1/199. Cockroach allergy and asthma in a 30-year-old man.A growing body of evidence has implicated allergens derived from cockroaches as an important environmental factor that may aggravate asthma in sensitized persons. We present the case of a 30-year-old man with asthma and a cockroach allergy. Allergy skin testing confirmed hypersensitivity to cockroach extract, and a home visit revealed visual evidence of infestation and the presence of Bla g 1 German cockroach allergen in vacuumed dust. As is typical of patients with a cockroach allergy and asthma, multiple factors in addition to cockroach allergen appeared to aggravate the patient's asthma. A multimodality therapeutic regimen, which included medications as well as cleaning of the home, integrated pest management, and professional application of chemical controls, resulted in substantial clinical improvement. The pathophysiology, epidemiology, and clinical features of cockroach-allergic asthma are reviewed, and an approach to diagnosis and management is suggested.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
2/199. Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato.BACKGROUND: Potato contains multiple heat-labile proteins which can induce immediate hypersensitivity reactions. Rhino-conjunctivitis, asthma, contact urticaria and protein contact dermatitis have been described in association with potato exposure. OBJECTIVE: A patient with possible airborne facial dermatitis to potato is described. RESULTS: A middle-aged atopic housewife with pre-existent atopic dermatitis suffered from rhino-conjunctivitis, asthma, and contact urticaria when pealing raw potatoes, but her main complaint was intense, treatment-resistant dermatitis of the face. The investigations showed a positive prick test, a positive patch test, and positive specific serum IgE to raw potato. Potato avoidance led not only to the resolution of the immediate symptoms, but also of the facial dermatitis, suggesting she had dermatitis due to this vegetable. CONCLUSIONS: Potato may induce contact dermatitis with positive immediate and delayed hypersensitivity tests.- - - - - - - - - - ranking = 2keywords = sensitivity (Clic here for more details about this article) |
3/199. asthma due to inhaled chemical agents--fumes from 'Multicore' soldering flux and colophony resin.Four patients with occupational asthma associated with exposure to soldering flux or hot-melt glue containing pine resin (colophony) were subjected to occupational type inhalation challenge testing. All four gave immediate bronchial reactions to inhalation of the fumes, varying from one breath to 3 min of exposure. The clinical history and provocation test reactions suggest hypersensitivity to colophony fumes.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
4/199. Detection of activated eosinophils in nasal polyps of an aspirin-induced asthma patient.aspirin-induced asthma (AIA) is frequently accompanied by nasal polyps. Eosinophil infiltration is a characteristic feature of nasal polyps associated with AIA. Even though steroids are well known to be effective on managing AIA and its nasal polyps, histochemical examinations after steroid therapy and at recurrence, involving eosinophil infiltration of nasal polyps, have been less studied. To know the histochemical effects of steroid treatment on eosinophil accumulation in nasal polyps of AIA and the histochemical feature of a recurring polyp and to detect distributional differences between storage and secreted forms of eosinophil cationic proteins, we carried out immunocytochemical labelling with antibodies against EGI (recognizing resting and activated eosinophils) and EG2 (recognizing only activated eosinophils), and determined eosinophil infiltration in nasal polyps that were obtained before and after steroid treatment, and at recurrence of polyps. A large number of eosinophils in AIA polyps were found before steroid treatment and at recurrence, and they were predominantly composed of activated eosinophils (EG2-positive). In contrast, eosinophil infiltration was rare in polyps obtained immediately after steroid treatment. This finding suggests that eosinophil infiltration may be associated with nasal polyp formation in AIA, and that activation of eosinophils plays an important role in accumulation of eosinophils and polyp formation beginning with the initial stage.- - - - - - - - - - ranking = 0.00756887306977keywords = contrast (Clic here for more details about this article) |
5/199. Occupational asthma caused by champignon flies.BACKGROUND: Occupational bronchial asthma in mushroom (champignon) workers is unusual, although reports on it appeared in 1938 and 1951; we have not found any others since those dates. Here we report the case of a 52-year-old man who works as a champignon cultivator. He suffered rhinoconjunctivitis and asthma attacks whenever he entered the champignon culture caves. We studied flies as a possible antigen source. We collected these insects from the growing sites in order to identify them, and then prepare an extract; the samples turned out to be of two families of insects of the order diptera, 98% from the Phoridae family (Brachycera suborder) and 2% from the Sciaridae (Nematocera suborder). methods: skin prick tests, conjunctival provocation tests, serum specific IgE, specific IgE-binding fractions in immunoblotting, and monitoring of PEFR (at work and off work) were performed. RESULTS: IgE-mediated hypersensitivity to these flies was demonstrated by skin prick test, conjunctival provocation test, serum specific IgE, and IgE-binding fractions in immunoblotting. Monitoring of PEFR both at work and off work showed a clear relationship between symptoms, or fall in PEFR, and the workplace. CONCLUSIONS: We report the case of a patient suffering from asthma and rhinoconjunctivitis caused by hypersensitivity to fly proteins.- - - - - - - - - - ranking = 2keywords = sensitivity (Clic here for more details about this article) |
