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Hypersensitivity Reaction

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1. Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults

Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults - Lim - - Vox Sanguinis - Wiley Online Library The full text of this article hosted at iucr.org is unavailable due to technical difficulties.

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2019 CPG Infobase

2. Contrast media and cutaneous reactions. Part 1. Immediate hypersensitivity reactions to contrast media and gadolinium deposition. (PubMed)

Contrast media and cutaneous reactions. Part 1. Immediate hypersensitivity reactions to contrast media and gadolinium deposition. Contrast media (CM) are commonly used worldwide to enhance the quality of imaging, which is invaluable for diagnostic accuracy. Adverse reactions to CM are uncommon, but frequently involve cutaneous symptoms. This two-part article reviews adverse events secondary to CM that are relevant to the practising dermatologist. Part 1 will classify CM, address immediate (...) hypersensitivity reactions and review the newly described condition, gadolinium deposition disease. Part 2 will cover the delayed hypersensitivity reactions of iodinated contrast medium including severe cutaneous adverse reactions and iododerma.© 2019 British Association of Dermatologists.

2019 Clinical & Experimental Dermatology

3. Contrast media and cutaneous reactions. Part 2: Delayed hypersensitivity reactions to iodinated contrast media. (PubMed)

Contrast media and cutaneous reactions. Part 2: Delayed hypersensitivity reactions to iodinated contrast media. Contrast media (CM) are an indispensable part of modern medical imaging. Adverse reactions to CM are uncommon, but frequently involve cutaneous symptoms. This two-part article reviews adverse events secondary to CM that are relevant to the practising dermatologist. Part 1 covers the classification of CM, immediate hypersensitivity reactions to CM and the newly described condition (...) , gadolinium deposition disease. Given that there has only been two case reports to our knowledge of a delayed adverse reaction to gadolinium-based CM, this second part will focus on cutaneous delayed reactions caused by iodinated CM (ICM). Delayed hypersensitivity reactions to ICM commonly present as maculopapular exanthems, but more rarely, they can manifest as fixed drug eruptions, acute generalized exanthematous pustulosis, drug-related eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic

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2019 Clinical & Experimental Dermatology

4. Immediate hypersensitivity reaction to human serum albumin in a child undergoing plasmapheresis. (PubMed)

Immediate hypersensitivity reaction to human serum albumin in a child undergoing plasmapheresis. Human serum albumin (HSA) is a commonly used colloid for volume expansion and albumin replacement and during plasmapheresis. Colloids are an uncommon cause of anaphylaxis, and cases of hypersensitivity reactions to HSA are extremely rare.A 10-year-old boy with chronic inflammatory demyelinating polyneuropathy was treated with plasmapheresis, with albumin as the replacement fluid. He developed (...) a severe reaction characterized by respiratory, gastrointestinal, and cutaneous symptoms.Skin testing to HSA was positive and resulted in objective systemic symptoms, suggesting an immediate hypersensitivity reaction to HSA.While colloids are an uncommon cause of immediate hypersensitivity reactions, they can lead to severe and potentially fatal reactions if not recognized and treated promptly.© 2019 AABB.

2019 Transfusion

5. Patients with a history of hypersensitivity reaction to iodinated contrast medium and given iodinated contrast during an interventional pain procedure. (PubMed)

Patients with a history of hypersensitivity reaction to iodinated contrast medium and given iodinated contrast during an interventional pain procedure. In patients with a history of a hypersensitivity reaction to iodinated contrast medium, iodinated contrast medium is avoided, antihistamine and steroid premedication are given, or a gadolinium-based contrast agent is employed. Six patients with a history of a hypersensitivity reaction to iodinated contrast medium and who were not premedicated (...) had an unintentional injection of iodinated contrast. None of the patients developed a moderate or severe reaction. All patients had gadopentetate dimeglumine in one of their injections; three had repeated injections of the gadopentetate. The lack of a significant reaction may be due to any or all of the following: questionable history of iodinated contrast reaction, low dose of iodinated contrast given, concomitant injection of (epidural) steroid, and slower absorption from epidural compared

