Retention of airborne latex particles by a bacterial and viral filter used in anaesthesia apparatus.

We have developed a series of laboratory tests to evaluate the efficiency of a heat and moisture exchanger filter (Pall BB25) in retaining latex particles in order to protect allergic patients during anaesthesia. Latex particles were nebulised with cornstarch as a support and collected for assay in a flask, with or without the filter integrated into the experimental circuit. With the Pall BB25 filter in the circuit, no natural latex proteins were detected by measurement of either total protein or antigenic latex proteins. The Pall BB25 filter may represent a useful means of preventing inhalation of latex particles during anaesthesia in susceptible patients.

Chronic generalized eczema caused by multiple dye sensitization.

Textile dye sensitization is rare; its low incidence (1.4% to 5.8%) is most likely because dye contact allergy is not suspected and therefore not tested. The greatest number of positive test results are obtained for disperse dyes. We report an uncommon observation of severe and chronic textile dye dermatitis with positive patch test results to Disperse Blue 106, Disperse Blue 124, Disperse Brown 1, Disperse Yellow 3, and p-aminophenol.p-aminophenol, Disperse Blue 124, and Disperse Blue 106 are derived from p-phenylenediamine, but this allergen seems to be unreliable as a detector of textile dye allergy. The admittedly allergic capacity of disperse dyes and the increasing fabrication of synthetic fibers (acrylics and polyesters) usually colored with this group of dyes could induce more frequent textile sensitization.

The allergenic properties of fresh and preserved Hevea brasiliensis latex protein preparations.

The allergenic properties of the proteins of two lyophilized fractions of fresh natural rubber latex obtained by ultracentrifugation, the C serum and the sedimented bottom or lutoid fraction, have been compared with those of the serum proteins of two samples of high ammonia latex (HAL) [A]HALS obtained from HAL stored for more than 1 year, and [M]HALS derived from HAL stored for 6 weeks before ultracentrifugation and lyophilization. The most potent source of allergenic polypeptides both for skin prick testing of latex-sensitive patients and for immunoblots of their blood serum was the lutoid fraction of fresh latex. Skin prick tests and immunoblots of patients' sera showed that the allergenicity of the ammoniated latex decreased during storage. Skin prick tests using fractions of [A]HALS, C serum and lutoid proteins obtained after passage through a Sephacryl S300 column showed that the components of all three preparations which eluted in the largest volumes were almost equally effective in provoking the largest number of responses. Immunoblots of the sera of 43 latex-sensitive individuals showed that the majority (66%) of sera of the adult allergic patients reacted with a polypeptide of 19 kD. No characteristic pattern of binding latex polypeptides could be recognized in the sera from patients who were also asthmatic or from those who had an anaphylactic response to latex proteins.

[Toxicoderma caused by prednisone and prednisolone. Value of skin tests in the screening of cross sensitivity]. / Toxidermie à la prednisone et prednisolone. Intérêt des tests cutanés dans la recherche de réactions croisées.

INTRODUCTION: Allergic reactions to general corticosteroid therapy are uncommon. CASE REPORT: We report a patient with systemic lupus erythematousus who developed skin rash after initiation of prednisone then prednisolone therapy. Histology evidence suggested leukocytoclastic vasculitis. The skin tests (prick tests, intradermoreactions and patch-tests) using a battery of injectable corticosteroids showed a highly positive reaction to prednisolone, methylprednisolone and dexamethasone on the intradermo-reactions 24 hours later. Histology examination of a positive-response showed leukocytoclastic vasculitis associated with eczematiform alterations of the epidermis compatible with a drug reaction. The skin tests however were negative for betamethasone, triamcinolone, paramethasone and hydrocorticose. The patient was treated with betamethasone and no skin reaction was observed. DISCUSSION: Skin tests, particularly intradermo-reactions read 24 hours later would appear to be useful in identifying possible cross-sensitivity.

[Practical aspects of leukotriene E4 determination in urine]. / Aspects pratiques du dosage du leucotriène E4 dans les urines.

Leukotrienes constitute a class of potent biological mediators of inflammation and anaphylaxis. However, their routine assay in various biological fluids is restricted by the complexity of the methodology. Previously this could only be performed by research laboratories with high pressure liquid chromatography and radioimmunological capabilities. The recent availability of kits for immunoenzymatic assay of leukotrienes offers a new tool for clinical laboratories provided the limitations of the method are understood. We suggest a simplified methodology for direct urinary LTE4 detection and outline a number of areas of concern encountered with this method.

[Why are some allergens enzymes?]. / Pourquoi certains allergènes sont-ils des enzymes?

In the last ten years, progress in the field of allergy research has led to the purification of some of the major allergens and to a better knowledge of their physico-chemical properties. A number of studies have shown that some allergens have enzymatic activities. Molecular biology has provided the means to clone and sequence genes encoding these allergens and to produce recombinant allergens in yeast and bacteria. Epitope mapping of natural and synthetic allergens, using polyclonal or monoclonal antibodies and cell-stimulation tests, has also contributed greatly to the understanding of their immunogenicity and allergenicity. Analysis of these new data allow us to explain why some allergens are enzymes.

Serum sickness with acquired precipitating antibodies during rush immunotherapy (2 cases).

Serum sickness can be induced by several heterologous proteins. Two patients undergoing rush immunotherapy developed clinical symptoms of serum sickness. One patient received a mite and grass pollens mixture and the second patient a wasp and yellow-jacket venoms mixture. Precipitating antibodies against some allergens used for immunotherapy were found in their serum during the disease but not in the sera drawn before immunotherapy and two and three months after. Pathologic findings showed a leukocytoclastic vasculitis. Pathogenesis of this complication is discussed.

[Total serum IgE: normal pediatric values using the FAST IgE fluoroimmunoenzymatic technic]. / IgE totales sériques: valeurs usuelles en pédiatrie par la technique fluoro-immuno-enzymatique IgE FAST.

This reports covers the application to paediatrics of total IgE determination by the means of a new direct, sandwich type, fluorescence enzyme immuno-assay (Fluoro-allergo sorbent test:FAST IgE). The technical process is adapted for usual determinations, in case of infants and young children, of low normal rates with a good sensitivity, and of high pathological rates. IgE total usual values are established by the FAST IgE test from serums of healthy children, aged from one day to 14 years. Seven age groups are to be distinguished.

[Correlation between serum IgE level and human basophil degranulation by anti-IgE antibodies]. / Corrélation entre le taux d'IgE sériques et la dégranulation des basophiles humains par les anticorps anti-IgE.

The human basophil degranulation test (HBDT) by anti-IgE antibodies was applied in 3 groups of subjects: 20 controls, 26 patients with helminthiasis and 28 allergic patients. Mean degranulation was higher in patients with helminthiasis than in the two other groups. A correlation was found between IgE serum level and HBDT results by anti-IgE (r = 0.373; p less than 0.02) with Spearman's rank correlation test. Therefore, degranulation with anti-IgE antibodies would appear to depend on the quantity of cell-bound IgE rather than on intrinsic basophil sensitivity.