Allergologie select最新文献

{"title":"Successful case of deferasirox slow desensitization in adults.","authors":"Buket Basa Akdogan, Ilkay Koca Kalkan, Gozde Koycu Buhari, Ozlem Ozdedeoğlu, Hale Ates, Kurtulus Aksu, Ferda Oner Erkekol","doi":"10.5414/ALX02501E","DOIUrl":"https://doi.org/10.5414/ALX02501E","url":null,"abstract":"<p><strong>Introduction: </strong>When deferasirox is used in iron chelation therapy, maculopapular rash occurs in 10% of patients, but there is no accepted and implemented protocol for the management of these drug reactions in adults.</p><p><strong>Case report: </strong>A 23-year-old woman diagnosed with thalassemia major is presented. She had taken 1,500 mg oral deferasirox for 1 week. Five hours after the last dose, a pruritic maculopapular rash developed on the body, face, and hands. The rash spread to the whole body within 3 days. The absolute necessity for the patient to take the drug was clarified by the hematology department. The patient's history was evaluated. A delayed-type hypersensitivity reaction due to deferasirox was considered.</p><p><strong>Management: </strong>The slow desensitization protocol described in the literature and applied on a case-by-case basis in pediatric patients was modified to shorten the duration by determining appropriate doses for the current preparation. The desensitization process was started with 1/100,000 of the total dose and the therapeutic dose was reached with a 2- to 2.5-fold increase in dose. No pre-medication was applied. During the procedure, at a low dose of 0.1 mg, local flushing and erythema was observed around the auricle on the face. The reaction did not progress.</p><p><strong>Conclusion: </strong>Slow desensitization protocol for oral deferasirox was successfully applied in an adult patient.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"278-282"},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basophil activation test in Hymenoptera venom allergy.","authors":"Bernadette Eberlein, Knut Brockow, Ulf Darsow, Tilo Biedermann, Simon Blank","doi":"10.5414/ALX02522E","DOIUrl":"https://doi.org/10.5414/ALX02522E","url":null,"abstract":"<p><p>Before starting venom-specific immunotherapy (VIT), systemic sting reactions to Hymenoptera venoms require allergological workup in order to prove an IgE-mediated reaction and to identify the culprit insect venom. In addition to skin tests and the determination of specific IgE antibodies, the basophil activation test (BAT) using flow cytometry has emerged as a powerful tool and sensitive marker for this purpose in recent years. BAT seems to have a better informative value in terms of clinical relevance compared to the other tests. In Hymenoptera venom allergies, BAT is particularly useful for the diagnosis of cases with unclear or contradictory history and sensitization profile. Its results are associated with adverse reactions during VIT and efficacy of VIT and therefore have a certain predictive value for side effects and treatment failure of VIT. In research, it is mainly used to characterize the allergenic components of Hymenoptera venoms. This review article focuses on these topics.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"293-298"},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible manufacture of test allergens in public pharmacies for the diagnosis of type I allergies: Legal aspects.","authors":"Robin Jost, Sabine Kespohl, Kathrin E Paulus-Tremel, Julia Zimmer, Andreas Bonertz, Ingrid Sander, Thomas Klose, Lena-Maria Altin, Simone Heller, Ralph Heimke-Brinck, Frank Dörje, Susanne Philippus, Matthias Meyer, Sabrina Segebrecht, Torsten Wessel, Dieter Starke, Stefan Schülke, Monika Raulf, Vera Mahler","doi":"10.5414/ALX02514E","DOIUrl":"10.5414/ALX02514E","url":null,"abstract":"<p><p>The availability of high-quality skin test allergens is a prerequisite for the reliable diagnosis of occupational type I allergies. Due to the withdrawal of existing marketing authorizations (MAs) by pharmaceutical companies and the lack of new MAs for commercial test allergens, there is an increasing diagnostic gap in Germany and other EU member states, which makes it necessary to investigate alternative ways of providing in vivo diagnostics. The German Medicinal Products Act (Arzneimittelgesetz = AMG) allows for the possibility of preparing medicinal products in pharmacies without the need for an MA or a manufacturing authorization pursuant to Section 13 (2) No. 1 in conjunction with Section 13 (2a) Sentence 2 No. 3 AMG. This also includes test allergens. In addition to the AMG, the requirements of the German Ordinance on the Operation of Pharmacies (Apothekenbetriebsordnung - ApBetrO) and the European Pharmacopoeia apply in particular. Medicolegal and practical challenges, as well as potentials of manufacturing skin prick test solutions in public pharmacies are presented based on examples of different allergen source materials.