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Hypersensitivity Reaction

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1. Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults Full Text available with Trip Pro

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.

2019 CPG Infobase

2. Metamizole-induced reactions as a paradigm of drug hypersensitivity: non-allergic reactions, anaphylaxis, and delayed-type allergy. Full Text available with Trip Pro

Metamizole-induced reactions as a paradigm of drug hypersensitivity: non-allergic reactions, anaphylaxis, and delayed-type allergy. Metamizole belongs to the group of non-opioid analgesics and, as for other non-steroidal anti-inflammatory drugs (NSAID) such as acetylsalicylic acid, diclofenac or ibuprofen, both isoforms of cyclooxygenase are inhibited. Metamizole is an important trigger of non-allergic and allergic hypersensitivity reactions and has been withdrawn from the US, Australian

2020 Clinical and Experimental Allergy

3. Hypersensitivity reactions with allopurinol and febuxostat: a study using the Medicare claims data (Abstract)

Hypersensitivity reactions with allopurinol and febuxostat: a study using the Medicare claims data To assess the risk of hypersensitivity reactions (HSRs) with allopurinol and febuxostat in a population-based study.We used the 5% Medicare beneficiary sample (≥65 years) from 2006 to 2012 to identify people with a newly filled prescription for allopurinol, febuxostat or colchicine. We used multivariable-adjusted Cox regression analyses to compare the hazard ratio (HR) of incident HSRs

2020 EvidenceUpdates

4. Allergy immunotherapy for inhalant allergens: Strategies to minimize adverse reactions. (Abstract)

Allergy immunotherapy for inhalant allergens: Strategies to minimize adverse reactions. Background: Allergy immunotherapy (AIT), both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), is an effective and safe treatment for allergic rhinitis and allergic asthma due to inhalant allergens. However, there are many variables in how it is administered. Objective: To review the evidence that suggests the optimal practice(s) to minimize adverse reactions to AIT. Methods: Articles (...) that reported the results of various approaches to the practice of AIT and evidence-based guidelines were consulted for guidance about approaches that would minimize adverse reactions to AIT. Results: Evidence is presented that supports care in the preparation of allergy extracts for treatment; use of modified extracts; location for administration of SCIT and SLIT; risk factors for systemic reactions; AIT in patients on adrenergic blocking agents and angiotensin-converting enzyme inhibitors; use

2020 Allergy and Asthma Proceedings

5. Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial. There are currently no approved treatments for peanut allergy.To assess the efficacy and adverse events of epicutaneous immunotherapy with a peanut patch among peanut-allergic children.Phase 3, randomized, double-blind, placebo-controlled trial conducted at 31 sites in 5 countries between January 8, 2016, and August 18, 2017 (...) . Participants included peanut-allergic children (aged 4-11 years [n = 356] without a history of a severe anaphylactic reaction) developing objective symptoms during a double-blind, placebo-controlled food challenge at an eliciting dose of 300 mg or less of peanut protein.Daily treatment with peanut patch containing either 250 μg of peanut protein (n = 238) or placebo (n = 118) for 12 months.The primary outcome was the percentage difference in responders between the peanut patch and placebo patch based

2019 JAMA Controlled trial quality: predicted high

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

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

7. Contrast media and cutaneous reactions. Part 2: Delayed hypersensitivity reactions to iodinated contrast media. Full Text available with Trip Pro

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

2019 Clinical & Experimental Dermatology

8. The skin as an immune organ: Tolerance versus effector responses and applications to food allergy and hypersensitivity reactions. Full Text available with Trip Pro

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

2019 Journal of Allergy and Clinical Immunology

9. Safety of allergen immunotherapy in North America from 2008-2017: Lessons learned from the ACAAI/AAAAI National Surveillance Study of adverse reactions to allergen immunotherapy. (Abstract)

Safety of allergen immunotherapy in North America from 2008-2017: Lessons learned from the ACAAI/AAAAI National Surveillance Study of adverse reactions to allergen immunotherapy. In 2004, it was estimated that one fatal anaphylactic reaction (FR) occurred in every 2.4 million subcutaneous immunotherapy (SCIT) injection visits. Uncontrolled asthma was the most commonly cited factor that contributed to FRs. Results of the annual American College of Allergy, Asthma, and Immunology/American Academy (...) of Allergy, Asthma and Immunology sponsored survey conducted among practicing allergists suggest that one nonfatal systemic reactions (SR) occurred in 0.15% of injection visits and in 0.7% of patients who were treated. Analysis of recent data indicated that FRs are 3.75-fold less frequent. Life-threatening grade 4 anaphylactic reactions are estimated to occur in 0.005% of patients who receive SCIT (or 1/160,000 injection visits). Analysis of data from annual surveys identified the following possible risk