2019 Regional Anesthesia and Pain Medicine

6. Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions. (PubMed)

Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions. Grading schemes for severity of suspected allergic reactions have been applied to the perioperative setting, but there is no scoring system that estimates the likelihood that the reaction is an immediate hypersensitivity reaction. Such a score would be useful in evaluating current and proposed tests for the diagnosis of suspected perioperative immediate hypersensitivity reactions and culprit agents.We (...) process to devise a clinical scoring system for suspected perioperative immediate hypersensitivity reactions. This will enable objectivity and uniformity in the assessment of the sensitivity of diagnostic tests.Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

2019 British Journal of Anaesthesia

7. Comparative epidemiology of suspected perioperative hypersensitivity reactions. (PubMed)

Comparative epidemiology of suspected perioperative hypersensitivity reactions. Suspected perioperative hypersensitivity reactions are rare but contribute significantly to the morbidity and mortality of surgical procedures. Recent publications have highlighted the differences between countries concerning the respective risk of different drugs, and changes in patterns of causal agents and the emergence of new allergens. This review summarises recent information on the epidemiology (...) of perioperative hypersensitivity reactions, with specific consideration of differences between geographic areas for the most frequently involved offending agents.Copyright © 2019. Published by Elsevier Ltd.

2019 British Journal of Anaesthesia

8. Hypersensitivity reactions to antiepileptic drugs in children. (PubMed)

Hypersensitivity reactions to antiepileptic drugs in children. Antiepileptic drugs (AEDs) can cause hypersensitivity reactions in children. These reactions are mainly cutaneous, self-limiting and benign but life-threatening severe cutaneous adverse reactions can occur. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions, if a drug is taken at the same time. The aims of our study was to confirm or rule out the diagnosis of hypersensitivity reactions to AEDs (...) in children as well as to detect an infection which mimic these reactions.A prospective survey was conducted in a group of 100 children with histories of hypersensitivity reactions to AEDs by performing patch tests, delayed -reading intradermal test, and in case of negative results, challenge test. In all children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae.Maculopapular exanthema and delayed appearing urticaria were the most reported hypersensitivity reactions to AEDs

2019 Pediatric Allergy and Immunology

9. The skin as an immune organ: Tolerance versus effector responses and applications to food allergy and hypersensitivity reactions. (PubMed)

The skin as an immune organ: Tolerance versus effector responses and applications to food allergy and hypersensitivity reactions. Skin is replete with immunocompetent cells that modulate signaling pathways to maintain a salubrious immunogenic/tolerogenic balance. This fertile immune environment plays a significant role in the development of allergic responses and sensitivities, but the mechanisms underlying these pathways have been underappreciated and underused with respect to developing

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2019 Journal of Allergy and Clinical Immunology

10. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions. (PubMed)

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions. Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized and it is becoming increasingly apparent (...) that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper are to provide recommendations for the investigation of immediate type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians

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2019 Allergy

11. Case Report: A Case of Type 1 Leprosy Reaction and Dapsone Hypersensitivity Syndrome Complicating the Clinical Course of Multibacillary Leprosy. (PubMed)

Case Report: A Case of Type 1 Leprosy Reaction and Dapsone Hypersensitivity Syndrome Complicating the Clinical Course of Multibacillary Leprosy. Type 1 reactions, characterized by increasing lesion erythema, pain, and nerve damage, commonly complicate leprosy. Dapsone hypersensitivity syndrome (DHS) is a potentially fatal reaction occurring 6-8 weeks into dapsone therapy. We present a case of intercurrent Type 1 reaction and DHS in a multibacillary leprosy patient recently started on multidrug

2019 American Journal of Tropical Medicine & Hygiene

12. Hypersensitivity transfusion reactions to platelet concentrate: a retrospective analysis of the French hemovigilance network. (PubMed)

