1/17. Severe systemic reactions caused by poppy seed.We describe a case of severe systemic reactions caused from poppy seed ingestion. Poppy seeds were suspected to be responsible for the symptoms on the basis of the clinical history. This suspicion was confirmed by skin testing and the prick-prick test. Moreover, a RAST assay was conducted with an extract of fresh food, confirming the presence of specific IgE to poppy seed. Although poppy seeds are not commonly used, we highlight the possible importance of such rare and often hidden sources of allergens.- - - - - - - - - - ranking = 1keywords = assay (Clic here for more details about this article) |
2/17. Treating allergic rhinitis in pregnancy. safety considerations.Allergic rhinitis affects approximately one-third of women of childbearing age. As a result, symptoms ranging from sneezing and itching to severe nasal obstruction may require pharmacotherapy. However, product labels state that medications for allergic rhinitis should be avoided during pregnancy due to lack of fetal safety data, even though the majority of the agents have human data which refute these notions. We present a systematic and critical review of the medical literature on the use of pharmacotherapy for the management of allergic rhinitis during pregnancy. Electronic databases and other literature sources were searched to identify observational controlled studies focusing on the rate of fetal malformations in pregnant women exposed to agents used to treat allergic rhinitis and related diseases compared with controls. immunotherapy and intranasal sodium cromoglycate (cromolyn) and beclo-methasone would be considered as first-line therapy, both because of their lack of association with congenital abnormalities and their superior efficacy to other agents. First-generation (e.g. chlorpheniramine) and second-generation (e.g. cetirizine) antihistamines have not been incriminated as human teratogens. However, first-generation antihistamines are favoured over their second generation counterparts based on their longevity, leading to more conclusive evidence of safety. There are no controlled trials with loratadine and fexofenadine in human pregnancy. Oral, intranasal and ophthalmic decongestants (e.g. pseudoephedrine, phenylephrine and oxymetazoline, respectively) should be considered as second-line therapy, although further studies are needed to clarify their fetal safety. No human reproductive studies have been reported with the ophthalmic antihistamines ketorolac and levocabastine, although preliminary data reported suggest no association between pheniramine and congenital malformations. There are no documented epidemiological studies with intranasal corticosteroids (e.g. budesonide, fluticasone propionate, mometasone) during pregnancy; however, inhaled corticosteroids (e.g. beclomethasone) have not been incriminated as teratogens and are commonly used by pregnant women who have asthma. In summary, women with allergic rhinitis during pregnancy can be treated with a number of pharmacological agents without concern of untoward effects on their unborn child. Although the choice of agents in part should be based on evidence of fetal safety, issue of efficacy needs to be addressed in order to optimally manage this condition.- - - - - - - - - - ranking = 152.25754779203keywords = count (Clic here for more details about this article) |
3/17. Unilateral rhinorrhea and nasal obstruction in an adult.BACKGROUND: choanal atresia is an uncommon malformation, consisting of congenital blockage of one of both choanae. Symptomatology varies according to the type of atresia and the age of the patient. The bilateral, or complete, form presents in newborns as respiratory distress while unilateral, or incomplete, forms present in older children or adults. CASE REPORT: a 16-year-old girl presented with a lifelong history of right-sided nasal blockage and unilateral watery rhinorrhea. The rhinorrhea increased when the patient bent her head forward. Treatment with antihistamines and topical nasal corticosteroid sprays produced little improvement. The patient's previous medical history was unremarkable except for the expulsion of a coagulated mass through the right nostril a few days after birth, and event that provoked her symptoms. physical examination was normal except for excoriation of the right external nasal margin. Anterior rhinoscopy revealed watery rhinorrhea, erythematous mucosa in the right nasal cavity and deviated nasal septum. No nasal masses or polyps were found. physical examination confirmed the absence of ventilation in the right nasal airway and nasal endoscopy indicated right choanal obstruction. Diagnostic test: skin prick tests with aeroallergens were positive for grass pollen and negative for all other allergens tested (mites, moulds, latex, and epithelia). Total IgE was normal (9 IU/ml). No eosinophilia was detected in the nasal secretion specimen. The results of laboratory tests including complete blood count and differential, erythrocyte sedimentation rate, and biochemical parameters were normal. The glucose level in nasal secretion was 4.6 mg/dl. x-rays of the paranasal sinuses and cavum showed no anomalies. Axial fine-cut computed tomography scans (3 3 mm) revealed choanal obstruction with bony and membranous components. CONCLUSIONS: a diagnosis of congenital choanal atresia should be considered in cases of unilateral blockage and rhinorrhea. Nasal endoscopy and computed tomography scans are essential to establish diagnosis.- - - - - - - - - - ranking = 152.25754779203keywords = count (Clic here for more details about this article) |
