Chronic allergic-like dermatopathies in nickel-sensitive patients. Results of dietary restrictions and challenge with nickel salts.

Nickel frequently contaminates foods. In sensitized patients, dietary nickel can cause a relapse of contact eczema and also widespread chronic dermatopathies quite similar to those triggered by authentic food allergy (IgE-mediated), from atopic dermatitis to chronic urticaria with angioedema. The present study was intended to evaluate the the results of an elimination diet and of the oral challenge test with nickel salts in a population of adults suffering from chronic urticaria or angioedema, pruritus or atopic dermatitis, and concomitant contract sensitization to nickel salts. The study involved a population of adult patients (112 subjects, 106 women and 6 men, aged from 16 to 58, mean age 29 +/- 10) with widespread allergic-like dermatopathies and contact sensitization to nickel salts (positive patch test). All of these subjects were prescribed a low nickel diet for four weeks. The patients who recovered or whose clinical manifestations greatly improved underwent an oral double-blind, placebo-controlled challenge: they were administered two successive, noncumulative doses of 10 and 20 mg nickel sulphate hexahydrate, respectively equal to 2.23 and 4.47 mg of elemental nickel. A search for specific IgE and the check on skin reactivity by skin-prick test against nickel were carried out in the patients who had shown particularly severe reactions after the oral challenge. A low nickel diet was effective in controlling the symptoms in 44 patients (39.28%, among whom there was one man). The oral double-blind, placebo-controlled challenge test was positive in all the patients who had favourably responded to the elimination diet, except one. In the patients with anaphylactoid reactions on the oral challenge, skin-prick tests were negative and no serum-specific IgE antibodies against nickel were found. Such findings appear to demonstrate that, in some patients with concomitant contact allergy, intolerance to ingested nickel salts might be the real cause of the onset and perpetuation of widespread, chronic, allergic-type dermatopathies.

[Chronic generalized skin diseases caused by food intolerance to nickel salts]. / Dermatopatie croniche generalizzate da intolleranza alimentare ai sali di nichel.

A group of patients with a patch-test positive to nickel sulphate, was selected within a population suffering from pseudo-allergic chronic cutaneous manifestations. On the ground of the results of dietary restriction and oral challenge, the Authors reach the conclusion that the intolerance to nickel salts is to be considered in these patients the mayor factor in the development of skin disorders.

[Irritable colon syndrome in intolerance to food additives]. / La sindrome del colon irritabile nelle intolleranze agli additivi alimentari.

The rate of the irritable bowel syndrome (IBS) and the follow-up of its symptoms on diet and in therapy with disodium cromoglycate have been studied in a group of patients suffering from mainly extra-digestive symptoms related to food intolerance. Following our observation, we can draw the conclusion that food additives intolerance may be a major factor in the pathogenesis of IBS.

[Epidemiological investigations among the viral hepatitis contact in a close children collectivity]. / Investigatii epidemiologice printre contactii de hepatita virala dintr-o colectivitate închisa de copii.

The results of the clinico-epidemiological and laboratory (TGP, tymol and HBsAg) investigations carried out in 164 contacts of an icteric case of viral hepatitis from a creche type children collectivity are presented. A wide spread of the infection, expressed by subclinical forms of disease identified on the basis of the alterations of TGP and their dynamics (27.4%) was pointed out. The increased incidence of HBsAg carriers and the correlation with the TGP increased values allowed the conclusion that the infection was caused by the hepatitis virus type B. The epidemiological investigation established that the infection was transmitted by direct contact favoured by children's close physical contact.