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"251-264"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the systematic reviews on the desirable and undesirable effects of pharmacological treatments of allergic rhinitis informing the ARIA 2024 guidelines.","authors":"Rafael José Vieira, Maria Inês Torres, Antonio Bognanni, Sara Gil-Mata, Renato Ferreira-da-Silva, Nuno Lourenço-Silva, António Cardoso-Fernandes, André Ferreira, Henrique Ferreira-Cardoso, João Teles, Miguel Campos-Lopes, João A Fonseca, Juan José Yepes-Nuñez, Ludger Klimek, Torsten Zuberbier, Holger Schünemann, Jean Bousquet, Bernardo Sousa-Pinto","doi":"10.5414/ALX02515E","DOIUrl":"10.5414/ALX02515E","url":null,"abstract":"<p><p>There is insufficient evidence regarding the comparative efficacy and safety of pharmacological treatments of allergic rhinitis (AR). In the context of informing the 2024 revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, we plan to perform three systematic reviews of randomized controlled trials (RCTs) comparing the desirable and undesirable effects (i) between intranasal and oral medications for AR; (ii) between combinations of intranasal and oral medications versus nasal or oral medications alone; and (iii) among different intranasal specific medications. We will search four electronic bibliographic databases and three clinical trials databases for RCTs examining patients ≥ 12 years old with seasonal or perennial AR. Assessed outcomes will include the Total Nasal Symptom Score, the Total Ocular Symptom Score, and the Rhinoconjunctivitis Quality-of-Life Questionnaire. We will assess the methodological quality of included primary studies by using the Cochrane risk-of-bias tool. If appropriate, we will perform a pairwise random-effects meta-analysis for each pair of assessed medication classes and outcomes, as well as a network meta-analysis to assess the comparative efficacy of intranasal medications among each other. Heterogeneity will be explored by sensitivity and subgroup analyses. This set of systematic reviews will allow for a comprehensive assessment of the effectiveness and safety of pharmacological interventions for AR and inform recommendations in the context of the ARIA guidelines.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"270-277"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maculopapular rash with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem in a patient with hairy cell leukemia.","authors":"Katie Townsend, Claire Leck, Thippeswamy Billahalli, Elizabeth Barachina, Timothy J Watts","doi":"10.5414/ALX02508E","DOIUrl":"10.5414/ALX02508E","url":null,"abstract":"<p><p>We describe a rare case of a 54-year-old female with hairy cell leukemia, who following treatment for neutropenic sepsis, developed an extensive severe maculopapular exanthema with perifollicular hemorrhage. Cladribine, cotrimoxazole, allopurinol, domperidone, amikacin, piperacillin/tazobactam, and meropenem had all been given in the 9 days prior to eruption onset. Three months later, drug patch testing/delayed intradermal testing was positive to cotrimoxazole, trimethoprim, amikacin, piperacillin/tazobactam, and meropenem, with additional evidence of penicillin cross-reactivity. Drug challenge tests were negative to allopurinol and domperidone. She was diagnosed with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem. Multiple drug hypersensitivity is a novel syndrome mainly seen with severe delayed type IV drug eruptions, involving long-lasting strong T-cell reactivity to two or more structurally unrelated drugs.