Cases reported "Rhinitis"

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1/25. Allergic reaction to gemfibrozil manifesting as eosinophilic gastroenteritis.

    Eosinophilic gastroenteritis (EGE) is a rare condition of unknown etiology characterized by eosinophilic infiltration of the gastrointestinal (GI) tract. Previous associations with a drug or food allergy, allergic rhinitis, atopic dermatitis, and elevated IgE levels suggest an atopic predisposition in the pathogenesis of this disorder. Diagnostic criteria are GI symptoms, eosinophilic infiltration proven by biopsy of the GI tract, and absence of parasitic infection. We describe a case of EGE manifested as an allergy to gemfibrozil.
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ranking = 1
keywords = allergy
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2/25. Occupational contact urticaria caused by airborne methylhexahydrophthalic anhydride.

    Acid anhydrides are low-molecular weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. A total of 3 subjects with occupational exposure to methylhexahydrophthalic anhydride (MHHPA) and hexahydrophthalic anhydride (HHPA) from an epoxy resin system were studied to evaluate the nature of their reported skin and nose complaints (work-related anamnesis, specific IgE, contact urticaria examinations, and ambient monitoring). Using a Pharmacia CAP system with a HHPA human serum albumin conjugate, specific IgE antibody was detected in serum from 1 (33.3%) out of the 3 workers. One unsensitized worker displayed nasal pain and rhinorrhea only when loading liquid epoxy resins into the pouring-machine (2.2 mg MHHPA/m3 and 1.2 mg HHPA/m3), probably being an irritant reaction. Two workers had work-related symptoms at relatively low levels of exposure (geometric mean 32-103 microg MHHPA/m3 and 18-59 microg HHPA/m3); one complained of only rhinitis, and the other was sensitized against HHPA and displayed both rhinitis and contact urticaria (the face and neck). The worker's skin symptoms were evidently due to airborne contact, since she had not had any skin contact with liquid epoxy resin or mixtures of MHHPA and HHPA. These urticaria symptoms were confirmed by a 20-min closed patch test for MHHPA, but not by that for HHPA. The causative agent was considered to be MHHPA, although the specific IgE determination to MHHPA was not performed.
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ranking = 1
keywords = allergy
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3/25. Fish allergy in atopic children.

    The prevalence of fish allergy among 11 atopic children with elevated levels of specific immunoglobulin (Ig) E for cod was determined. None of the children had a history of fish allergy. All of the children had asthma and allergic rhinitis and 5 of them had also atopic dermatitis. The children underwent allergy skin tests (codfish, tuna, catfish, salmon, flounder, and bass), specific IgE tests (salmon, trout, tuna, eel, and mackerel), and food challenge tests. skin tests in cod-specific IgE-positive children were positive for codfish in 4 children, tuna in 2, catfish in 2, salmon in 6, flounder in one, and bass in 2. Three children had elevated specific IgE for salmon, 5 for trout, 8 for tuna, 4 for eel, and 4 for mackerel. Oral fish challenge with 10 g of fish did not result in positive reaction in any of the children. In conclusion, a positive food challenge test provided the only definitive confirmation of fish allergy, whereas positive allergy skin tests or positive specific IgE tests were less reliable. skin tests and in vitro specific IgE assays were not correlated with clinical symptoms of fish allergy, and the results of these 2 tests did not correlate with each other in this study.
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ranking = 5
keywords = allergy
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4/25. Allergic contact urticaria and rhinitis to roe deer (Capreolus capreolus) in a hunter.

    Roe deer (Capreolus capreolus) is one of the most common game mammals in europe, where hundreds of thousands people are exposed to this animal. Despite this fact, we are aware of only two cases of allergy to roe deer published until recently, one case of allergic rhinoconjunctivitis and asthma and the second of contact urticaria. We describe another case with co-existing allergic contact urticaria and rhinitis in a 55-year old male professional hunter. The symptoms were provoked only by exposure to roe deer, and there were no other past or present allergic diseases. Specific IgE was found to following animal allergens: cow dander (CAP class 5), goat epithelium and horse dander (each CAP class 4), dog epithelium, dog dander and swine epithelium (each CAP class 2). Skin prick tests have shown positive reaction only to cow epithelium ( ). Because of lack of deer dander allergen for specific IgE and skin tests, we have confirmed the causal relationship between exposure to roe deer and allergy using the rub test with roe deer's fur. There was a clearly positive urticarial reaction on the patient's skin accompanied by nasal itch, sneezing and rhinorrhea. No reaction was seen in a control person. We surmise that the positive tests with cow epithelium seen in this patient may result from a cross-reactivity to deer allergens. We conclude that although occupational allergies to roe deer seem to be rare, such possibility should be always considered among people having contact with these animals.
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ranking = 1
keywords = allergy
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5/25. Nonoccupationally induced allergy to monkey.

