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Hypersensitivity Reaction

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21. Differential diagnosis of late-type reactions to injected local anaesthetics: Inflammation at the injection site is the only indicator of allergic hypersensitivity. (Abstract)

Differential diagnosis of late-type reactions to injected local anaesthetics: Inflammation at the injection site is the only indicator of allergic hypersensitivity. Anaphylaxis-like reactions developing within a few minutes are the most frequent complications of subcutaneous or submucosal injections of local anaesthetics (LAs), and topically applied LAs are potential contact allergens. In addition, injected LAs have been reported to induce delayed reactions, including local inflammation (...) reported various systemic symptoms. LA hypersensitivity could be excluded in all patients with systemic complaints by means of skin testing and subsequent subcutaneous provocation. In 8 of the 40 patients (20%) with local inflammatory reactions, late-type allergic LA hypersensitivity was confirmed.Late-type LA allergy commonly causes inflammatory skin reactions confined to the injection site. Conversely, LAs are highly unlikely to trigger delayed systemic symptoms such as urticarial or exanthematous

2018 Contact Dermatitis

22. The Incidence of Delayed-Type Hypersensitivity Reactions to Apples Among Patients Allergic to Birch Pollen Full Text available with Trip Pro

of delayed-type hypersensitivity reactions and immediate IgE-mediated reactions against high- and low-allergenic apple cultivars in patients with birch pollen allergy. Data were obtained from 45 adults with clinical symptoms of birch pollen allergy. Patients were exposed to apple pulp via atopy patch tests (APTs) and SPTs. Levels of IgE specific to Bet v 1 and Mal d 1 were measured with a radioallergosorbent test. Patients allergic to birch pollen showed the highest rate of positive SPT responses (...) The Incidence of Delayed-Type Hypersensitivity Reactions to Apples Among Patients Allergic to Birch Pollen The major apple allergen Mal d 1 cross-reacts with the homologous birch pollen allergen Bet v 1 and causes immunoglobulin E (IgE)-mediated immediate-type allergic reactions. In some patients, delayed-type hypersensitivity to apples may develop within 72 hours without evidence of specific IgE or a positive skin prick test (SPT). The aim of the study was to evaluate the concomitance

2018 Allergy, asthma & immunology research

23. Nanoemulsion adjuvant-driven redirection of T<sub>H</sub>2 immunity inhibits allergic reactions in murine models of peanut allergy. Full Text available with Trip Pro

Nanoemulsion adjuvant-driven redirection of TH2 immunity inhibits allergic reactions in murine models of peanut allergy. Immunotherapy for food allergies involves progressive increased exposures to food that result in desensitization to food allergens in some subjects but not tolerance to the food. Therefore new approaches to suppress allergic immunity to food are necessary. Previously, we demonstrated that intranasal immunization with a nanoemulsion (NE) adjuvant induces robust (...) mucosal antibody and TH17-polarized immunity, as well as systemic TH1-biased cellular immunity with suppression of pre-existing TH2-biased immunity.We hypothesized that immunization with food in conjunction with the nanoemulsion adjuvant could lead to modulation of allergic reactions in food allergy by altering pre-existing allergic immunity and enhancing mucosal immunity.Mice were sensitized to peanut with aluminum hydroxide or cholera toxin. The animals were then administered 3 monthly intranasal

2018 Journal of Allergy and Clinical Immunology

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

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

25. Estimated risk reduction to packaged food reactions by epicutaneous immunotherapy (EPIT) for peanut allergy. Full Text available with Trip Pro

Estimated risk reduction to packaged food reactions by epicutaneous immunotherapy (EPIT) for peanut allergy. Peanut allergy is a generally persistent, sometimes life-threatening food allergy. With no treatments demonstrating the ability to cure a food allergy, the focus of drugs in development has been on providing a level of protection against accidental exposure reactions. However, no study has estimated the relative risk reduction of a food-allergic population receiving a specific (...) immunotherapeutic treatment for their allergies.To estimate the relative risk reduction when consuming peanut-contaminated packaged food products in a double-blind, placebo-controlled Phase 3 study population of children treated with epicutaneous immunotherapy (EPIT) for 12 months with either a patch containing 250 μg peanut protein (250-μg patch) or a placebo patch.The probability of an allergic reaction due to the unintended presence of peanut protein in packaged food products was modeled per study group

2019 Asthma & Immunology

26. Severe hypersensitivity reactions to biological drugs in children with rheumatic diseases. (Abstract)

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

27. Contact allergy to citral and its constituents geranial and neral, coupled with reactions to the pre- and prohapten geraniol. (Abstract)

