1/21. 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 = 1keywords = suffering (Clic here for more details about this article) |
2/21. Leukocytoclastic vasculitis: a rare manifestation of propylthiouracil allergy.OBJECTIVE: To report a case of leukocytoclastic vasculitis as a manifestation of propylthiouracil allergy. methods: We present the history, findings on physical examination, and results of laboratory evaluation in a 25-year-old woman. Associated reports from the literature are reviewed. RESULTS: The patient, with a history of Graves' disease, was referred for evaluation of a purpuric rash on the pinnas and buttocks bilaterally. Findings included exophthalmos and bilateral goiter with neck bruits. She was biochemically hyperthyroid. biopsy of the skin lesions revealed leukocytoclastic vasculitis. propylthiouracil therapy was discontinued, and prednisone was prescribed. Treatment with radioactive iodine resulted in appreciably diminished skin lesions and reduction in the size of the thyroid gland, but thyroxine and triiodothyronine levels increased. Administration of a second, higher dose of radioactive iodine with concomitant lithium carbonate resulted in clinical and biochemical improvement. Six months after initial assessment, the rash had resolved, and the patient's free thyroxine value had normalized, although the thyrotropin level was still suppressed. CONCLUSION: Leukocytoclastic vasculitis, although rarely seen as a manifestation of propylthiouracil allergy, has been reported in the medical literature and should be considered in the differential diagnosis of patients with a vasculitic rash. Treatment consists of discontinuation of the offending medication and administration of a corticosteroid and, occasionally, cyclophosphamide or plasmapheresis.- - - - - - - - - - ranking = 0.52928292440016keywords = physical (Clic here for more details about this article) |
3/21. The safety of low-dose larrea tridentata (DC) Coville (creosote bush or chaparral): a retrospective clinical study.OBJECTIVE: To determine whether internal use of low doses of larrea tridentata tincture or topical applications of this traditional herbal medicine are safe. DESIGN: Retrospective review of all people prescribed larrea for internal or for topical use over a 22-month period. SETTING/LOCATION: A general naturopathic practice in Sedona, arizona. SUBJECTS: Thirteen patients were identified for whom larrea tincture for internal use was prescribed. An additional 20 female and 3 male patients were identified for whom an extract of larrea in ricinus communis (castor) oil for topical use was prescribed. No patient had any history of liver disease. INTERVENTIONS: larrea was prescribed as part of the usual care of each patient. In all cases it was given as either part of a complex herbal formula individualized for each patient containing less than 10% larrea tincture or as an extract in ricinus oil for topical use. OUTCOME MEASURES: serum liver enzyme levels as well as blood urea nitrogen and creatinine levels, glucose levels, electrolytes, bilirubin levels, iron levels, ferritin levels, lipid levels, and complete blood count (CBC) were available for analysis in four patients; general clinical history and physical examination findings were relied on in all other cases. RESULTS: The four patients with complete before and after blood chemistry panels and CBC had no indication of liver damage from use of larrea. This included one patient who was taking medications with significant potential for hepatotoxicity. No patient in the study, whether using larrea for short term or long, internally or externally, showed any sign of organ damage during the period of follow-up. CONCLUSIONS: Relatively small intakes of larrea tincture, or topical application of extracts in ricinus oil, are safe when prescribed by a clinically trained botanical prescriber. larrea should be used with caution in persons with a history of previous, or current, liver disease. It may be preferable to avoid the use of larrea capsules because they have been associated with potentially dangerous overdosing.- - - - - - - - - - ranking = 0.52928292440016keywords = physical (Clic here for more details about this article) |
4/21. silver-coated prosthetic heart valve: a double-bladed weapon.A St. Jude Medical Silzone was implanted in a 72-year-old female, suffering from mitral valve disease. Four months later, the patient had acute cardiac failure due to partial detachment of the prosthetic valve. The mitral annulus was ulcerated and there were multiple erosions in the myocardial tissue in contact with the prosthetic valve. Histological examination revealed chronic inflammation with hemosiderine deposits and giant cells. No allergy to silver ions was found. The silver-coated sewing cuff had caused a chronic inflammatory reaction due to a toxic reaction to silver. The Silzone valve was withdrawn from the market on January 2000.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
5/21. A case of cold-dependent exercise-induced anaphylaxis.exercise-induced anaphylaxis (EIA) is a form of physical urticaria that is induced by exercise. A 16-year-old Japanese boy had a 4-year history of recurrent wealing and dyspnoea after physical exercise such as jogging, playing handball or riding a bicycle in winter. The episodes were not associated with ingestion of foods including wheat or soya bean. A provocation test, with 15 min of exercise and 2 min of cold stimulation immediately before or immediately after the exercise, elicited a weal that was localized to the test area. A challenge test with ingestion of boiled soya beans and exercise did not elicit a weal. Therefore, in this case, cold exposure, but not food ingestion, was essential for inducing EIA. Cold-dependent EIA is different from cold urticaria, food-dependent EIA, cholinergic urticaria and cold-induced cholinergic urticaria, and may be a distinct entity.- - - - - - - - - - ranking = 1.0585658488003keywords = physical (Clic here for more details about this article) |
