1/6. Critical incident: idiosyncratic allergic reactions to essential oils.Essential oils have the potential to initiate allergic reactions due to their volatile and skin absorbent nature. Practitioners and aromatherapy teachers need to be aware of the potential for allergies and be equipped to deal with them if they should arise. Two cases are presented of potentially serious reactions that occurred within a learning situation along with a brief literature critique about allergic reactions to essential oils.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Contact urticaria from carboxymethylcellulose in white chalk.BACKGROUND: Carboxymethylcellulose (CMC) is widely used in consumer goods, foods, and medicaments as a binder, emulsifier, and viscosity enhancer. Cases of immediate and delayed allergic reactions to this anionic cellulose polymer have been reported. OBJECTIVE: To report a case of contact urticaria from CMC in chalk, with possible cross-reaction to methyl hydroxyethylcellulose (MHEC). METHOD: patch tests with readings at 48 and 96 hours were performed with the North American Contact dermatitis Group standard series and benzisothiazolinone. Open and prick tests with readings after 30 minutes were performed with two brands of chalk as well as with various petrolatum and aqueous dilutions of CMC, MHEC, oleic acid, and calcium carbonate. RESULTS: The patient developed strong urticarial reactions during open tests with both powdered chalks and had milder reactions to the open test with CMC 10% aqueous (aq) and to prick testing with CMC 0.1% aq. No reaction to MHEC or any of the other ingredients of the chalks was observed. No relevant delayed reaction was noted. CONCLUSION: CMC can cause contact urticaria. It remains unclear why our patient reacted more strongly to the chalk than to CMC itself. We speculate that the abrasive nature of the chalk enhances the cutaneous penetration of CMC or that calcium carbonate, the main ingredient of the chalk, acts as an adjuvant. It is also possible that CMC and MHEC cross-react and that our negative results with MHEC may be due to improper testing technique or concentrations.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. Clinical report and investigation of a patient with localized heat urticaria.Localized heat urticaria is a rare disorder, in which the nature of the mediator is not fully established. We report the case of a 41-year-old woman with the condition, dependent upon mast cell integrity, in which histamine was demonstrated as the dominant, if not sole mediator. Non-sedative antihistamines conferred some therapeutic benefit, but subsequent sequential desensitization has enabled her to lead a full and active life again.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Kimura's disease and membranous nephropathy.An interesting association of Kimura's disease and membranous nephropathy is reported in a 71-year-old Chinese patient, 40 years after emigrating to the UK from hong kong. Significant blood eosinophilia and a very high serum IgE level were detected, the latter with a moderate level of specificity to candida albicans. light microscopy of renal biopsy was unremarkable despite a proteinuria of nephrotic proportions; diffuse subepithelial dense deposits compatible with membranous nephropathy were identified on electron microscopy. The atopic nature of Kimura's disease is confirmed and C. albicans is suggested as a possible causative agent.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. Immediate and delayed contact hypersensitivity to verbena plants.plants from the verbenaceae family may cause contact dermatitis of unknown nature. This report describes 2 cases of allergic reactions to the Verbena species. A teenage boy developed an anaphylactic allergic response following contact with the leaves of Verbena hybrida. Characterization of the patient's specific IgE response to Verbena hybrida, using Western blots and autoradiography, identified the specific 62000 Dalton allergen present in the verbena leaves to which the patient reacted. This is the first report of an IgE-mediated immediate contact hypersensitivity reaction to Verbena hybrida, a common perennial in South African gardens. The other case was a 23-year-old female gardener who developed immediate and delayed-type contact dermatitis from Verbena elegans 'Cleopatra' produced in a Danish nursery. Prick tests to plant material were considered positive and of an allergic nature.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
6/6. Severe hypersensitivity reaction during hemodialysis.BACKGROUND: Hemodialysis-associated hypersensitivity reactions are well documented in the literature. ethylene oxide sensitization and activation of complement are important factors involved during such reactions. The majority of severe hypersensitivity reactions in dialysis patients, however, is due to sensitization to ethylene oxide. methods: We report a patient admitted to the hospital with worsening of his renal function. He subsequently required three hemodialysis treatments, all of which resulted in severe hypersensitivity reactions requiring endotracheal intubation. The initial hypersensitivity episode was thought to be due to complement activation to the cupramonium-rayon membrane dialyzer. Despite changing to a polyacrylonitrile membrane, which does not activate complement, a second hypersensitivity reaction developed. Suspecting ethylene oxide hypersensitivity, the third hemodialysis session incorporated a biocompatible dialyzer that was sterilized with gamma irradiation, not ethylene oxide. Yet again, an anaphylactoid reaction resulted. It was postulated that residual ethylene oxide in the tubing might have triggered this last attack. RESULTS: Despite a negative RAST (radioallergosorbent test) to ethylene oxide, the strong history surrounding each of the hypersensitivity episodes and high index of suspicion pointed to ethylene oxide hypersensitivity as the etiologic factor. To this end, the patient fared much better when peritoneal dialysis was initiated. The patient subsequently died from other complications of his illness. CONCLUSIONS: This case report demonstrates both the complex nature involving a hypersensitivity reaction to hemodialysis and the life-threatening severity of such a reaction. Replacing ethylene oxide with steam or gamma radiation to sterilize dialyzers and thoroughly rinsing new dialyzers and tubing with normal saline may help circumvent this problem.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |