Allergy Asthma and Clinical Immunology最新文献

{"title":"Impact of injectable HAE on-demand treatments on health-related quality of life: a patient and caregiver interview study.","authors":"Patrick F K Yong, Timothy J Craig, Paula J Busse, Tomaz Garcez, Rebekah Hall, Siu Hing Lo, Caleb Dixon, Paul K Audhya, Alice Wang, Aleena Banerji, Sorena Kiani-Alikhan","doi":"10.1186/s13223-025-00997-w","DOIUrl":"10.1186/s13223-025-00997-w","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) attacks can be unpredictable, painful, and debilitating. Although studies described the burden of prophylactic HAE treatments on patient and caregiver health-related quality of life (HRQoL), few have explored the effects of injectable on-demand treatments on HRQoL.</p><p><strong>Objective: </strong>To understand the impact of injectable on-demand HAE treatments on HRQoL.</p><p><strong>Methods: </strong>Patients (aged ≥ 12 years) with ≥ 1 HAE attack in the prior 6 months and adult caregivers (aged ≥ 18 years) of patients of any age with HAE were recruited between July and October 2024 to complete a qualitative interview. Questions concerned on-demand injectable treatment use, impacts, and burden. Thematic analysis was used to identify key themes across responses.</p><p><strong>Results: </strong>The 25 study participants from the US and UK (17 patients; 8 caregivers), who completed the interview, highlighted emotional and logistical reasons for delaying or forgoing injectable on-demand treatment, including fear of needles, portability, and complexity of administration. All participants described at least one negative impact on HRQoL, including anxiety and pain associated with treatment administration, disruption of daily activities or work/school days, and impacts on personal relationships. Adolescent patients reported greater impacts than adult patients. Although indicated for self-administration, some adult and all adolescent patients reported needing assistance with administration of their injectable on-demand treatment. All participants expressed interest in an oral on-demand treatment for reasons including portability, pain-free administration, and ability to treat attacks earlier.</p><p><strong>Conclusion: </strong>This study highlights the unmet need for an on-demand treatment that allows for earlier, pain-free administration, ultimately increasing patient independence and improving HRQoL for both patients and caregivers.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":"52"},"PeriodicalIF":2.4,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Omalizumab against Japanese Cedar pollinosis in clinical practice.","authors":"Momoko Takeda, Hiroshi Utsunomiya, Toshio Miki","doi":"10.1186/s13223-025-00995-y","DOIUrl":"10.1186/s13223-025-00995-y","url":null,"abstract":"<p><strong>Background: </strong>Japanese cedar pollinosis (JCP), which affects over 40% of the population and represents a major public health issue in Japan, has various treatment options, but limited clinical reports and high costs necessitate careful patient selection. This study aimed to evaluate the efficacy of omalizumab in treating JCP and identify key considerations for its appropriate clinical application.</p><p><strong>Methods: </strong>We retrospectively analyzed 42 patients with JCP treated with omalizumab from 2021 to 2024. Treatment response was assessed using a 3-category patient-reported scale across all years. In a 2023-2024 subset (n = 23), quantitative total symptom score (TSS) data were available, allowing effect-size estimation and subgroup analyses.</p><p><strong>Results: </strong>The study included 42 patients (30 men, 71.4%) aged 12-80 years (mean, 41.5 ± 17.2 years). Symptom improvement was observed in 38 patients (90%), including marked improvement in 23 (55%). Responders were younger (mean age 39.9 vs. 55.5 years) and had higher total IgE levels (251 vs. 211 IU/mL) than nonresponders. No significant correlation was observed between nasal eosinophil counts and treatment response. In the 2023-2024 subset (n = 23), TSS decreased significantly (mean paired difference - 2.61; p = 0.0010). Subgroup analyses suggested that CRSsNP cases tended to show insufficient improvement, while younger age and higher IgE levels were associated with better response trends.</p><p><strong>Conclusions: </strong>Omalizumab significantly improved symptoms and QOL in patients with JCP. However, its high cost and the risk of nonresponse necessitate careful patient selection. Age and IgE levels may help guide treatment decisions, highlighting the importance of individualized strategies for severe JCP.