Serum sickness-like illness associated with rifampicin.

We describe a patient with human immunodeficiency virus infection who developed the main clinical features of a serum sickness reaction while receiving treatment with daily therapeutic doses of tuberculostatic drugs. A decrease in complement titers as well as a detection of significant levels of circulating immune complexes were observed. A positive skin test result was observed six hours after an intradermal test with rifampicin. No immunoglobulin or complement deposition was observed by direct immunofluorescence of a punch biopsy specimen from the cutaneous lesion.

Pistachio nut hypersensitivity: identification of pistachio nut allergens.

Type I hypersensitivity to pistachio nut antigens was demonstrated in three patients by means of immediate skin-test reactivity, specific IgE determination by a fluoroimmunoassay (CAP), CAP-inhibition and leucocyte histamine release. Sensitization to other dried fruits and pollens was observed in the patients. The CAP-inhibition studies revealed significant crossreactivity between pistachio and cashew nut belonging to the Anacardiaceae family, and between pistachio nut and other dried fruits belonging to taxonomically unrelated botanical families. No relevant crossallergenicity was observed between pistachio nut and Lolium and Olea pollens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of a pistachio nut extract followed by immunoblotting analysis identified four IgE-binding bands with molecular weights of 34, 41, 52 and 60 kD.

Bronchial asthma caused by two unrelated vegetables.

Vegetable-induced asthma is an uncommon hazard. We report an atopic housewife, in whom rhinoconjunctivitis and acute asthma were associated with two vegetables of taxonomically unrelated botanical families (Swiss chard/Chenopodiaceae family and green beans/legume family). Type I hypersensitivity to the antigens in Swiss chard and green beans was demonstrated by means of skin tests, histamine release test, and specific IgE determination by RAST. Bronchial responses after specific bronchial challenges indicated that Swiss chard and green beans might be the causative factor for the acute asthma.

Occupational asthma in a hairdresser caused by persulphate salts.

Persulphate salts, which are common constituents of hair bleaches, have occasionally been reported to cause occupational asthma in hairdressers. We describe the clinical and immunological studies carried out in a hairdresser who developed cutaneous and respiratory symptoms, about 1 year after being employed in a hairdressing salon. Skin prick tests with 1:5 w/v potassium and sodium persulphate extracts were positive in our patient at 15 min and negative in control subjects. The European standard contactans (ECDRG) and a battery of hairdressing agents were patch tested with positive result to KATHON CG (isothiazolinone). The methacholine-inhalation test showed airway hyperresponsiveness. Bronchial provocation test with a 1:50 w/v potassium persulphate extract elicited a nonimmediate asthmatic reaction, followed by recurrent nocturnal fall in FEV1 lasting up to 3 days after the test. Plethysmography results revealed air trapping caused by a marked increase of airway resistance 3 h after the specific bronchial challenge. Histamine release test was not conclusive, and the determinations of specific IgA, IgM, IgG and IgG subclasses by EIA and IgE by RAST against persulphate salts were negative.

Serum sickness-like syndrome associated with cefaclor therapy.

We describe 2 cases of paediatric patients who developed the main clinical features of a serum sickness reaction, while on treatment with cefaclor. A decrease in complement values was observed in both cases. Physicians should be aware of the possibility of such drug adverse reaction.