4/17. food allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy).BACKGROUND: spices originate in various botanical families: apiaceae, lamiaceae, lauraceae, Leguminosae, liliaceae, myristicaceae, myrtaceae, piperaceae, solanaceae, zingiberaceae.... METHODOLOGY: Prick-tests to native spices have been carried out in patients suspected of food allergies to spices. The CICBAA data bank includes 589 cases of food allergies, a part of which has benefited from investigations for spices. Data about the rate of sensitization and food allergy are available. RESULTS: Frequent sensitization to apiaceae is observed: coriander, caraway, fennel, celery: 32% of prick-tests in children, 23% of prick-tests in adults. Sensitization to liliaceae: garlic, onion, chive, is observed in 4.6% of prick-tests in children, 7.7% of prick-tests in adults. Rare cases of sensitization to paprika and saffron are recorded. Prick-tests to nutmeg, ginger and clove are currently negative. 10 food allergies related to the mugwort-celery-spices syndrome are reported: coriander: 1, caraway: 2, fennel: 3, garlic: 3, onion: 1. food allergy to spices is unfrequent: 2% of the totality of food allergies. However, only adults are allergic to spices and allergy to spices accounts for 6.4% of food allergies in adults. Tiny amount of proteins are usually ingested. patients at risk of spice allergy are young adults sensitized to mugwort and birch allergens, sharing cross-sensitization with various food vegetal allergens. The clinical suspicion raises from frequent post-prandial systemic reactions. Other allergens of vegetal origin have to be cleared. diagnosis can be established by DBPCFC using powdered spices in capsules.- - - - - - - - - - ranking = 152.25754779203keywords = count (Clic here for more details about this article) |
5/17. Influence of natural exposure to pollens and domestic animals on airway responsiveness and inflammation in sensitized non-asthmatic subjects.BACKGROUND: Atopy may be a risk factor in the development of asthma. Indoor allergens are considered to be more potent asthma inducers than outdoor ones such as pollens. Lower airway inflammation may be present in non-asthmatic subjects during natural exposure to relevant allergens and may eventually lead to the development of asthma. AIMS: To document seasonal variation in lower airway responsiveness and inflammation in sensitized non-asthmatic subjects, during natural exposure to allergens, and to determine whether it is more marked in those exposed to animals to which they are sensitized. methods: Twenty-two atopic subjects were seen during and out of the pollen season. All (but the controls) were sensitized to domestic animals, and to trees, grasses or ragweed. Eleven were not exposed to animals at home and 8 were exposed. They were compared with 3 normal controls. A respiratory questionnaire was administered, allergy skin prick tests, spirometry, methacholine challenge, blood and induced sputum with differential cell counts were obtained during the pollen season for all subjects. These tests were repeated out of the pollen season. RESULTS: Throughout the study, none of the subjects had asthma symptoms. Mean PC(20) was significantly lower in subjects exposed to animals compared with unexposed subjects or controls, both during and out of the pollen season. In season, subjects exposed to animals had significantly higher sputum eosinophil numbers than unexposed or normal control subjects. CONCLUSIONS: Non-asthmatic atopic subjects show variable degrees of airway responsiveness and inflammation. However, subjects exposed to animals show higher airway eosinophilia, which may suggest they are at increased risk of developing airway hyperresponsiveness and asthma.- - - - - - - - - - ranking = 152.25754779203keywords = count (Clic here for more details about this article) |
6/17. Cross-reactivity between raw mushroom and molds in a patient with oral allergy syndrome.BACKGROUND: Oral allergy syndrome, resulting from a cross-reactivity between raw fruits and vegetables and a number of pollens, is well described. However, it has never been associated with mold spore sensitivity and mushrooms. We evaluated a patient with oral allergy symptoms to raw, but not cooked, mushrooms, who also had positive skin testing to molds. OBJECTIVE: To identify and characterize antigenic cross-reactivity between mushroom and mold spores. methods: The patient underwent skin prick testing to molds and mushroom. proteins from raw and cooked mushrooms were extracted and immunoblot/inhibition assays were performed to evaluate for cross-reacting immunoglobulin e antibodies between mushroom and mold extracts to which the patient was sensitive. RESULTS: The patient had a positive skin prick test result to raw mushroom and four types of molds. The immunoblot assay revealed immunoglobulin e antibodies directed against similar molecular weight proteins in the raw mushroom and 3 of the 4 molds: alternaria tenuis, fusarium vasinfectum, and Hormodendrum cladosporioides. These protein bands on protein electrophoresis were absent in the cooked mushrooms. Inhibition immunoblot of the raw mushroom with the three molds indicated total inhibition of the 43- and 67-kD protein bands. CONCLUSIONS: We report the first case of cross-reactivity between mushroom and molds in a patient with oral allergy syndrome to raw mushroom and allergic rhinitis secondary to molds.- - - - - - - - - - ranking = 2keywords = assay (Clic here for more details about this article) |
