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Hypersensitivity Reaction

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181. Outpatient desensitization in selected patients with platinum hypersensitivity reactions. (Abstract)

Outpatient desensitization in selected patients with platinum hypersensitivity reactions. Platinum-based chemotherapies are a standard treatment for both initial and recurrent gynecologic cancers. Given this widespread use, it is important to be aware of the features of platinum hypersensitivity reactions and the subsequent treatment of these reactions. There is also increasing interest in the development of desensitization protocols to allow patients with a history of platinum hypersensitivity (...) to receive further platinum based therapy. In this review, we describe the management of platinum hypersensitivity reactions and the desensitization protocols utilized at our institution. We also describe the clinical categorizations utilized to triage patients to appropriate desensitization protocols.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Gynecologic Oncology

182. Comparison of Hypersensitivity Reactions to Carboplatin Retreatment in Gynecologic Cancer Patients between One and Two Hour Infusions: a Randomized Trial Study (Full text)

Comparison of Hypersensitivity Reactions to Carboplatin Retreatment in Gynecologic Cancer Patients between One and Two Hour Infusions: a Randomized Trial Study Objective: To compare the incidence rate of carboplatin hypersensitivity reactions (HSRs) in gynecologic cancer patients receiving one-hour or two-hour carboplatin retreatment infusions. Setting: A Prospective Randomized Controlled Trial. Methods: Recurrent gynecologic cancer patients 25 to 80-years of age who were scheduled to receive (...) carboplatin retreatment after previously receiving at least six cycles of carboplatin without a history of platinum allergy were invited to enroll. They were randomized to receive either a one-hour or two-hour carboplatin infusion in each cycle. The nurses recorded any occurrence of HSR. Patients who developed carboplatin HSR were discontinued from the study. Results: Forty-five patients were enrolled and randomized to receive either a one-hour carboplatin infusion arm in 69 cycles or a two-hour infusion

2017 Asian Pacific journal of cancer prevention : APJCP Controlled trial quality: uncertain PubMed abstract

183. Debunking the Myth of Wool Allergy: Reviewing the Evidence for Immune and Non-immune Cutaneous Reactions. (Full text)

dermatitis exacerbation, contact urticaria, allergic contact dermatitis) and non-immune-mediated (irritant contact dermatitis, itch). Secondary aims of this paper were to examine evidence that lanolin and textile-processing additives (formaldehyde, chromium) cause cutaneous reactions in the context of modern wool-processing techniques. Current evidence does not suggest that wool-fibre is a cutaneous allergen. Furthermore, contact allergy from lanolin, chromium and formaldehyde is highly unlikely (...) Debunking the Myth of Wool Allergy: Reviewing the Evidence for Immune and Non-immune Cutaneous Reactions. Although wool is commonly believed to cause irritant (non-immune) and hypersensitivity (immune) cutaneous reactions, the evidence basis for this belief and its validity for modern garments have not been critically examined. Publications from the last 100 years, using MEDLINE and Google Scholar, were analysed for evidence that wool causes cutaneous reactions, both immune-mediated (atopic

2017 Acta Dermato-Venereologica PubMed abstract

184. Type III Hypersensitivity Reaction to Subcutaneous Insulin Preparations in a Type 1 Diabetic. (Full text)

Type III Hypersensitivity Reaction to Subcutaneous Insulin Preparations in a Type 1 Diabetic. Management of type 1 diabetes in patients who have insulin hypersensitivity is a clinical challenge and places patients at risk for recurrent diabetic ketoacidosis (DKA). Hypersensitivity reactions can be due to the patient's response to the insulin molecule itself or one of the injection's non-insulin components. It is therefore crucial for clinicians to quickly recognize the type of hypersensitivity (...) reaction that is occurring and identify potentially immunogenic additives for the purpose of directing therapy as various insulin preparations have differing ingredients. We present the case of a 23-year-old diabetic female with common variable immunodeficiency (CVID) and autoimmune enteropathy who developed a type III hypersensitivity reaction to multiple formulations of subcutaneous insulin after years of use and the challenges of devising a long-term management strategy.