Hypersensitivity transfusion reactions to platelet concentrate: a retrospective analysis of the French hemovigilance network. Among labile blood products, platelet concentrates (PCs) are the leading cause of hypersensitivity transfusion reactions (HTRs). These reactions often lead to interruption of PC transfusion and can result in a prolonged transfusion process leading to significant morbidity and use of premedication and close monitoring for patients with a history of allergic transfusion (...) reactions. The French hemovigilance database is one of the largest standardized databases providing information on HTRs following administration of labile blood products. In this study, we analyzed this database to assess the relative risk of HTR for each type of PC.HTRs following PC transfusion were retrospectively extracted from the e-Fit Hemovigilance database of the French National Agency for Medicines and Health Products Safety (ANSM). Frequencies were calculated using the number of specific PCs

2019 Transfusion

13. Epidemiology of acute coronary syndrome co-existent with allergic/hypersensitivity/anaphylactic reactions (Kounis syndrome) in the United States: A nationwide inpatient analysis. (PubMed)

Epidemiology of acute coronary syndrome co-existent with allergic/hypersensitivity/anaphylactic reactions (Kounis syndrome) in the United States: A nationwide inpatient analysis. The nationwide epidemiological data on Kounis Syndrome (KS), still remains indistinct in the United States (US) after it was first reported in 1991.We assessed the prevalence of KS among patients primarily hospitalized for allergic/hypersensitivity/anaphylactic reactions. We then compared baseline demographics (...) , comorbidities, and outcomes of KS with patients with only allergic/hypersensitivity/anaphylactic reactions using the National Inpatient Sample, 2007-2014.The cohort comprised of 235,420 patients primarily hospitalized with allergy/hypersensitivity/anaphylactic reactions. Of these, 2616 [1.1%; 0.2% unstable angina, 0.2% ST-elevation myocardial infarction & 0.7% non-ST-elevation myocardial infarction] patients experienced ACS and were identified as having KS. Patients with KS were older (mean 65.9 ± 14.1 vs

2019 International journal of cardiology

14. A case of hypersensitivity reaction to alcohol confirmed by oral provocation test. (PubMed)

A case of hypersensitivity reaction to alcohol confirmed by oral provocation test. 31081232 2019 07 04 1468-3083 2019 May 13 Journal of the European Academy of Dermatology and Venereology : JEADV J Eur Acad Dermatol Venereol A case of hypersensitivity reaction to alcohol confirmed by oral provocation test. 10.1111/jdv.15673 Aurich S S Department of Dermatology, Venereology and Allergology, Universität Leipzig, Leipzig, Germany. LICA - Leipziger Interdisziplinäres Centrum für Allergologie

2019 Journal of the European Academy of Dermatology and Venereology

15. Prognostic value of hypersensitivity reactions on epidural steroid injection outcomes: a phenotypic signature? A prospective cohort study. (PubMed)

Prognostic value of hypersensitivity reactions on epidural steroid injection outcomes: a phenotypic signature? A prospective cohort study. Studies have found that diffuse pain, indicative of central sensitization, portends poor interventional outcomes. Multiple chemical sensitivities are associated with signs of central sensitization. We sought to prospectively determine whether hypersensitivity reactions (HR) were associated with epidural steroid injection (ESI) outcomes.HR were classified

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2019 Regional Anesthesia and Pain Medicine

16. Graded Dalbavancin Challenge in a Patient with Severe Vancomycin Hypersensitivity Reaction. (PubMed)

Graded Dalbavancin Challenge in a Patient with Severe Vancomycin Hypersensitivity Reaction. Cross-reactivity should be considered when treating patients with a previous hypersensitivity reaction within the same class of antibiotics that share similar chemical structures. This case report describes a patient with severe hypersensitivity reaction to vancomycin who successfully tolerated a dalbavancin graded challenge.© The Author(s) 2019. Published by Oxford University Press for the Infectious