2020 Allergy and Asthma Proceedings

10. Immune dysregulation increases the incidence of delayed-type drug hypersensitivity reactions. Full Text available with Trip Pro

Immune dysregulation increases the incidence of delayed-type drug hypersensitivity reactions. Delayed-type, T cell-mediated, drug hypersensitivity reactions are a serious unwanted manifestation of drug exposure that develops in a small percentage of the human population. Drugs and drug metabolites are known to interact directly and indirectly (through irreversible protein binding and processing to the derived adducts) with HLA proteins that present the drug-peptide complex to T cells. Multiple (...) forms of drug hypersensitivity are strongly linked to expression of a single HLA allele, and there is increasing evidence that drugs and peptides interact selectively with the protein encoded by the HLA allele. Despite this, many individuals expressing HLA risk alleles do not develop hypersensitivity when exposed to culprit drugs suggesting a nonlinear, multifactorial relationship in which HLA risk alleles are one factor. This has prompted a search for additional susceptibility factors. Herein, we

2020 Allergy

11. Clinical factors before or after device implantation in predicting metal hypersensitivity reactions: A retrospective study. (Abstract)

Clinical factors before or after device implantation in predicting metal hypersensitivity reactions: A retrospective study. Metal hypersensitivity reactions (MHR) as a cause of implant-related complications are highly debated and recommendations regarding pre-procedural allergy evaluation vary dramatically.To examine patients referred before or after device implantation and identify factors that can be useful to guide the value of patch testing.Patients who underwent patch testing pre- or post (...) , and/or other symptoms) for patients referred following orthopaedic and dental (post-) device implantation. Eight patients in the orthopaedic group and six patients in dental group with relevant patch test reactions underwent implant revisions, and seven and five patients improved, respectively.Pre-implant patch testing for selected individuals with a history of metal allergy can help guide implant choice. Post-implant patch testing may be helpful in some patients if other causes have been excluded

2020 Contact Dermatitis

12. Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19. Full Text available with Trip Pro

Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19. Coronavirus disease 2019 (COVID-19), a respiratory tract infection caused by a novel human coronavirus, the severe acute respiratory syndrome coronavirus 2, leads to a wide spectrum of clinical manifestations ranging from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Given the huge influence caused by the overwhelming COVID-19 pandemic affecting over three (...) million people worldwide, a wide spectrum of drugs is considered for the treatment in the concept of repurposing and off-label use. There is no knowledge about the diagnosis and clinical management of the drug hypersensitivity reactions that can potentially occur during the disease. This review brings togetherall the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off-label drugs andhighlights relevant recommendations

2020 Allergy

13. The complexity of T cell-mediated penicillin hypersensitivity reactions. Full Text available with Trip Pro

The complexity of T cell-mediated penicillin hypersensitivity reactions. Penicillin refers to a group of beta-lactam antibiotics that are the first-line treatment for a range of infections. However, they also possess the ability to form novel antigens, or neoantigens, through haptenation of proteins and can stimulate a range of immune-mediated adverse reactions - collectively known as drug hypersensitivity reactions (DHRs). IgE-mediated reactions towards these neoantigens are well studied (...) , however, IgE-independent reactions are less well understood. These reactions usually manifest in a delayed manner as different forms of cutaneous eruptions or liver injury consistent with priming of an immune response. Ex vivo studies have confirmed the infiltration of T cells into the site of inflammation, and the subsets of T cells involved appear dependent on the nature of the reaction. Here, we review the evidence that has led to our current understanding of these immune-mediated reactions

2020 Allergy

14. Diagnosis and treatment of drug hypersensitivity reactions to biologicals: Medical algorithm. (Abstract)

Diagnosis and treatment of drug hypersensitivity reactions to biologicals: Medical algorithm. Monoclonal antibodies have become an essential treatment modality for many inflammatory diseases and malignancies. Hypersensitivity reactions to monoclonal antibodies need not prevent their use as first-line therapy. Through the use of rapid desensitization, the patient may be safely re-exposed to the agent. In this article, we review the algorithm for rapid desensitization of monoclonal antibodies.©