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"50"},"PeriodicalIF":2.4,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and association of elevated total serum IgE levels with ICU admissions and poor asthma control: a retrospective study in a tertiary hospital in Saudi Arabia.","authors":"Hassan Alwafi, Husna Irfan Thalib, Ayesha Jamal, Safaa M Alsanosi, Abdallah Y Naser, Abdulelah M Aldhahir, Abdullah A Alqarni, Jaber S Alqahtani, Saeed M Alghamdi, Mohammad Saleh Dairi, Omaima Ibrahim Badr","doi":"10.1186/s13223-025-01003-z","DOIUrl":"10.1186/s13223-025-01003-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence of elevated serum Immunoglobulin E (IgE) levels among adult patients with asthma and to investigate the association between IgE levels and hospital admissions, ICU admissions, asthma control, and other clinical outcomes.</p><p><strong>Methods: </strong>This was a retrospective single-centre study. Adult patients with a confirmed diagnosis of asthma between 28 February 2023 and 1 March 2024 at Al-Noor Specialist Hospital, Mecca, Saudi Arabia, were included. Patients were excluded if their records lacked spirometry or serum IgE data. Population characteristics were presented as frequency for categorical variables and median with interquartile range for continuous variables. Logistic regression analysis was used to identify predictors of severe asthma outcomes stratified by IgE levels.</p><p><strong>Results: </strong>The study included 807 asthma patients, with a majority being females (68.9%) and a mean age of 48.2 years. A total of 311 patients (38.5%) had elevated serum IgE levels (> 100 IU). Patients with high IgE levels had significantly higher rates of hospital admission due to asthma (16.4% vs. 7.1%, p < 0.001) and ICU admission (4.2% vs. 1.2%, p = 0.008). They were also less likely to have controlled asthma (42.4% vs. 78.9%, p < 0.001) and more likely to report frequent acute care service visits (62.1% vs. 32.5%, p < 0.001). Logistic regression showed that elevated IgE levels were significantly associated with increased odds of hospital admission (OR = 2.6, 95% CI = [1.6-4.0], p < 0.001), ICU admission (OR = 3.5, 95% CI = [1.3-9.4], p = 0.011), uncontrolled asthma (OR = 0.2, 95% CI = [0.1-0.3], p < 0.001), and frequent ACS visits (OR = 0.3, 95% CI = [0.2-0.4], p < 0.001).</p><p><strong>Conclusions: </strong>Elevated serum IgE levels are significantly associated with poorer asthma control, increased hospital admissions, and higher ICU admission rates. Stratifying asthma patients based on IgE levels may help identify high-risk individuals and guide management strategies through a targeted approach.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12763928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric anaphylaxis: age-related symptom trends and the limited role of allergen molecules: a retrospective analysis.","authors":"Izabela Kucharek, Krzysztof Przystał-Dyszyński, Aleksandra Godyńska, Maria Gregorczyk, Natasza Krajewska, Adam J Sybilski","doi":"10.1186/s13223-025-01000-2","DOIUrl":"10.1186/s13223-025-01000-2","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence suggests that specific allergen molecules may influence the clinical phenotype of anaphylaxis in children, but robust data are scarce. This study aimed to rigorously test the molecule-phenotype association in a large pediatric cohort and to determine the relative influence of the sensitizing molecule versus patient age on symptom presentation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 184 pediatric patients (0-18 years) hospitalized for anaphylaxis. Molecular allergen-specific immunoglobulin E (IgE) profiles were determined using the ALEX² test. Symptom frequencies across different organ systems were analyzed in relation to allergen molecules and age groups using Cochran's Q and Pearson's χ2 tests.</p><p><strong>Results: </strong>The most frequent molecular triggers were Ara h 2 (18.79%), Gal d 1 (9.09%), and Ana o 3 (9.09%). While significant differences in symptom distribution were observed within individual allergen molecules (p < 0.05), no molecule-specific symptom pattern was identified. In contrast, age significantly influenced respiratory symptom prevalence, with a higher frequency in older children compared to infants (p = 0.003). A similar trend was observed for gastrointestinal symptoms (p = 0.051).