2019 Clinical Infectious Diseases

17. Evaluation of Antibody Properties and Clinically Relevant Immunogenicity, Anaphylaxis, and Hypersensitivity Reactions in Two Phase III Trials of Tralokinumab in Severe, Uncontrolled Asthma. (PubMed)

Evaluation of Antibody Properties and Clinically Relevant Immunogenicity, Anaphylaxis, and Hypersensitivity Reactions in Two Phase III Trials of Tralokinumab in Severe, Uncontrolled Asthma. Tralokinumab is a monoclonal antibody (mAb) that neutralizes interleukin (IL)-13, a cytokine involved in the pathogenesis of asthma.The objectives of this study were to characterize the potential immunogenic properties of tralokinumab and report data for anti-drug antibodies (ADAs) and hypersensitivity (...) reactions from two phase III clinical trials.The oligosaccharide structure of tralokinumab, Fab-arm exchange, and ADAs were characterized by standard techniques. Hypersensitivity adverse events (AEs) were evaluated in two pivotal clinical trials of tralokinumab in severe, uncontrolled asthma: STRATOS 1 and 2 (NCT02161757 and NCT02194699).No galactose-α-1,3-galactose (α-Gal) epitopes were found in the Fab region of tralokinumab and only 4.5% of glycoforms contained α-Gal in the Fc region. Under non

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2019 Drug Safety Controlled trial quality: uncertain

18. Severe hypersensitivity reactions to biological drugs in children with rheumatic diseases. (PubMed)

Severe hypersensitivity reactions to biological drugs in children with rheumatic diseases. Hypersensitivity reactions (HSR) to biologic drugs (BD) may limit their use in children with rheumatic diseases. We aimed to analyze the incidence and clinical characteristics of immediate type I (IgE/non-IgE) hypersensitivity reactions to BD and the risk factors for these reactions.Children with rheumatic diseases using BD who were evaluated in the pediatric allergy department for possible drug (...) hypersensitivity reaction (DHR) due to BD or any other drug were included in the study.One hundred and twenty-eight children (49.2% boys; 14.6 years [9.9-16.9 years] with juvenile idiopathic arthritis [58%], familial Mediterranean fever [14%], vasculitis [14%], and other diseases [14%]) had used eight different BD with 32 494 infusions/injections. Fifteen patients were evaluated for DHR [injection-site reactions [n = 4], adverse events [n = 2], drug hypersensitivity other than BD [n = 3], and immediate BD

2019 Pediatric Allergy and Immunology

19. Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. (PubMed)

Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs-hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross-hypersensitivity reactions (CRs), associated with COX-1 inhibition (...) , and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs-exacerbated respiratory disease, NSAIDs-exacerbated cutaneous disease, and NSAIDs-induced urticaria/angioedema. Two phenotypes fill into the second one: single-NSAID-induced urticaria/angioedema/anaphylaxis, and single-NSAID-induced delayed reactions. Diagnosis of NSAIDs-hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness

2019 Allergy

20. A practical 16-day desensitization protocol in lenalidomide-induced non-immediate hypersensitivity reactions. (PubMed)

A practical 16-day desensitization protocol in lenalidomide-induced non-immediate hypersensitivity reactions. Desensitization in immediate-type hypersensitivity reactions (HRs) caused by chemotherapeutics is well described and standardized for many drugs. However, there are no standardized protocols in non-immediate HRs.To evaluate the effectiveness of a 16-day desensitization protocol in the non-immediate HRs induced by lenalidomide.According to our previously published slow desensitization (...) protocol, we desensitized patients who had experienced non-immediate HRs attributable to lenalidomide. The protocol was started with the 1/100 of the daily-prescribed dose in milligrams of the culprit drug; then the doses were slowly increased to complete the procedure in 16 days. Demographic and clinical features of the patients were further appraised.Ten patients (mean age was 64.7 ± 10.8 years; 7 male) were successfully desensitized to lenalidomide. The mean reaction time was 7.3 ± 3.9 days

2019 Asthma & Immunology

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