides/immunology , Desensitization, Immunologic , Pyroglyphidae/immunology , Rhinitis, Allergic, Perennial/immunology , Rhinitis, Allergic, Perennial/therapy , Administration, Sublingual , Aged , Animals , Antigens, Dermatophagoides/administration & dosage , Desensitization, Immunologic/adverse effects , Female , Humans , Male , Middle Aged , Nasal Provocation Tests , Rhinitis, Allergic , Rhinitis, Allergic, Perennial/diagnosis , Treatment OutcomeABSTRACT
In this study the serum calcitonin concentrations were assessed in patients with Psoriasis vulgaris. The results were compared with healthy volunteers. The serum calcitonin levels of psoriatic patients was significantly increased than in healthy volunteers.
Subject(s)
Calcium/blood , Psoriasis/blood , Adult , Humans , Male , Middle AgedABSTRACT
A case of rare form of colliquative tuberculosis in a 58-year old man is presented. The preliminary diagnosis was made on the basis of clinical observation. Confirmation was achieved after obtaining a significant improvement of the general and local condition as a positive results after antituberculous therapy.
Subject(s)
Antitubercular Agents/therapeutic use , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Humans , Male , Middle AgedABSTRACT
A 63-year old patient who had suffered from mild lymphomatoid papulosis with periods of relapse and spontaneous remissions is presented. After 23 years of that chronic dermatosis he developed a malignant lymphoma covering skin, lymph nodes and internal organs, which was confirmed by histopathological examination. Despite intensive chemo and X-ray therapy the patient died. The importance of continuous follow-up of usually benign lymphomatoid papulosis is stressed.