2017 Journal of General Internal Medicine PubMed abstract

185. Anaphylactic Reactions to Novel Foods: Case Report of a Child With Severe Crocodile Meat Allergy. (Full text)

this reaction. Basophil activation and immunoglobulin E testing confirmed the boy's allergic reaction to crocodile meat proteins. Molecular analysis identified a crocodile α-parvalbumin, with extensive sequence homology to chicken α-parvalbumin, as the main cross-reactive allergen. We conclude that crocodile meat can be a potent food allergen and patients with allergy to chicken meat should be advised to avoid intake of meat from crocodile species. Both foods and people travel around the world (...) Anaphylactic Reactions to Novel Foods: Case Report of a Child With Severe Crocodile Meat Allergy. Availability of "exotic" foods is steadily increasing. In this report, we describe the first case of anaphylaxis to crocodile meat. The patient was a 13-year-old boy with severe immunoglobulin E-mediated allergy to chicken meat. When tasting crocodile meat for the first time, he developed an anaphylactic reaction. Cross-reactivity between chicken and crocodile meat was suspected to have triggered

2017 Pediatrics PubMed abstract

186. International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary-Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. (Full text)

International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary-Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. Food protein-induced enterocolitis (FPIES) is a non-IgE cell- mediated food allergy that can be severe and lead to shock. Despite the potential seriousness of reactions, awareness of FPIES is low; high-quality studies providing insight (...) into the pathophysiology, diagnosis, and management are lacking; and clinical outcomes are poorly established. This consensus document is the result of work done by an international workgroup convened through the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology and the International FPIES Association advocacy group. These are the first international evidence-based guidelines to improve the diagnosis and management of patients with FPIES. Research on prevalence

2017 Journal of Allergy and Clinical Immunology PubMed abstract

187. Hypersensitivity reactions in patients receiving hemodialysis. (Full text)

and the complexity of the environment to which patients on dialysis are exposed make it challenging to identify the precise cause of these reactions. Great diligence is needed to investigate hypersensitivity reactions to avoid recurrence in this high-risk population.Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. (...) Hypersensitivity reactions in patients receiving hemodialysis. To describe hypersensitivity reactions in patients receiving maintenance hemodialysis.PubMed search of articles published during the past 30 years with an emphasis on publications in the past decade.Case reports and review articles describing hypersensitivity reactions in the context of hemodialysis.Pharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis

2017 Asthma & Immunology PubMed abstract

188. Reactions of Buckwheat-Hypersensitive Patients during Oral Food Challenge Are Rare, but Often Anaphylactic. (Full text)

Reactions of Buckwheat-Hypersensitive Patients during Oral Food Challenge Are Rare, but Often Anaphylactic. Buckwheat (BW) is a common cause of life-threatening allergy in Asia. Few have examined oral food challenges (OFCs) using BW. We here describe the OFC outcomes for the diagnosis or confirmation of tolerance acquisition and clarify risk factors for positive OFCs.Between July 2005 and March 2014, we retrospectively reviewed data from children who underwent OFCs using 3,072 mg of BW protein (...) at Sagamihara National Hospital. Children were suspected of having BW allergy because of positive results for BW-specific IgE or because they had been previously diagnosed with BW allergy owing to immediate reactions to BW.Of 476 such patients, we analyzed 419 aged 1-17 years (median age 6.7 years). Forty-four (10.5%) reacted to the BW OFC and 24 (54.5%) experienced anaphylaxis. Among patients with suspected BW allergies (n = 369), 30 (8.1%) reacted to OFC. However, among patients with definitive BW