    BACKGROUND: A previous study described 2 patients with occupationally induced asthma caused by exposure to monkey. We describe a patient who developed asthma, rhinitis, and conjunctivitis owing to sensitivity to a pet monkey. The patient had a long history of upper and lower allergic airway disease. When 2 pet macaque monkeys were introduced into the home, the patient noticed increasing coughing, wheezing, and shortness of breath. During a particularly long exposure to the monkey in a car, the patient developed severe wheezing, rhinitis, and conjunctival edema. OBJECTIVE: To demonstrate that a nonoccupational exposure to monkey can lead to allergic sensitivity. methods: Commercially obtained macaque monkey hair was defatted in acetone and extracted. A total of 5 microg/mL of extract protein was adsorbed onto microtiter plates, and an alkaline phosphatase enzyme-linked immunosorbent assay was performed on serum samples from 4 individuals: 2 controls, 1 individual with suspected sensitivity, and the patient. A positive result was an optical density greater than twice that of the control. RESULTS: The patient's serum had an optical density greater than twice that of the control. The antibody levels of 2 control subjects-the patient's wife and one of the investigators-were elevated but not positive. The investigator had manifested asthma after exposure. CONCLUSIONS: This is the first report of sensitivity to monkey occurring in a nonoccupational setting.
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ranking = 2
keywords = allergy
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6/25. Hashimoto's thyroiditis: a rare cause for rhinosinusitis.

    Rhinosinusitis is a common disorder with various etiological factors. In our clinical practice allergy seems to be a predominant cause followed by other less common causes like infection, drugs and aspirin hypersensitivity. We present a case of chronic rhinosinusitis secondary to hypothyroidism. Although hormonal causes like hypothyroidism have been proven to cause nasal congestion and rhinosinusitis, this is the first reported case of chronic rhinosinusitis in Hashimoto's thyroiditis in our center. This is a diagnosis of exclusion for chronic rhinosinusitis not responding to optimal medical therapy.
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ranking = 0.5
keywords = allergy
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7/25. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.

    Sinus headache is a widely accepted clinical diagnosis, although many medical specialists consider it an uncommon cause of recurrent headaches. The inappropriate diagnosis of sinus headache can lead to unnecessary diagnostic studies, surgical interventions, and medical treatments. Both the International headache Society and the American Academy of otolaryngology-Head and neck Surgery have attempted to define conditions that lead to headaches of rhinogenic origin but have done so from different perspectives and in isolation of each other. An interdisciplinary ad hoc committee convened to discuss the role of sinus disease as a cause of headache and to review recent epidemiological studies that suggest sinus headache (headache of rhinogenic origin) and migraine are frequently confused with one another. This committee reviewed available scientific evidence from multiple disciplines and concluded that considerable research and clinical study are required to further understand and delineate the role of nasal pathology and autonomic activation in migraine and headaches of rhinogenic origin. However, this group agreed that greater diagnostic and therapeutic attention needs to be given to patients with sinus headaches.
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ranking = 2
keywords = allergy
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8/25. Acute, short-lasting rhinitis due to camomile-scented toilet paper in patients allergic to compositae.

    A 20-year-old woman with a proven allergy to camomile suffered from short-lasting rhinitis when using a camomile-scented toilet paper. The prick-by-prick test performed with the toilet paper was positive. diagnosis was confirmed by a challenge test that also resulted positive. This is the first reported case of toilet-paper-induced acute rhinitis. The removal of the toilet paper from the bathroom was sufficient to obtain the disappearance of symptoms. patients allergic to camomile should avoid a camomile-scented toilet paper.
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ranking = 0.5
keywords = allergy
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9/25. Exotic pets are new allergenic sources: allergy to iguana.

    Although furry animals are known sources of respiratory allergy, scaly animals are assumed not to be allergenic. Exotic animals such as iguanas are becoming increasingly common pets. Nevertheless, these animals are not suspected to be allergenic. We present the case of a 42-year-old woman suffering from allergic rhinoconjunctivitis and asthma caused by a pet iguana. Clear IgE-sensitization and respiratory allergy to iguana scales is demonstrated, suggesting that scaly pets should be taken into account as possible allergenic sources.
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ranking = 3
keywords = allergy
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10/25. Occupational rhinitis and asthma due to cedroarana (Cedrelinga catenaeformis Ducke) wood dust allergy.

    We describe a case of occupational rhinitis and asthma in a 46-year-old carpenter who presented nasal and bronchial symptoms after cedrorana (Cedrelinga catenaeformis Ducke) wood dust exposure. Skin prick tests (SPT) with a battery of common allergens and different kinds of wood, were positive to cedrorana and grass pollen and negative to the other wood extracts. Nasal provocation and exposure challenge tests with Cedrorana wood dust also gave a positive reaction. IgE-immunoblotting showed two bands of 45 and 78 kDa respectively. This is the first reported case of occupational rhinitis and asthma due to Cedrorana wood dust where an IgE mediated mechanism has been found.
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ranking = 2
keywords = allergy
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