6/199. aspirin sensitivity: the role for aspirin challenge and desensitization in postmyocardial infarction patients.aspirin is one of the world's most commonly used medications and its use benefits many diverse conditions. Adverse reactions, however, are relatively common as well. hypersensitivity to aspirin can be manifested as acute asthma, urticaria and/or angioedema, or a systemic anaphylactoid reaction. We report 3 cases in whom aspirin was indicated for secondary prophylaxis of myocardial infarction but in whom a remote history of an untoward reaction to it prevented its initial use. These patients all underwent further evaluation of their pulmonary and allergic history and all 3 were challenged with aspirin. Two patients were found not to be sensitive and started on aspirin, the other had a classic asthmatic reaction to the drug and was successfully desensitized to aspirin allowing for its use.- - - - - - - - - - ranking = 5keywords = sensitivity (Clic here for more details about this article) |
7/199. Amalgam allergy associated with exacerbation of aspirin-intolerant asthma.BACKGROUND: aspirin-intolerant asthma can be induced not only by acidic analgesics (including acetylsalicylic acid), which effectively inhibit cyclo-oxygenase, but also by cross-reactivity with paraben, and other chemical additives. OBJECTIVE: We examined whether amalgam allergy is involved in the pathogenesis of a aspirin-intolerant asthma. methods: We present the first case of aspirin-intolerant asthma that improved after the removal of dental amalgam. In addition, we performed both the methacholine provocation testing and sulpyrine provocation testing before and after the removal of dental amalgam. RESULTS: In addition, the methacholine concentration causing a 20% fall in FEV1 in provocation tests rose significantly, though hypersensitivity to analgesics evaluated with sulpyrine provocation testing did not decrease. These results suggest that amalgam sensitization is involved in bronchial hyperresponsiveness in aspirin-intolerant asthma. CONCLUSION: Sensitivity to amalgam may cause exacerbation of aspirin-intolerant asthma in some patients. To the best of our knowledge, this is the first case report of amalgam allergy associated with aspirin-intolerant asthma.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
8/199. Analysis of immunoglobulin e VH transcripts in a bronchial biopsy of an asthmatic patient confirms bias towards VH5, and indicates local clonal expansion, somatic mutation and isotype switch events.immunoglobulin e (IgE)-dependent mechanisms play a pivotal role in mediating allergic disease. Previously, VH-Cepsilon transcripts from blood or spleen of atopic asthmatics have been analysed for VH gene usage and patterns of somatic mutation. An over-representation of the minor VH5 family has been observed, consistent with a superantigen drive. As local mucosal events in IgE production may be more significant in the disease process, we have analysed VH-Cepsilon transcripts from a bronchial biopsy of a patient with severe asthma. VH5 predominance was confirmed with 10 of 30 unique clones derived from this family. Repeated sequences, some with intraclonal variation, revealed clonal expansion and continuing mutational activity at the site. Unexpectedly, three unmutated VH-Cepsilon sequences were found, indicating that isotype switching to IgE can occur without mutation. Detection of a sister clone with extensive mutations was again consistent with local mutational activity. Evidence for local isotype switching was obtained by identification of clonally related immunoglobulin m (IgM), immunoglobulin g (IgG) and immunoglobulin e (IgE) sequences. However, in contrast to findings in blood, no IgG4 transcripts clonally related to IgE were detected, suggesting that the balance between synthesis of IgG4 and IgE may differ between systemic and local sites. These data confirm a VH5 bias in IgE, and support the concept that IgE-synthesizing B cells arise via local differentiation.- - - - - - - - - - ranking = 0.00756887306977keywords = contrast (Clic here for more details about this article) |
9/199. Radiographic features of eosinophilic gastroenteritis (allergic gastroenteropathy) of childhood.The child with eosinophilic gastroenteritis has failure to thrive, a history of allergy or asthma, iron deficiency anemia, and peripheral eosinophilia. This type of eosinophilic gastroenteritis has earned the designation "allergic gastroenteropathy." Pathologic change in the gastric antrum of six children with this disease correlated with an abnormal air-contrast examination of the antrum. The affected children had an irregular, lacy, antral surface rather than the smooth, bald surface seen in normal children. The small bowel in allergic gastroenteropathy is usually abnormal but nonspecific as to etiology. Much more specific is the combination of small bowel and gastric antral abnormalities. Findings encourage air-contrast radiography of the antrum in children with suspected allergic gastroenteropathy.- - - - - - - - - - ranking = 0.01513774613954keywords = contrast (Clic here for more details about this article) |
10/199. Allergy to an occupational allergen (Sapelli wood) in a child.The case is presented of a child who developed rhinoconjunctivitis, angioedema and asthma by sensitization to Sapelli wood, which was used in his father's carpentry. Positive skin-prick test, high levels of specific immunoglobulin e by ELISA and a positive conjunctival challenge test suggest a type I hypersensitivity mechanism to this wood. This is the first case report of sensitization to Sapelli wood and it confirms that occupational allergen exposure as Sapelli wood may also cause sensitization in a child.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
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