Contact allergy to citral and its constituents geranial and neral, coupled with reactions to the pre- and prohapten geraniol. 31566752 2019 09 30 1600-0536 2019 Sep 30 Contact dermatitis Contact Derm. Contact allergy to citral and its constituents geranial and neral, coupled with reactions to the pre- and prohapten geraniol. 10.1111/cod.13404 Hagvall Lina L https://orcid.org/0000-0002-9141-9215 Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy (...) markers of the baseline series. 1476 dermatitis patients with suspected allergic contact dermatitis were patch tested using geranial, neral and citral, all 3.5% pet., geraniol 6.0% and oxidized geraniol 11% pet. in addition to the Swedish baseline series. Frequencies of positive reactions to citral, geranial and neral were 2.9%, 3.4% and 1.9%, respectively. Together, citral and geranial gave 4.2% positive patch test reactions in consecutive dermatitis patients. In patients with positive reactions

2019 Contact Dermatitis

28. Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Full Text available with Trip Pro

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

29. Effect of sleep deprivation and exercise on reaction threshold in adults with peanut allergy: A randomized controlled study. (Abstract)

Effect of sleep deprivation and exercise on reaction threshold in adults with peanut allergy: A randomized controlled study. Peanut allergy causes severe and fatal reactions. Current food allergen labeling does not address these risks adequately against the burden of restricting food choice for allergic patients because of limited data on thresholds of reactivity and the influence of everyday factors.We estimated peanut threshold doses for a United Kingdom population with peanut allergy (...) for 1% of the population were 1.5 mg (95% CI, 0.8-2.5 mg) during nonintervention challenge (n = 81), 0.5 mg (95% CI, 0.2-0.8 mg) after sleep, and 0.3 mg (95% CI, 0.1-0.6 mg) after exercise.Exercise and sleep deprivation each significantly reduce the threshold of reactivity in patients with peanut allergy, putting them at greater risk of a reaction. Adjusting reference doses using these data will improve allergen risk management and labeling to optimize protection of consumers with peanut

2019 Journal of Allergy and Clinical Immunology Controlled trial quality: uncertain

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

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

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

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

32. A case of hypersensitivity reaction to alcohol confirmed by oral provocation test. (Abstract)

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

33. Hypersensitivity Reactions to Iodinated Contrast Media: A Multicenter Study of 196 081 Patients. (Abstract)

Hypersensitivity Reactions to Iodinated Contrast Media: A Multicenter Study of 196 081 Patients. Background Multicenter studies may be required for establishing guidelines for safe usage of iodinated contrast media (ICM). Purpose To identify the prevalence, patterns, risk factors, and preventive measures for ICM-related hypersensitivity reactions (HSRs). Materials and Methods Between March 2017 and October 2017, a total of 196 081 patients who underwent ICM administration were enrolled from (...) % (17 of 196 081). Conditional logistic regression for patients with HSR (n = 1433) and a control group (1:1 matched group for age, sex, ICM product, and institution) demonstrated that a patient's previous individual history of an ICM-related HSR (adjusted odds ratio [OR], 198.8; P < .001), hyperthyroidism (adjusted OR, 3.6; P = .04), drug allergy (adjusted OR, 3.5; P < .001), and other allergic diseases (adjusted OR, 6.8; P < .001) and a family history of ICM-related HSRs (adjusted OR, 14.0; P

2019 Radiology

34. Graded Dalbavancin Challenge in a Patient with Severe Vancomycin Hypersensitivity Reaction. (Abstract)

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

35. Evaluation of Antibody Properties and Clinically Relevant Immunogenicity, Anaphylaxis, and Hypersensitivity Reactions in Two Phase III Trials of Tralokinumab in Severe, Uncontrolled Asthma. Full Text available with Trip Pro

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

2019 Drug Safety Controlled trial quality: uncertain

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

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

37. Allergic reaction to a green tattoo with nickel as a possible allergen. Full Text available with Trip Pro

England Contact Dermatitis 7604950 0105-1873 allergic reaction allergy case report green hypersensitivity nickel pigment tattoo 2018 12 11 2019 01 15 2019 01 16 2019 1 22 6 0 2019 1 22 6 0 2019 1 22 6 0 aheadofprint 30663069 10.1111/cod.13226 (...) Allergic reaction to a green tattoo with nickel as a possible allergen. 30663069 2019 03 06 1600-0536 2019 Jan 21 Contact dermatitis Contact Derm. Allergic reaction to a green tattoo with nickel as a possible allergen. 10.1111/cod.13226 van der Bent Sebastiaan A S SAS Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands. Berg Tanja T Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany

2019 Contact Dermatitis

38. Comparative epidemiology of suspected perioperative hypersensitivity reactions. Full Text available with Trip Pro

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

39. Prognostic value of hypersensitivity reactions on epidural steroid injection outcomes: a phenotypic signature? A prospective cohort study. Full Text available with Trip Pro

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

2019 Regional Anesthesia and Pain Medicine

40. Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions. Full Text available with Trip Pro

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

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