2017 International Archives of Allergy and Immunology PubMed abstract

189. Positive allergen reaction in allergic and nonallergic rhinitis: a systematic review. (Abstract)

Positive allergen reaction in allergic and nonallergic rhinitis: a systematic review. The diagnosis of allergic rhinitis (AR) is based on cutaneous and serological assessment to determine immunoglobulin E (IgE)-mediated disease. However, discrepancies between these tests and nasal provocation exist. Patients diagnosed as non-allergic rhinitis (NAR) but with positive nasal allergen provocation test (NAPT) may represent a local allergic condition or entopy, still suitable to allergy interventions (...) when defined by subjective end-points: AR 91.0% (95% CI, 86.6 to 94.8) and NAR 30.2% (95% CI, 22.9 to 37.9); and lower with objective end-points: AR 80.8% (95% CI, 76.8 to 84.5) and NAR 14.1% (95% CI, 11.2 to 17.2).Local allergen reactivity is demonstrated in 26.5% of patients previously considered non-allergic. Similarly, AR, when defined by skin-prick test (SPT) or serum specific IgE (sIgE), may lead to 13.7% of patients with inaccurate allergen sensitization or non-allergic etiologies.© 2017 ARS

2017 International forum of allergy & rhinology

190. Pegaspargase hypersensitivity reactions: intravenous infusion versus intramuscular injection - a review. (Abstract)

Pegaspargase hypersensitivity reactions: intravenous infusion versus intramuscular injection - a review. Pegaspargase is a mainstay in the treatment of acute lymphoblastic leukemia. When intravenous (IV) infusion replaced intramuscular (IM) injection as the standard route of administration, there were early reports suggested an increased hypersensitivity reactions (HSRs) rate with IV administration. There have since been eight published reports comparing the incidence of HSRs occurring with IV (...) versus IM pegaspargase. This review analyzes the reports and summarizes their consistent findings where feasible. For grade 3-4 HSRs, the rates are comparable with IV and IM administration. Grade 2 HSRs appear to be more likely with IV than IM administration but the validity of the difference is uncertain. Multiple factors confound the analyses, including the historically controlled nature of the comparisons and the increased likelihood of reporting adverse reactions with IV administration

2017 Leukemia & lymphoma

191. Acarizax - house dust mite allergic rhinitis and allergic asthma

it is likely that symptomatic treatment will still be needed. There are no comparative studies against subcutaneous immunotherapy, but indirect statistical analyses suggest that the efficacy is comparable (1). Acarizax has the advantage that it is an at-home treatment, except for the first dose, which is given under the supervision of a doctor. The adverse reactions are mainly transient and show in the form of mild allergic reactions up until the first three months of treatment. Acarizax must be taken (...) daily for three years, and the price of treatment totals DKK 31,749. References 1. Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis? The Journal of allergy and clinical immunology. 2016;137(2):339-49.e10 23 August 2016 The Danish Health Authority Islands Brygge 67 2300 København S Denmark Telephone: +45 72 22 74 00

2017 Danish Pharmacotherapy Reviews

192. ASCIA Clinical Update Infant Feeding and Allergy Prevention

for solid foods. • When infant is ready, introduce foods according to what the family usually eats, regardless of whether the food is considered to be a common food allergen. • Common food allergens (including peanut) should be introduced in an age appropriate form (e.g. smooth peanut butter/paste, cooked egg) before 12 months of age. This includes infants considered to have an increased risk of developing food allergy. • Infants who are already allergic to a particular food must not be given that food (...) . • Introduce one new food at a time so that if a reaction occurs, the problem food can be more easily identified. If a food is tolerated, continue to give this regularly as a part of a varied diet. • Cow’s milk or soy milk (or their products, such as cheese and yoghurt) can be used in cooking or with other foods if dairy products/soy are tolerated. • When introducing foods that other family members are allergic to, it is important to do so in a manner that does not put the family member with food allergy