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"265-269"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedure for a standardized preparation of skin prick test solutions for the diagnosis of occupational type I allergies in the absence of commercial extracts.","authors":"Sabine Kespohl, Robin Jost, Silke Maryska, Lena-Maria Altin, Ingrid Sander, Stefan Schülke, Kathrin E Paulus-Tremel, Andreas Bonertz, Thomas Klose, Vera Mahler, Monika Raulf","doi":"10.5414/ALX02506E","DOIUrl":"10.5414/ALX02506E","url":null,"abstract":"<p><p>In order to ensure valid diagnostics for occupational test allergen solutions despite the ongoing reduction in the availability of commercial test extracts, a plan B was initiated for the possible production of skin prick test (SPT) solutions in public pharmacies. For important occupational allergen sources (wheat and rye, storage mites, animal epithelia, mold material) laboratory extraction methods were analyzed in comparison to pharmacy compatible extraction methods regarding protein quantity and quality in SDS-PAGE combined with silver staining. Subsequently, using the example of bovine epithelia, adapted extraction procedures as well as in-process and final product controls were transferred to a public pharmacy. Allergen sources with a high protein content, such as wheat and rye grains as well as storage mites, showed good comparability of the extractable protein quantity and protein pattern, regardless of the applied extraction method. In contrast, allergen source materials with a low total protein content, such as animal epithelia and molds, can benefit from laboratory extraction conditions such as mechanical disruption and specific buffer additives. In the qualitative protein silver staining, characteristic protein patterns were identified for each allergen source. Depending on the extraction method, only minor differences in total protein patterns were observed in animal epithelia and molds. Using source materials from two suppliers, the resulting allergen extracts displayed clear differences in protein content in storage mites and quantitative and qualitative differences in molds. A practical preparation attempt of SPT solutions in a public pharmacy was successful. SPT solutions prepared with adapted pharmacy extraction methods showed a comparable protein and Bos d 2 allergen content and equivalent qualities in the protein pattern compared to a previously available commercial SPT solution. Accordingly, it can be assumed that standardized SPT solutions with sufficient allergen quality for occupational allergen sources can be prepared in public pharmacies if certified allergen sources with appropriate protein content are available.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"238-250"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of paradoxical vocal cord movement misdiagnosed as anaphylaxis.","authors":"Mustafa Ilker Inan, Yasemin Akgul Balaban, Sait Yesillik, Ozgur Kartal","doi":"10.5414/ALX02502E","DOIUrl":"10.5414/ALX02502E","url":null,"abstract":"<p><strong>Introduction: </strong>Anaphylaxis is a severe and life-threatening systemic hypersensitivity reaction. The most frequently encountered causes are foods, drugs, and bee venom, but anaphylaxis may also occur idiopathically. Paradoxical vocal cord movement (PVCM), is a cause of upper airway obstruction due to abnormal adduction of vocal cords during inspiration and, to some degree on expiration. It may be misdiagnosed as asthma or anaphylaxis, and there may be delays in diagnosis.</p><p><strong>Case report: </strong>We present a 20-year-old male patient with coexistence of urticaria and stridor findings who was evaluated and treated as having idiopathic anaphylaxis but then was diagnosed with PVCM after recurrence of stridor attacks.</p><p><strong>Conclusion: </strong>It is useful to bear the diagnosis of PVCM in mind in patients with recurrent and unexplained stridor or in patients with stridor that does not improve despite treatment for another diagnosis such as anaphylaxis. This way, administration of epinephrine, high-dose corticosteroids and interventions such as intubation or tracheostomy can be avoided.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scorpion sting and allergic reaction to scorpion venom: A case-based review.","authors":"Jozélio Freire de Carvalho","doi":"10.5414/ALX400582","DOIUrl":"10.5414/ALX400582","url":null,"abstract":"<p><strong>Objective: </strong>To describe a young patient with scorpion sting (SS) with typical lesions of urticaria besides the local SS clinical picture.</p><p><strong>Materials and methods: </strong>A systematic screening of articles dating from 1966 to 2021 was conducted in the main databases. All articles included the association between SS and urticaria. A new case report is added to the published list.