7/17. The effect of topical fluticasone on nasal nitric oxide levels in a patient with allergic rhinitis.nitric oxide (NO) in exhaled breath is produced primarily by the upper respiratory airway mucosa. The nasal output of this gas is increased in patients with allergic rhinitis. We performed a study on a 41-year-old nonsmoking male volunteer with allergic rhinitis to investigate the effect of fluticasone nasal spray on nasal NO output (VNO). A total of 28 nasal NO measurements from both nostrils were taken during the 2-month period of June and July 2002. During the second half of the study period (treatment phase), the patient took fluticasone in doses of 100 micrograms per nostril once a day. During the treatment phase, nasal NO measurements were taken 10 days after the initiation of treatment. In addition, we also recorded the patient's nasal symptom scores and the grass pollen counts in the greater Pittsburgh area. The patient's mean VNO was 989.9 nl/min prior to treatment and 787.7 nl/min following treatment--a statistically significant 20.4% decrease (p < 0.01). The findings of our study support the observation that topical nasal steroid treatment decreases NO production in sinonasal mucosa.- - - - - - - - - - ranking = 152.25754779203keywords = count (Clic here for more details about this article) |
8/17. plantago lanceolata (English plantain) pollinosis in japan.OBJECTIVE: The objective was to ascertain the prevalence of plantago lanceolata (English plantain) pollinosis in japan. methods: A total of 160 patients with allergic rhinitis were examined at the Hokkaido University Hospital otolaryngology Clinic between January 2002 and December 2003. We investigated the frequency of P. lanceolata antigen-specific immunoglobulin e (IgE) antibody-positive serum using the radioallergosorbent test (RAST), the P. lanceolata pollen counts in the Sapporo area and the clinical symptoms of patients with allergic rhinitis caused by this pollen. RESULTS: P. lanceolata pollen was dispersed throughout the Sapporo area from mid-May to early September, peaking in the latter half of May. The airborne pollen count showed little variation between years. The P. lanceolata RAST-positive rate was 12.8%, which was close to those for ragweed and sagebrush. All subjects showed overlapping antigen sensitization, that is, none displayed sensitization (by RAST) exclusively to P. lanceolata. The onset of subjective symptoms peaked in June and the symptoms worsened from April to October. CONCLUSION: P. lanceolata was dispersed over a long period, from mid-May to early September. The P. lanceolata RAST-positive rate (12.8%) was similar to those for sagebrush and ragweed, which are dispersed during the fall. These results suggest that P. lanceolata is an important causative agent of pollinosis in japan.- - - - - - - - - - ranking = 304.51509558406keywords = count (Clic here for more details about this article) |
9/17. role of Dau c 1 in three different patterns of carrot-induced asthma.OBJECTIVE: To assess the role of Dau c 1 in three patients with carrot induced asthma. MATERIAL AND methods: Patient 1 had asthma when handling raw carrots. Sensitization to pollens wasn't detected. Patient 2 had rhinoconjunctivitis due to grass and olive pollen allergy. She had asthma when handling raw carrots. Patient 3 was diagnosed of rhinoconjunctivitis and asthma due to allergic sensitization to mites, several pollens and cat. She had asthma due to raw carrot ingestion and inhalation. IgE immunobot analysis and ELISA inhibition assay were used to investigate the allergens and specific antibodies. RESULTS: IgE Immunoblot Analysis: Dau c 1 from carrot extract and the recombinant rDau c 1 were recognized by IgE from patients 1 and 2. Band of Bet v 1 in birch pollen extract wasn't recognized. Patient 3 didn't recognize any of these allergens. Specific IgE to rDau c 1 was measured by ELISA. Specific IgE ELISA-inhibition with carrot as solid phase showed an intermediate inhibition (30 %) between carrot and rDau c 1 in patient 1; and a considerable inhibition (nearly 100 %) between carrot and rDau c 1 in patient 2. No inhibition was found in patient 3. Specific IgE ELISA inhibition between rDau c 1 and rBet v 1, employing rDau c 1 as solid phase was made in patients 1 and 2. Bet v 1 showed less than 40 % of inhibition of rDau c 1 in patient 1; and an intermediate inhibition (> 40 %) between rBet v 1 and rDau c 1 in patient 2. CONCLUSIONS: Airborne carrot allergens are able to sensitize without the implication of a previous pollen allergy. Dau c 1 was the main allergen in patient 2. In patient 1, there was a band of 30 kd that looks like the predominant allergen. patients 1 and 2 were sensitized directly from carrot allergens. In patient 3, Dau c 1 isn't related to the carrot allergy. Allergy to carrot in patient 3 seems to be related to her allergy to different pollens; however, it wasn't related to birch pollen. Mediterranean countries didn't show the same patterns of food-related pollen allergy than Nordic countries.- - - - - - - - - - ranking = 305.51509558406keywords = count, assay (Clic here for more details about this article) |
10/17. Simultaneous allergy to vine pollen and grape.We report the case of an 18-year-old female student suffering from seasonal rhinoconjunctivitis with sensitization to pollens from vine and also from grass, olive, and chenopodiaceae plants who had recently developed episodes of itching, maculopapular rash, and facial angioedema after eating grapes. Testing revealed positive reactions to vine pollen and grapes, and specific IgE were found for both allergens. immunoblotting and inhibition assays revealed cross-reactivity between the allergenic structures of vine pollen and grape fruit and also among botanically unrelated pollens.- - - - - - - - - - ranking = 1keywords = assay (Clic here for more details about this article) |
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