2018 Australasian Society of Clinical Immunology and Allergy

193. ASCIA Manual - Skin Prick Testing for Allergy Diagnosis

etc.); and ? Screening for allergy in the absence of symptoms (e.g. family history of allergy). Skin prick testing is not usually appropriate for the diagnosis of reactivity to low molecular weight substances such as food additives, non-allergic adverse reactions to drugs (with some exceptions - see later), respiratory irritants, and most occupational allergens (with some exceptions - see later). 2.1.3 Conditions for which intradermal testing is appropriate: Intradermal testing may be used (...) and whether negative test results are potentially false negative. ? Determine final diagnosis and management plan. ? Counsel the patient on the meaning of the results and their diagnosis and management. Medical practitioners involved in allergy testing should maintain a good knowledge of allergic diseases, of allergens relevant in their area, and the significance of particular skin prick test reactions in relation to the condition in question (an example might be the relative importance of allergy to dust

2018 Australasian Society of Clinical Immunology and Allergy

194. The diagnosis of hypersensitivity to antibiotics is rarely confirmed by allergy work-up in cystic fibrosis patients. (Abstract)

The diagnosis of hypersensitivity to antibiotics is rarely confirmed by allergy work-up in cystic fibrosis patients. Cystic fibrosis (CF) patients receive many antibiotic treatments for recurrent respiratory infections and frequently report antibiotic hypersensitivity reactions (HSRs). In this retrospective study, medical records of CF patients were reviewed to clarify the clinical features, the culprit antibiotics, and the prevalence of antibiotic HSRs in the CF population. From 601 CF (...) patients, 95 suspected antibiotic HSRs occurred in 60 patients (prevalence of 10.0%). β-Lactams were the most common inducers, but cotrimoxazole was also frequently involved. Seventy-six of 95 suspected HSRs were assessed by allergy workup including skin tests (43/76 reactions) and/or drug reintroduction as a full course of the culprit antibiotic (73 of 76 reactions). From the 43 suspected HSRs that were skin-tested, only three had positive skin tests and were not subjected to drug readministration

2020 Pediatric Allergy and Immunology

195. On the cause and consequences of IgE to galactose-α-1,3-galactose: A report from the National Institute of Allergy and Infectious Diseases Workshop on Understanding IgE-Mediated Mammalian Meat Allergy. (Full text)

On the cause and consequences of IgE to galactose-α-1,3-galactose: A report from the National Institute of Allergy and Infectious Diseases Workshop on Understanding IgE-Mediated Mammalian Meat Allergy. The mammalian meat allergy known as the "α-Gal syndrome" relates to IgE specific for galactose-α-1,3-galactose (α-Gal), an oligosaccharide that is present in cells and tissues of nonprimate mammals. The recognition of delayed reactions to food derived from mammals in patients with IgE to α-Gal (...) research priorities and for the development of resources to advance our knowledge of the mechanisms, diagnosis, management, and prevention of this allergic disease. This publication is a summary of the workshop and the panel's recommendations are presented herein.Copyright © 2020 American Academy of Allergy, Asthma & Immunology. All rights reserved.

2020 Journal of Allergy and Clinical Immunology PubMed abstract

196. Consensus Report from the Food Allergy Research and Education (FARE) 2019 Oral Immunotherapy for Food Allergy Summit. (Full text)

of food allergen triggers and acute management of allergic reactions. A considerable body of data exists supporting oral immunotherapy (OIT) as a promising, novel treatment option, including that for the now FDA-approved peanut OIT product, Palforzia. However, data for long-term quality of life improvement with OIT varies, depending on the measures used for analysis. Like many therapies, OIT is not without potential harms, and burdens, and the evaluation of patient-specific risk-benefit ratio of food (...) Consensus Report from the Food Allergy Research and Education (FARE) 2019 Oral Immunotherapy for Food Allergy Summit. Food allergy is a major health problem affecting 5 to 10% of the population in developed nations, including an estimated 32 million Americans. Despite the large number of patients suffering from food allergies, up until the end of January 2020, no treatment for food allergies had been approved by the U.S. Food and Drug Administration (FDA). The only options were avoidance