</p><p><strong>Conclusions: </strong>In pediatric anaphylaxis, patient age is a more significant determinant of clinical presentation, particularly for respiratory symptoms, than the specific sensitizing allergen molecule. This suggests that clinical risk stratification and management strategies in children should prioritize age-related factors over specific molecular sensitization profiles.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":" ","pages":"54"},"PeriodicalIF":2.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of mast cell activation syndrome (MCAS) in Canada: a practical approach.","authors":"Erika Lee, Matthieu Picard","doi":"10.1186/s13223-025-00998-9","DOIUrl":"10.1186/s13223-025-00998-9","url":null,"abstract":"<p><p>An increasing number of patients are presenting to allergists with concerns about mast cell activation syndrome (MCAS), often in the context of persistent, unexplained, multisystem symptoms. This review aims provide a practical, stepwise approach to the diagnosis and management of MCAS, based on the consensus criteria established by the European Competence Network on Mastocytosis-American Initiative on Mast Cell Diseases, an international consortium of leading experts in mast cell disorders endorsed by major scientific organizations. The first step is to evaluate whether the clinical presentation is consistent with MCAS, recognizing that the prototypical presentation is idiopathic anaphylaxis. Symptoms should be severe, episodic, typical of mast cell activation, and involve at least two organ systems. The next step is to exclude secondary causes of mast cell activation, particularly cofactor-dependent food allergy and nonsteroidal anti-inflammatory drug hypersensitivity. Objective evidence of mast cell activation must then be obtained, preferably by identifying an acute increase in serum tryptase (on a sample drawn within four hours of an episode) compared to baseline. Alternatively, urinary metabolites of mast cell mediators can be assessed by comparing baseline values with those obtained 3-6 h post-event. Importantly,elevated baseline values in serum tryptase or urinary metabolites are not diagnostic of MCAS, nor do normal values exclude the diagnosis. In patients with idiopathic anaphylaxis, evaluation for a clonal mast cell disorder is recommended. This includes measuring baseline serum tryptase, testing for the KIT p.D816V mutation in peripheral blood (using high-sensitivity assays, if available), and calculating a mast cell clonality prediction score. A bone marrow biopsy should be considered for those with a high probability of mast cell clonality. Management includes instructing patients to treat acute episodes with an epinephrine auto-injector, particularly when anaphylaxis criteria are met. For patients with recurrent episodes, prophylactic therapy may be initiated, starting with H1-antihistamines and stepping-up as needed. While most patients have a favourable clinical course, some may require multiple medications to prevent or attenuate episodes. Future research should focus on validating and refining diagnostic and therapeutic strategies. In clinical practice, expanding access to key diagnostic tools-such as urinary mediator assays, sensitive KIT mutation testing, and tryptase genotyping-would facilitate and improve care of those patients.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"49"},"PeriodicalIF":2.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12639879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staphylococcus aureus nasal carriage is associated with faster symptom resolution following nasal allergen challenge in ragweed-allergic participants: a subset of the Allergic Rhinitis Microbiome Study.","authors":"Sophia Linton, Lubnaa Hossenbaccus, Abigail Davis, Jenny Thiele, Sarah Garvey, Hannah Botting, Lisa Steacy, Prameet M Sheth, Anne K Ellis","doi":"10.1186/s13223-025-00990-3","DOIUrl":"10.1186/s13223-025-00990-3","url":null,"abstract":"<p><p>In this letter, we report that ragweed-allergic participants with nasal Staphylococcus aureus carriage (n = 7) exhibited significantly smaller reductions in Peak Nasal Inspiratory Flow from baseline at 3 h (P = 0.013) and 5 h (P = 0.008) post-nasal allergen challenge compared to non-carriers (n = 12). There was no significant difference between carriers and non-carriers in the initial response within the first three hours following the challenge (all P > 0.05). Carriers also reported significantly lower Total Nasal Symptom Scores (P = 0.015) and Total Rhinoconjunctivitis Symptom Scores (P = 0.021) at 48 h. These findings suggest that S. aureus carriage does not exacerbate allergic responses and may instead be associated with more rapid symptom resolution.