</p><p><strong>Results: </strong>The literature search found 5 articles with 29 patients with SS and urticaria/allergic reactions. We performed our analysis by adding our present case, resulting in a total of 30 cases. Most were male, and their ages varied from 29 to 48 years. Regarding SS severity, most were mild or moderate. In two articles, patients had more than one sting. The allergic reaction varied from urticaria, pruritus, flushing, angioedema, wheezing, rhinorrhea, sneezing, consciousness alterations, and gastrointestinal and cardiovascular alterations. In 5/6 (83%) articles, the patients were alive at the study time. One subject died from anaphylactic shock.</p><p><strong>Conclusion: </strong>The present article systematically reviewed all published cases of SS and allergic reactions to scorpion venom. It is an infrequent association; most patients are male and in the productive age, and reaction may vary from mild to severe, including death.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum of the article Reese I, Schäfer C, Ballmer-Weber B, Beyer K, Dölle-Bierke S, van Dullemen S, Jappe U, Müller S, Schnadt S, Treudler R, Worm M. Vegan diets from an allergy point of view - Position paper of the DGAKI working group on food allergy. Allergol Select. 2023; 7: 57-83.","authors":"","doi":"10.5414/ALX02400ECorr","DOIUrl":"https://doi.org/10.5414/ALX02400ECorr","url":null,"abstract":"<p><p>[This corrects the article on p. 57 in vol. 7, PMID: 37056444.].</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Delabeling\" by direct provocation testing in children and adolescents with a suspected history of a delayed reaction to β-lactam antibiotics: Consensus paper of Gesellschaft für pädiatrische Allergologie und Umweltmedizin (GPAU), Deutsche Gesellschaft für Allergologie und klinische Immunologie (DGAKI), and Ärzteverband deutscher Allergologen (ÄDA).","authors":"Irena Neustädter, Sophie Blatt, Gerda Wurpts, Heinrich Dickel, Christian Walter, Werner Aberer, Sebastian Bode, Timo Buhl, Sunhild Gernert, Susanne Harner, Guido Heine, Sebastian Kerzel, Meike Köhler, Lars Lange, Joachim List, Hans F Merk, Thomas Nüßlein, Hagen Ott, Franziska Sattler, Antje Schuster, Helen Straube, Bettina Wedi, Torsten Zuberbier, Knut Brockow","doi":"10.5414/ALX02480E","DOIUrl":"10.5414/ALX02480E","url":null,"abstract":"<p><strong>Background: </strong>Approximately 10% of European children are classified as allergic to drugs. In the majority of these children, no allergy to β-lactam antibiotics (BLA) can be found. In most cases, the exanthema is caused by the infection.</p><p><strong>Materials and methods: </strong>The objective of this paper is to describe the causes and consequences of a misdiagnosis of drug allergy. We propose a method for establishing a correct diagnosis in the case of a history of a delayed reaction during treatment with a BLA. For this purpose, a proposal was discussed via e-mail communication, and consensus was reached among the members of the drug allergy working groups of the participating medical societies.</p><p><strong>Results: </strong>The suspicion of a BLA allergy based on the medical history alone can have a negative impact on future antibiotic treatment. Exanthema associated with febrile infections not related to drug administration is a frequent finding in children. This makes it all the more important to be able to recommend a standardized procedure for clarification in children and adolescents with suspected hypersensitivity reactions. The medical history should be the basis on which to diagnose either a drug allergy or another possible differential diagnosis. A mild maculopapular exanthema (MPE) can be an expression of a drug allergy or a nonspecific viral exanthema. Uncomplicated MPE is not associated with significant systemic involvement, and there is no involvement of the mucous membranes or cutaneous blistering. Only a small number of children with uncomplicated MPE show positive skin tests and only ~ 7 - 16% of suspected BLA diagnoses can be confirmed by provocation tests. Thus, in children with uncomplicated MPE, drug provocation can be performed in an outpatient setting even without prior skin testing. This paper presents a 3-day outpatient direct provocation scheme for BLA delabeling in children with uncomplicated MPE.</p><p><strong>Conclusion: </strong>Many children and adolescents are unnecessarily denied treatment with BLA after an uncomplicated MPE while being treated with a BLA.</p>","PeriodicalId":101298,"journal":{"name":"Allergologie select","volume":"8 ","pages":"206-211"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}