Clinical Characteristics and Management of Angioedema Attacks in Polish Adult Patients with Hereditary Angioedema Due to C1-Inhibitor Deficiency.

Hereditary angioedema (HAE) due to C1-inhibitor (C1-INH) deficiency is a rare disease characterized by recurrent swellings. This study aims to determine (i) the clinical characteristics of the HAE patient population from Poland, and (ii) real-life patients' treatment practices. A cross-sectional study involved 138 adult HAE patients (88 females, 50 males) treated in six regional HAE centers in Poland. Consecutive patients during routine follow-up visits underwent a structured medical interview on the clinical characteristics of the course and treatment of HAE attacks within the last six months. A total of 118 of 138 patients was symptomatic. They reported in total 2835 HAE attacks predominantly peripheral and abdominal, treated with plasma-derived C1-INH (61.4%), icatibant (36.7%) and recombinant C1-INH (1.9%). An amount of 116 patients carried the rescue medication with them while traveling, and 74 patients self-administrated on demand treatment. There were twice as many symptomatic women (n = 78) as there were men (n = 40). Women treated their HAE attacks significantly more often than men. Older patients (≥65 years) reported a longer delay in diagnosis, and practiced the self-administration of rescue medication less frequently in comparison to other patients. Clinical features of the surveyed population are similar to other European, but not Asian, HAE patient groups. Self-administration still remains an unmet medical need. Some distinct HAE patients may require special attention due to the severe course of the disease (females) or a delay in diagnosis (the elderly).

Allergic phenotypes in adult patients with atopic dermatitis, determined with the ISAC test (ImmunoCAP ISAC).

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory dermatosis, often with a concomitant allergy. The ImmunoCAP ISAC (Immuno Solid-Phase Allergen Chip) test is a novel method to determine the allergenic phenotype in a given patient. AIM: In this study, we used the ImmunoCAP ISAC test to analyze allergic phenotypes in adult patients with AD. MATERIAL AND METHODS: The study included 19 adult patients with AD. The severity of AD was assessed using SCORAD index. Serum concentrations of total IgE were determined by means fluoro-enzyme immunoassay (FEIA). The levels of asIgE were measured with the ImmunoCAP ISAC kits. RESULTS: Positive results of the ISAC test were documented in 84.2% of the study subjects. All patients synthesized asIgE against species-specific respiratory allergens; major components of animal allergens (57.87%), tree pollen allergens (47.3%), grass pollen allergens (42.1%), dust mite allergens (26.3%) and major allergen of mugwort (26.3%). 47.3% of the subjects were sensitive to cross-reactive allergenic components, most often proteins of the lipocalin family (57.8%), followed by PR-10 (26.3%), PR-14 (21%) and PR-5 proteins (21%). asIgE against species-specific allergens were found in 10.5% of the study subjects. No statistically significant relationships were observed between the severity or duration of AD and the prevalence and levels of asIgE against the allergens included in the ISAC panel. However, duration of AD correlated significantly with the serum concentration of total IgE. CONCLUSIONS: The ISAC test is suitable for determination of the allergenic phenotype in a given patient, and as such has an unquestioned diagnostic and therapeutic value.

Role of immunoglobulin G antibodies in diagnosis of food allergy.

This paper presents current views on the role of immunoglobulin G (IgG) antibodies in the reactions with food antigens in the digestive tract and their role in the diagnosis of food allergy based on the assays of specific IgG class antibodies, with a special focus on contemporary practice guidelines. In the light of current scientific knowledge, the IgG-specific antibody-mediated reactions are a body's natural and normal defensive reactions to infiltrating food antigens, which are considered as pathogens. On the other hand, specific IgG antibodies against food allergens play a crucial role in the induction and maintaining of immunological tolerance to food antigens. The statements of many scientific societies stress that sIgG are of no significant importance in the diagnosis of food allergy since their presence is associated with a normal immune response to food allergens and attests to a protracted exposure to food antigens.

[Food hypersensitivity in patients with pollen allergy].

Clinical observations indicate the frequently reported food hypersensitivity among patients, sensitive to airborne allergens. Symptoms of food hypersensitivity in this group of patients are often exacerbated during the pollen season. These reactions may be the results of cross-reactions between pollen and food allergens or food and pollen allergy coexisting. The aim of the study was to determine the incidence of food hypersensitivity in patients allergic to airborne allergens, the type of clinical manifestations and a kind of food frequently causing the symptoms. Retrospective analyses of case records of 55 randomly selected patients with airborne allergy aged from 18 to 72 yrs (mean 55 yrs), including 28 women ranging in age from 18 years to 62 yrs (mean 36 yrs) and 27 men aged from 18 to 72 yrs (mean 34 yrs) were carried out. All patients underwent skin prick tests with the following allergens: grass, rye, birch, alder, hazel, mugwort, plantain, Dermatophagoides farinae, Dermatophagoides pteronyssinus, skin dog, cat dander, Alternaria alternata, Cladosporium herbarum. We assessed the type of clinical manifestations of pollen allergy and evaluated the type of clinical manifestations of food hypersensitivity and the type of foods that caused it. In the examined 55 patients, 15 individuals reported food hypersensitivity (27.2%), the most frequently after consumption of apples, carrots, cherry, peach, hazelnut, walnut, celery and nectarines. Clinical manifestation of food hypersensitivity was mainly oral allergy syndrome (OAS). Hypersensitivity to food above all was reported by patients with allergic rhinitis, sensitive to grass and tree pollen. Due to the high prevalence of food hypersensitivity in patients allergic to airborne allergens, it seems advisable to consider avoiding eating some foods, such as apple, carrots, cherries, peach, particularly frequently cross-reacting with grass and trees allergens. This dietary restriction can prevent about 30% of patients with inhalant allergy against onset of oral allergy.

Stevens Johnson syndrome after carbamazepine and SJS/TEN overlap syndrome after amoxicillin: case reports and a review.

We present a case of Stevens Johnson syndrome in a child after carbamazepine application and Stevens Johnson/TEN overlap syndrome in an adult after amoxicillin application. On the basis of two reported cases we review the most commonly associated drugs, the postulated pathogenesis, clinical manifestation and management in these severe life-threatening diseases. We especially discuss the controversial systemic corticosteroid therapy. Topical care is also discussed.

[Cosmetic allergy]. / Alergia na kosmetyki.

Cosmetics are substances or mixtures for an external contact with a human body: their skin, hair, lips, nails, external sex organs, teeth and mucous membranes of an oral cavity. The only or main aim of cosmetics is to keep the body clean, take care of it, protect, perfume as well as groom it. Since the products are supposed to be safe and well-tolerated, they tend to cause side effects, for instance irritation or allergy. This is mainly due to scented substances as well as preservatives which are included in cosmetics.