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"48"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for the diagnosis and management of eosinophilic esophagitis in adults and children in Canada: a Delphi consensus project.","authors":"Vishal Avinashi, Milli Gupta, Beth A Payne, Haneen Amhaz, Alisha T Temirova, Waqqas Afif, Dhandapani Ashok, Janice Barkey, David Burnett, Jonathan W Bush, Scott Cameron, Stuart Carr, Dina El Demellawy, Stephanie Erdle, Hien Q Huynh, Jennifer Griffin, Samir C Grover, Kelly Grzywacz, Samira Jeimy, Hin Hin Ko, Gina Lacuesta, Margaret Marcon, Serge Mayrand, Harrison Petropolis, David Rodrigues, Mary Sherlock, Christine Song, Natacha Tardio, Timothy K Vander Leek, Meagan Vurzinger, Brock A Williams, Ted Xenodemetropoulos, Christopher Ma, Edmond S Chan","doi":"10.1186/s13223-025-00993-0","DOIUrl":"10.1186/s13223-025-00993-0","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus that effects both pediatrics and adult patients in Canada and is increasing in prevalence. No Canadian focused best practice recommendations currently exist to guide clinical practice.</p><p><strong>Methods: </strong>The study used a modified Delphi technique to develop evidence and expert opinion-based recommendations for providing care for patients with EoE. The Delphi process consisted of 3 rounds of quantitative surveys and qualitative consensus meetings. Experts were included in the Delphi if they had experience caring for EoE patients in Canada within one of the following professional groups: allergist, adult gastroenterologists, pathologists, pediatric gastroenterologists, and dieticians.</p><p><strong>Results: </strong>Delphi rounds were completed between May 1, 2024, and June 30, 2024. A total of 31 experts in EoE care from across Canada were recruited to participate in the Delphi consensus process. All participants completed all three rounds of Delphi surveys. The final statement includes 38 recommendations for the care of patients with EoE organized into three sections: definition, diagnosis, and management. A Table of research gaps is provided to stimulate further knowledge development on this topic.</p><p><strong>Conclusion: </strong>This consensus statement includes actionable recommendations to support quality care of patients with EoE at any age across Canada. We encourage EoE centers in Canada to come together in a multi-disciplinary form to not only provide clinical care but also do much needed research on Canadian specific topics and gaps in EoE care.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"47"},"PeriodicalIF":2.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12595650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis to dextromethorphan with positive skin testing: a case report.","authors":"Eman Badawod, Jackie Campbell, Erika Lee","doi":"10.1186/s13223-025-00987-y","DOIUrl":"10.1186/s13223-025-00987-y","url":null,"abstract":"<p><strong>Background: </strong>Dextromethorphan (DM) is a cough suppressant that is widely available in many prescribed and over-the-counter medications. Both immediate and delayed hypersensitivity reactions have been reported following the ingestion of DM. Anaphylaxis to DM is rare, with only three reported cases in the literature. Among these, skin prick testing for DM yielded a positive result in one case, a negative result in another, and was not performed in the third.</p><p><strong>Case presentation: </strong>We present a rare case of anaphylaxis linked to DM, confirmed by skin testing. The patient experienced a severe allergic reaction after taking Vicks Dayquil Complete®, a common over-the-counter cold and flu medicine that contains acetaminophen, DM, phenylephrine hydrochloride, and guaifenesin. Among these, only DM triggered a positive response on skin testing.</p><p><strong>Conclusion: </strong>This case highlights an uncommon allergy to a combination cold medicine, with skin testing identifying DM as the cause.