2020 Journal of Allergy and Clinical Immunology PubMed abstract

197. Allergy to local anaesthetic agents used in dentistry – what are the signs, symptoms, alternative diagnoses and management options?

hypersensitivity reactions (type I – angioedema, urticaria, pruritus, chest tightness, wheezing, fall in blood pressure) or delayed hypersensitivity reactions (type IV – localised reaction at the injection site, contact dermatitis). Due to the rarity of local anaesthetic allergy, if a patient experiences signs and symptoms suggestive of an allergic response, consideration should be given to other possible causes of the symptoms e.g. toxicity (sedation, light headedness, slurred speech, mood alteration (...) and management of a patient with suspected allergy to local anaesthetics used in dentistry. Summary Allergy to amide local anaesthetics is rare. Allergic reactions are most likely to occur with ester local anaesthetic agents; these are not used routinely in dentistry. Adverse effects experienced after administration of local anaesthetics may be mistaken for allergic reactions, but often there is another explanation for the symptoms. True allergic reactions to local anaesthetics are either immediate

2019 Specialist Pharmacy Services

198. Severe allergic reaction during angioplasty culminating to fatal acute stent thrombosis: An association with Kounis syndrome. (Abstract)

Severe allergic reaction during angioplasty culminating to fatal acute stent thrombosis: An association with Kounis syndrome. Kounis syndrome is a systemic complication following an allergic reaction, presenting with coronary artery spasm or thrombosis and occasionally with stent thrombosis that can have fatal outcome.Heparins can induce allergic reactions via tissue antigenicity, heparin induced thrombocytopenia and contact system-activating effects of contaminants but allergy bivalirudin has (...) not been reported so far.Herein, we describe a patient with fatal acute coronary in-stent thrombosis following an allergic reaction soon after an intra-arterial heparin dose and intravenous administration of bivalirudin during angioplasty.The patient received intense myocardial infarction protocol treatment including angioplasty and defibillation together with antiallergic therapy but despite all of these efforts and measures, he succumbed 2 h later.Significant suspicion should be raised that life

2018 Heart & Lung

199. Potential cofactors in accidental food allergic reactions are frequently present but may not influence severity and occurrence. (Abstract)

study was conducted, with a 1-year follow-up in adult patients with a physician-diagnosed food allergy. Patients were required to fill in a questionnaire after every accidental allergic reactions to food over a 1-year period. The primary outcome measure was the frequency that potential cofactors were present in these allergic reactions.A total of 157 patients were included, of which 46% reported a total of 153 reactions during a 1-year follow-up period. In 74% of the reactions, ≥1 potential cofactor (...) (antacids, angiotensin receptor blockers [ARBs], beta blockers and angiotensin-converting enzyme inhibitors [ACEIs]) on a daily basis, which however did not influence the occurrence of reactions. Furthermore, 38% daily used allergy-suppressing medication.Although factors suggested to be cofactors were frequently present during accidental food allergic reactions, we found no evidence for an association between the potential cofactors examined and reaction severity, in a population where most reactions

2018 Clinical and Experimental Allergy

200. The Circadian Clock Drives Mast Cell Functions in Allergic Reactions (Full text)

The Circadian Clock Drives Mast Cell Functions in Allergic Reactions Allergic diseases are known to vary in the severity of their symptoms throughout the day/night cycle. This rhythmicity is also observed in mast cell function and responsiveness. Mast cells are key effector cells of allergic reactions and release cytokines, chemokines, and important inflammatory mediators such as histamine, which have been shown to display diurnal variation. Recent research clarified that mast cells (...) are controlled by their internal clock-which is regulated by a specific set of clock genes-as well as external factors such as light sensed by the suprachiasmatic nuclei, hormonal status, or diet. Here, we give an overview of the connections between circadian clock, mast cells, and allergic disease. Further work aimed at studying the role of chronotherapy/chronomedicine should take into account this rhythmic nature of not only mast cells but also the immune responses generated by mast cell signaling.

2018 Frontiers in immunology PubMed abstract

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