Subject(s)
Status Asthmaticus , Adrenal Cortex Hormones/therapeutic use , Adrenergic beta-Agonists/therapeutic use , Bronchodilator Agents/therapeutic use , Humans , Oxygen/therapeutic use , Physical Examination , Status Asthmaticus/diagnosis , Status Asthmaticus/drug therapy , Status Asthmaticus/etiology , Xanthines/therapeutic useSubject(s)
Allergens , Hypersensitivity/etiology , Animals , Bee Venoms , Fungi , Humans , Mites , Pollen , Wasp VenomsABSTRACT
This is a report of 46 employees exposed to trimellitic anhydride (TMA). The evaluation consisted primarily of periodic serum antibody studies and a questionnaire that identified symptoms compatible with allergic asthma and/or rhinitis, late respiratory systemic syndrome (LRSS), or pulmonary disease anemia (PDA) syndrome. Industrial hygiene data from the plant in 1989 reported exposures that were lower than levels in 1979. Seven employees had positive IgE antibody against trimellityl-human serum albumin (TM-HSA); one had TMA rhinitis, and another possibly had TMA asthma/rhinitis. Fourteen employees had positive IgG antibody against TM-HSA of whom only three had titers high enough to cause disease, and none of them had symptoms compatible with LRSS or PDA. At most, two workers had asthma or rhinitis during the 1990 evaluation. In summary, in this employee population with low level TMA exposure there is a low incidence of immunologically mediated disease due to TMA.
Subject(s)
Occupational Diseases/chemically induced , Phthalic Anhydrides/adverse effects , Respiratory Hypersensitivity/chemically induced , Adult , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin E/analysis , Immunoglobulin G/analysis , Incidence , Male , Middle Aged , Occupational Exposure/analysis , Occupational Health , Phthalic Anhydrides/analysis , United StatesABSTRACT
To confirm that corticosteroids are beneficial in the treatment of Stevens-Johnson syndrome (SJS), 15 patients with the syndrome were evaluated by the same group of physicians over 2 years. All patients had cutaneous and most had mucosal lesions. Patients were treated with corticosteroids ranging from prednisone 40 mg daily to methylprednisolone 750 mg daily. The same group of physicians participated in the management of these patients until recovery. No deaths occurred among the 15 patients. Recovery was complete in all cases, and there was no residual skin, mucosal, or visceral damage except for minimal scarring in one patient. In some cases, reversal of disease after onset of corticosteroid therapy was sufficiently dramatic to demonstrate a benefit. The use of corticosteroids in the treatment of SJS remains controversial. We conclude that corticosteroids are beneficial in treatment of the syndrome. They may be lifesaving in some patients and should be the standard of therapy. SJS should be considered to be erythema multiforme with either bullous lesions or visceral involvement or both.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Stevens-Johnson Syndrome/drug therapy , Adrenal Cortex Hormones/adverse effects , Adult , Aged , Female , Humans , Male , Middle Aged , Recurrence , Stevens-Johnson Syndrome/pathologyABSTRACT
A case of anaphylaxis is reported after IUI with sperm processed in Tyrode's solution supplemented with BSA. The patient had a positive prick cutaneous test to BSA and also had specific IgE antibody against it. Repeat IUI using the patient's own blood serum instead of BSA for processing the sperm proceeded without incident. Clinicians should be aware of this rare, but not inconsequential, adverse effect of using xenogeneic proteins during IUI and other assisted reproductive techniques.