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"46"},"PeriodicalIF":2.4,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12577429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of a novel home-based oral food challenge protocol for pediatric food protein induced enterocolitis syndrome.","authors":"Emily G Morris, Peter W Huan, Jennifer L P Protudjer, Lucy Li, Natalie Rondilla, Jeevan Abraham, Harold Kim","doi":"10.1186/s13223-025-00994-z","DOIUrl":"10.1186/s13223-025-00994-z","url":null,"abstract":"<p><strong>Background: </strong>Oral food challenges (OFCs) are considered the gold standard for diagnosis of food protein-induced enterocolitis syndrome (FPIES), a non-immunoglobulin E mediated gastrointestinal food allergy characterized by delayed, repetitive vomiting, lethargy, and sometimes diarrhea, primarily affecting infants and young children. Our modified approach to OFCs involves smaller, gradually increased doses to mitigate the risk of severe reactions. We aimed to measure the successful completion of this OFC protocol.</p><p><strong>Methods: </strong>In a retrospective chart review, patients age < 18 years, who had 1 + episode of acute FPIES between 2015 and 2023 were identified using an allergy clinic database. Patients underwent OFCs with home up dosing every 2-4 weeks. Steps included 1%, 2%, 5%, 10%, 20%, 30%, 40%, 60%, 80%, and 100% of the final serving amount. The primary outcome was successful completion, i.e. absence of severe reactions during the OFC protocol and 1 year after. Data were analysed using logistic regression and reported as odds ratios (OR) and 95% confidence intervals (95% CI). Results were adjusted for multiple allergic comorbidities, age of FPIES onset, and biological sex.</p><p><strong>Results: </strong>Among 47 patients who began the OFC protocol, 38 (80.85%) completed it without significant reactions. Of the 9 (19.14%) who did not complete the protocol, 4 (44.4%) paused due to reactions, and 5 (55.6%) paused due to non-FPIES symptoms. The 4 reactors paused due to mild-to-moderate reactions; there were no severe reactions during the protocol. There were no significant associations identified between OFC completion and severity of symptoms (OR 1.05; 95% CI 0.24-4.71; p = 0.94); age at onset of symptoms (OR 0.99; 95% CI 0.94-1.02; p = 0.58); or age of starting OFC (OR 1.00; 95% CI 0.98-1.02; p = 0.90). Patients who reacted to milk tended to be less likely to complete the protocol than those reacting to other foods (OR 0.28; 95% CI 0.07-1.06; p = 0.06).</p><p><strong>Conclusions: </strong>This study supports the potential for a home-based gradual approach to OFCs in FPIES, evidenced by a high completion rate and no severe reactions.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"45"},"PeriodicalIF":2.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient refractory period in severe iodinated contrast media allergy: a case report.","authors":"Lara S Dungan, Fionnuala Cox","doi":"10.1186/s13223-025-00972-5","DOIUrl":"10.1186/s13223-025-00972-5","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reactions to iodinated contrast media (ICM) are rare but can be life-threatening. Management typically involves avoidance of the offending agent and the use of alternative imaging strategies. The phenomenon of a transient refractory period-wherein a patient does not exhibit an allergic response upon re-exposure to the allergen shortly after an initial reaction-has been proposed but is not well-documented in the context of ICM.</p><p><strong>Case presentation: </strong>We report the case of a 56-year-old woman who experienced an anaphylaxis associated cardiac arrest following administration of iopamidol 370 (Niopam 370) during a computed tomography pulmonary angiogram (CTPA). She was resuscitated, intubated, and stabilized with noradrenaline. Two hours later, she underwent a second CT scan using iopamidol 300 (Niopam 300) without any obvious immediate hypersensitivity reaction. Subsequent skin testing was positive for both Niopam 370 and Niopam 300, but negative for alternative agents - iodixanol (Visipaque) and iohexol (Omnipaque).</p><p><strong>Conclusions: </strong>This case suggests the presence of a transient refractory period following a severe hypersensitivity reaction to ICM, during which re-exposure to the allergen does not elicit an immediate response. Understanding this phenomenon could have significant implications for the management of urgent imaging needs in patients with known ICM hypersensitivity.</p>","PeriodicalId":51302,"journal":{"name":"Allergy Asthma and Clinical Immunology","volume":"21 1","pages":"43"},"PeriodicalIF":2.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}