6/21. Ladybug hypersensitivity: report of a case and review of literature.For years, allergists have known that inhalant allergens arise from insects such as flies, beetles, moths, cockroaches, and mites. Now, it is becoming evident that the Asian ladybeetle Harmonia axyridis possibly should be added to this list. Several cases have been reported recently in the literature describing patients suffering from allergic respiratory symptoms including rhinitis, conjunctivitis, and asthma related to exposure to ladybugs. These patients reveal positive skin-prick testing with ladybug extract and immunoglobulin e immunoblotting with the sera showing at least two distinct allergenic proteins. This species infests homes in very large numbers in the fall and winter months and stay there in a hibernation-like state until the warm weather arrives with early spring. We discuss avoidance measures, which are the key to successful treatment.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/21. Bee moth (Galleria mellonella) allergic reactions are caused by several thermolabile antigens.BACKGROUND: Exposure and contact with bee moth (Galleria mellonella) larvae (Gm) can cause an allergic reaction both in anglers and breeders. We described the case of an amateur fisherman who experienced an allergic reaction using Gm but not using heat-treated Gm (h-Gm) (mummies). The aim of this study was to demonstrate by immunoblotting and radioallergosorbent test (RAST)-inhibition experiments the loss of allergenic epitopes in h-Gm extracts. methods: Galleria mellonella larvae and h-Gm were homogenized and extracted at 10% (w/v) in 0.5 M phosphate-buffered saline, pH 7.4 containing 0.5% NaN(3) for 16 h at 4 degrees C. Gm and h-Gm extracts were electrophoresed in a 10% polyacrylamide precast Nupage Bis-Tris gel at 180 mA for 1 h and the resolved proteins stained with 0.1% Coomassie brilliant blue and the molecular weight calculated. For the immunoblotting detection of allergenic components the resolved extracts were transferred onto a nitrocellulose membrane and incubated with the patient's serum. Bound specific-IgE was detected by peroxidase-conjugated anti-human IgE. RAST inhibition experiments were performed according to the Ceska method. RESULTS: The protein profile of Gm and h-Gm extracts resulted markedly different in number, intensity and the position of bands, indicating that heat-treatment modifies the chemical-physical characteristics of the protein contents. The Gm extract showed a strong-coloured band at 73 kDa and more than 20 components ranging from 12 to 133 kDa; h-Gm showed two main band at 77 and 38 kDa and about 15 faint bands between 20 and 133 kDa apparently without any correspondence to the bands present in the Gm extract. immunoblotting with the patient's serum demonstrated several bands of reactivity with the Gm extract ranging from 20 to 100 kDa and no recognizable bands, but only a diffuse smear with h-Gm. When used in a RAST inhibition experiment the h-Gm extract demonstrated an inability to compete with the Gm one for the binding to patient's IgE serum. CONCLUSIONS: The h-Gm seems to lose the allergenic epitopes and has two advantages for anglers: to avoid new possible sensitizations as well as allergic symptoms in sensitized people, without interfering with their skills and satisfaction in their fishing performance.- - - - - - - - - - ranking = 0.52928292440016keywords = physical (Clic here for more details about this article) |
8/21. Clinical holistic medicine: developing from asthma, allergy, and eczema.This paper shows how consciousness-based holistic medicine can be used in the case of asthma, allergy, and eczema. We have many fine drugs to relieve patients from the worst of these symptoms, where many children and adults suffer health problems related to hyper-reactivity of the immune system. Many symptoms remain throughout life because the drugs do not cure the allergy and allergy today is the sixth leading cause of chronic illness. The etiology of the immune disturbances is mostly unknown from a biomedical perspective. consciousness-based holistic medicine could therefore be used to treat these diseases if the patient is willing to confront hidden existential pain, is motivated to work hard, and is dedicated to improve quality of life, quality of working life, and personal relationships. Improving quality of life is not always an easy job for the patient, but it can be done with coaching from the physician. An increased physical health is often observed after only a few sessions with a physician skilled in using holistic medical tools and able to coach the patient successfully through a few weeks of dedicated homework. Children with allergy and asthma can also be helped if their parents are able to do work on personal development, to improve the general quality of life in the family and their relationship with the child.- - - - - - - - - - ranking = 0.52928292440016keywords = physical (Clic here for more details about this article) |
9/21. Type I allergy induced by Limulus Amoebocyte Lysate (LAL).During the last few years Limulus Amoebocyte Lysate (LAL) has been extensively used to detect minimal amounts of endotoxins of gram-negative bacteria in products of the pharmaceutical industry, in food stuff, body fluids, house dust and room air. LAL is produced from cells of the haemolymph (amoebocytes) of the horseshoe crab (Limulus polyphemus), which respond with an extremely sensitive clotting system upon contact with endotoxins. In this study we demonstrate by typical case history, positive skin test and ELISA the occurrence of Type I allergy to LAL in a patient suffering from conjunctivitis and rhinitis at work.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
10/21. Insect bite-induced hypersensitivity and the SCRATCH principles: a new approach to papular urticaria.Insect bites and the associated hypersensitivity reactions known as papular urticaria account for a significant number of all referrals from pediatricians and dermatologists to our pediatric dermatology clinic. Unfortunately, children affected by these eruptions are frequently misdiagnosed and often subject to expensive evaluations including invasive and unnecessary procedures. Here we review the course of 4 children with the typical physical findings and natural history of these reactions. On the basis of our clinical findings and experience with this patient population, we propose a set of principles (termed "SCRATCH") as clinical features to aid clinicians in making an early and accurate clinical diagnosis. We conclude that a more appropriate term for future study and diagnosis of this entity is insect bite-induced hypersensitivity.- - - - - - - - - - ranking = 0.52928292440016keywords = physical (Clic here for more details about this article) |
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