2020 Allergy

15. Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits. (Abstract)

Hypersensitivity to antibiotics in drug reaction with eosinophilia and systemic symptoms (DRESS) from other culprits. Antibiotics have been implicated in the reactivation of exanthema and systemic involvement in drug reaction with eosinophilia and systemic symptoms (DRESS); however, it is not clear whether these patients become sensitized to the antibiotic.To evaluate if, after DRESS, patients become sensitized to antibiotics.We retrospectively reviewed the patch test (PT) data and clinical (...) patients with positive PT results had an accidental re-exposure to antibiotics and developed a maculopapular exanthema without systemic symptoms.Exposure to antibiotics during DRESS or its prodromal phase could enhance sensitization to antibiotics, as confirmed by a positive PT. Reproducibility of positive PTs to antibiotics after several years and reactivation after re-exposure support that T-cell-mediated hypersensitivity to antibiotics in the setting of DRESS is a specific reaction.© 2020 John Wiley

2020 Contact Dermatitis

16. Hypersensitivity reactions to proton-pump inhibitors: Clinical presentation, diagnosis, and management. (Abstract)

Hypersensitivity reactions to proton-pump inhibitors: Clinical presentation, diagnosis, and management. Background: Proton-pump inhibitors (PPI) are one of the most commonly prescribed drugs, and they are generally well tolerated. However, several immediate and delayed hypersensitivity reactions due to PPIs have been reported. Objective: To review the clinical characteristics and management of immune-mediated immediate and delayed hypersensitivity reactions to PPIs. Methods: We performed (...) a search of a medical literature data base from January 1980 to October 2019 by using keywords that included "proton-pump inhibitors" and "hypersensitivity." Results: Anaphylaxis is the most-common clinical presentation in patients with immediate hypersensitivity reactions to PPIs, followed by urticaria and/or angioedema. Occupational contact dermatitis, maculopapular eruption, fixed drug eruption, symmetrical drug-related intertriginous and flexural exanthema, and severe cutaneous adverse reactions

2020 Allergy and Asthma Proceedings

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

, 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 (...) 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

2019 International journal of cardiology

18. Immunoglobulin (Ig)G antibodies against IgE identified by basophil activation test as the putative causative agent of a serious allergic transfusion reaction: potential utility of the test as a new safety measure for allergic transfusion reactions. (Abstract)

Immunoglobulin (Ig)G antibodies against IgE identified by basophil activation test as the putative causative agent of a serious allergic transfusion reaction: potential utility of the test as a new safety measure for allergic transfusion reactions. In most cases of allergic transfusion reactions (ATRs), the causative agents have not been identified and the mechanisms are largely unknown, with a few exceptions. The basophil activation test (BAT) was recently introduced in the field

2018 Transfusion

19. Breakthrough hypersensitivity reactions to gadolinium based contrast agents (GBCAs) and strategies to decrease subsequent reaction rates: A systematic-review and meta-analysis.

Breakthrough hypersensitivity reactions to gadolinium based contrast agents (GBCAs) and strategies to decrease subsequent reaction rates: A systematic-review and meta-analysis. Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2020 PROSPERO

20. Myth or Reality: Are Shellfish Allergies Related to Contrast Reactions?

with the common shellfish allergy had similar reactions after contrast administration, iodine must be the allergen. In fact, many patients, including the one in the anecdote above, use the terminology “iodine allergy” to describe their contrast hypersensitivity. In the survey by Shih-Wen Huang from Asthma and Allergy Proceedings [2], patients were also asked, “Do you think that it is the iodine in the seafood that is responsible for the allergic reaction?” Not surprisingly, 92% of these patients believed (...) . How could she possibly be allergic to something that she had tolerated without problem for 40 years? Moreover, is there any factual basis behind the common recommendation that patients with contrast reactions should avoid shellfish? Conversely, should iodinated contrast agents be avoided in patients with documented seafood allergies? Is there evidence behind this clinical practice, or is it actually just a medical myth? Although it would be virtually impossible to determine when this myth began

2016 Clinical Correlations

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