1/3. vasculitis during immunotherapy treatment in a patient with allergy to cupressus arizonica.Allergen immunotherapy dates back to 1911 and has been used successfully to treat large numbers of patients throughout the last century. CASE REPORT: a 66-year-old woman presented with symptoms of allergic rhinitis and asthma due to sensitization to cupressus arizonica. Specific immunotherapy was prescribed as a continuous 2-year treatment with a depot preparation of standarized and characterized allergen extracts of cupressus arizonica pollen. Forty-eight hours after one maintenance dose of 0.8 cc, the patient presented palpable violaceous purpuric lesions and pruritus on both legs. We performed skin prick and intradermal tests with cupressus arizonica. Twenty-four hours later, the 1/1 dilution intradermal skin test was positive. biopsy showed leukocytoclastic vasculitis. CONCLUSIONS: A middle-aged woman experienced cutaneous non-necrotizing vasculitis after 2 years of maintenance immunotherapy. The interval between injections and the first appearance of cutaneous lesions suggests a type III hypersensitivity immune reaction. skin biopsy of the positive intradermal test also supports this hypothesis.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
2/3. Persistent local insulin allergy in a diabetic with chronic lymphatic leukaemia.A 75 year old maturity-onset diabetic developed persistent local allergy to insulin. She had coexistent asymptomatic chronic lymphatic leukaemia. All species of insulin provoked a recurrence of the allergy and attempts at hyposensitization and treatment of the leukaemia produced only marginal benefit. Administration of subcutaneous steroids with insulin relieved the problem, but could not be stopped without relapse. Immunological investigations suggested an immune complex-mediated hypersensitivity reaction to insulin. The later development of immune complex-mediated arthropathy tended to support this suggestion. The lack of histological and immunological evidence of an IgE-mediated reaction suggested that in this case the mechanism of insulin allergy and arthralgia was IgG mediated. We suggest that the chronic leukaemia was implicated in both processes by interfering with homeostatic mechanisms that normally prevent the development of autoallergic disorders.- - - - - - - - - - ranking = 1.75keywords = allergy (Clic here for more details about this article) |
3/3. Identification of the causative antigen in immune complex allergy. A simple method.Two cases are presented of an anaphylactoid reaction after intravenous drug injection. The first reaction immediately after the operation, the second during the induction. At the first sight it was not clear which substance was responsible. Therefore a technique was developed in cooperation with the Immunologic laboratory in order to diagnose exactly the causative antigen. This method is described.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |