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Hypersensitivity Reaction

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101. Allergic reactions to lower concentrations of nickel sulfate and formaldehyde often appear later than reactions to higher concentrations. (Abstract)

Allergic reactions to lower concentrations of nickel sulfate and formaldehyde often appear later than reactions to higher concentrations. A late-appearing patch test reaction may be a sign of active sensitization or represent a delayed elicitation reaction.To retrospectively study the effect of concentration on the time course of allergic reactions to routine concentration dilution series of formaldehyde and nickel sulfate.We tested concentration dilution series of 2%, 1%, 0.32% and 0.1 (...) % formaldehyde and 5%, 1.6%, 0.5% and 0.16% nickel sulfate, respectively. The last readings were performed on day 4 to day 6. We included patients with allergic reactions to either of the two lowest concentrations in each dilution series and whose tests had been read three times.Forty-two nickel-allergic and 23 formaldehyde-allergic patients fulfilled the inclusion criteria. In 26 (62%) of the nickel-sensitive patients, reactions to lower concentrations appeared later than reactions to the highest

2018 Contact Dermatitis

102. CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis

CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis - CanadiEM CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis In , by Chris Lipp October 19, 2017 This episode of CRACKCast covers Rosen’s Chapter 119 (109 in 9th), Allergy, Hypersensitivity, Angioedema, and Anaphylaxis. Patients suffering from acute allergic reactions, anaphylaxis, and angioedema are amongst the most unstable (...) in this chapter to refer to mast cell–mediated hypersensitivity reactions. For most allergic diseases to occur, predisposed individuals need to be exposed to allergens through a process called sensitization. Substances that elicit an allergic reaction are referred to as allergens, and those that elicit an antibody response (activated by B- and T-cell receptors) are called antigens. Urticaria A common allergic reaction to foods, drugs, or physical stimuli and is clinically characterized by an erythematous

2017 CandiEM

103. Assessment of food allergies and sensitivities

a food allergy; it only means that they are sensitised to a food. Only the history, or an oral food challenge, can identify true food allergens. Once produced, food-specific IgE binds on to mast cells. When the particular food is subsequently ingested, the food is broken down and absorbed. The food antigen then binds to the IgE on the mast cells, leading to mast-cell degranulation and release of mediators that cause the signs and symptoms of the allergic reaction. Sicherer SH. Food allergy. Lancet (...) Mini-Primer):S470-5. http://www.ncbi.nlm.nih.gov/pubmed/16455349?tool=bestpractice.com Although approximately 20% of people alter their diet due to a perceived adverse reaction to food, only 6% of young children and 3.7% of adults in the US have a true food allergy. Sicherer SH, Sampson HA. 9. Food allergy. J Allergy Clin Immunol. 2006 Feb;117(2 Suppl Mini-Primer):S470-5. http://www.ncbi.nlm.nih.gov/pubmed/16455349?tool=bestpractice.com People who believe they have a food allergy may suffer from

2018 BMJ Best Practice

104. Food allergy

respiratory, GI, or cardiovascular (e.g., hypotensive) manifestations. Epinephrine (adrenaline) given by intramuscular injection is the treatment of choice for severe systemic symptoms (anaphylaxis); lesser reactions are managed with a range of therapies from simple withdrawal of suspected food allergen to oral antihistamines. Patients should be encouraged to obtain medical identification jewellery, be knowledgeable of the incipient signs and symptoms of an allergic reaction, be trained how to use (...) Food allergy Food allergy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Food allergy Last reviewed: February 2019 Last updated: May 2018 Summary Most reactions are from peanut, tree nuts, milk, egg, fish, shellfish, wheat, and soya. Symptoms usually appear within 20 minutes of ingestion and nearly always within 2 hours. Symptoms and signs may vary from pruritus and mild cutaneous eruption to severe anaphylactic

2018 BMJ Best Practice

105. Systemic contact dermatitis caused by cobalt chloride and palladium in a 26-year-old woman with allergic type I reactions, non-steroidal anti-inflammatory drug hypersensitivity and autoimmune thyroiditis Full Text available with Trip Pro

Systemic contact dermatitis caused by cobalt chloride and palladium in a 26-year-old woman with allergic type I reactions, non-steroidal anti-inflammatory drug hypersensitivity and autoimmune thyroiditis 28951718 2018 11 13 1642-395X 34 4 2017 Aug Postepy dermatologii i alergologii Postepy Dermatol Alergol Systemic contact dermatitis caused by cobalt chloride and palladium in a 26-year-old woman with allergic type I reactions, non-steroidal anti-inflammatory drug hypersensitivity and autoimmune (...) Krzysztof K Department of Internal Medicine and Allergology, Wroclaw Medical University, Wroclaw, Poland. eng Journal Article 2017 08 02 Poland Postepy Dermatol Alergol 101168357 1642-395X 2015 11 02 2016 10 04 2017 9 28 6 0 2017 9 28 6 0 2017 9 28 6 1 ppublish 28951718 10.5114/ada.2017.69324 30428 PMC5560191 Actas Dermosifiliogr. 2014 Jul-Aug;105(6):590-6 24530124 Postepy Dermatol Alergol. 2015 Jun;32(3):154-61 26161054 Curr Opin Allergy Clin Immunol. 2014 Aug;14(4):271-7 24915547 Prosthet Orthot Int

2017 Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii

106. In Vivo Cysteinyl Leukotriene Release in Allergic and Nonallergic Immediate Hypersensitivity Reactions during Anesthesia. (Abstract)

In Vivo Cysteinyl Leukotriene Release in Allergic and Nonallergic Immediate Hypersensitivity Reactions during Anesthesia. Immediate hypersensitivity reactions occurring during anesthesia are classified as allergic when skin tests and mast cell tryptase are positive and as nonallergic when negative results are obtained. Cysteinyl leukotrienes (cysLTs) are potent mediators synthesized by mast cell and eosinophil that induce bronchial constriction. They could play a role in hypersensitivity (...) were highly increased 30 to 60 min after the reaction (17.9 [7.8 to 36.0] μg/l), while the patients with nonallergic reactions had less increased values (7.3 [3.0 to 11.5] μg/l). The difference between the three groups was significant (P < 0.0001). Increased values persisted during the 24 h of observation. Concentrations were significantly higher in patients with bronchospasm (P = 0.016).cysLTs appear to be an important mediator of allergic and nonallergic immediate hypersensitivity reactions

2017 Anesthesiology

107. Stinging insect hypersensitivity: Evaluation and management in children and youth

Stinging insect hypersensitivity: Evaluation and management in children and youth There are two types of IgE-mediated reactions to stinging insects: large local reactions and systemic reactions. Acute management of large local reactions is symptomatic and a patient history of a large local reaction does not indicate need for an epinephrine auto-injector or venom immunotherapy. By contrast, acute management of systemic reactions requires intramuscular epinephrine. Long-term management includes (...) prescribing an epinephrine auto-injector and consideration for venom immunotherapy by a paediatric allergist.  Keywords:   Allergy; Anaphylaxis; Large local reaction; Stinging insect; Venom immunotherapy 

2018 Canadian Paediatric Society

108. True Allergic Reaction to Amide Local Anesthetics Such as Lidocaine Is Confirmed by Immunologic Testing

] AND "hypersensitivity, immediate"[Mesh]) OR "hypersensitivity/immunology"[Mesh] AND "anesthetics, local"[Mesh] Comments on The Evidence Validity: The studies by Fuzier and Sambrook were retrospective in nature and did not include randomization; however, both compiled data from large national databases over extended periods of many years. The follow-up of reported allergic reactions with allergy testing to confirm true allergy also strengthens data reported in the Fuzier study; however, this follow-up (...) a pseudoallergic psychogenic response, and can this be confirmed as an immunologic reaction to the anesthetic agent itself and not to known additives or preservatives? Clinical Bottom Line True allergy to amide local anesthetics such as lidocaine does exist and has been documented as type I and IV hypersensitivity reactions; however, the occurrence of this allergy in the population has been shown to be less than 1%. This should be differentiated from more common psychogenic responses to injection

2016 UTHSCSA Dental School CAT Library

109. The culprit insect but not severity of allergic reactions to bee and wasp venom can be determined by molecular diagnosis. Full Text available with Trip Pro

The culprit insect but not severity of allergic reactions to bee and wasp venom can be determined by molecular diagnosis. Allergy to bee and wasp venom can lead to life-threatening systemic reactions. The identification of the culprit species is important for allergen-specific immunotherapy.To determine a panel of recombinant bee and wasp allergens which is suitable for the identification of bee or wasp as culprit allergen sources and to search for molecular surrogates of clinical severity (...) of sting reactions.Sera from eighty-seven patients with a detailed documentation of their severity of sting reaction (Mueller grade) and who had been subjected to titrated skin testing with bee and wasp venom were analyzed for bee and wasp-specific IgE levels by ImmunoCAPTM. IgE-reactivity testing was performed using a comprehensive panel of recombinant bee and wasp venom allergens (rApi m 1, 2, 3, 4, 5 and 10; rVes v 1 and 5) by ISAC chip technology, ImmunoCAP and ELISA. IgG4 antibodies to rApi m 1

2018 PLoS ONE

110. Intravenous iron and serious hypersensitivity reactions

Intravenous iron and serious hypersensitivity reactions Intravenous iron and serious hypersensitivity reactions - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Intravenous iron and serious hypersensitivity reactions Clarification of advice on new recommendations regarding initial test dose. Published 11 December 2014 From: Therapeutic area: , Article date: September 2013 We would like to make you aware that on 9 September 2013, we updated the information in the recent published

2013 MHRA Drug Safety Update

111. Intravenous iron and serious hypersensitivity reactions: strengthened recommendations

Intravenous iron and serious hypersensitivity reactions: strengthened recommendations Intravenous iron and serious hypersensitivity reactions: strengthened recommendations - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Intravenous iron and serious hypersensitivity reactions: strengthened recommendations New strengthened recommendations to manage and minimise risk. Published 11 December 2014 From: Therapeutic area: , Contents Article date: August 2013 Intravenous (IV) iron (...) products are indicated in the treatment of iron deficiency and anaemia when iron supplements cannot be given or have not worked. Hypersensitivity reactions are well known to occur rarely with IV iron products, and may be life-threatening or fatal. Warnings about this risk are given in the product information. European review A European review of IV iron products has taken place after concerns in France about the risk of serious hypersensitivity reactions, especially in pregnant women. The review has

2013 MHRA Drug Safety Update

112. ASCIA Position Statement - Unorthodox Techniques for the Diagnosis and Treatment of Allergy, Asthma and Immune Disorders

allergic reaction to inhaled allergen, or to stinging insects. Both sublingual/oral and systemic/injectable immunotherapy have been shown in controlled studies to reduce the severity and frequency of symptoms in the majority of patients. This form of therapy is the closest thing to cure for proven allergic disease. In recent years however, unorthodox “allergy elimination techniques” have also become popular. Also known as advanced allergy elimination and Nambudripad’s allergy elimination in some (...) ASCIA Position Statement - Unorthodox Techniques for the Diagnosis and Treatment of Allergy, Asthma and Immune Disorders Unorthodox Testing and Treatment - Australasian Society of Clinical Immunology and Allergy (ASCIA) | | Unorthodox Testing and Treatment Use of unproven “allergy tests” is common in Australia Despite advances in scientific knowledge about allergic disorders, 50-70 per cent of adults and children with allergic disease consult alternative practitioners yearly for diagnosis

2019 Australasian Society of Clinical Immunology and Allergy

113. ASCIA Information on how to introduce solid foods to babies for allergy prevention

. If your baby has an allergic reaction, stop giving that food and seek medical advice. Q 1: Why should egg and peanut be introduced by 12 months of age? • All babies should be given common allergy causing foods by 12 months of age, including egg and peanut, in an age appropriate form such as well cooked egg and smooth peanut butter/paste. This includes babies who have severe eczema, another food allergy, or a family member with food allergy, even though they may have a higher chance of developing food (...) amount of the food inside your baby’s lip as a starting point. If there is no allergic reaction after a few minutes, you can start giving small amounts of the food as described above. • Never smear or rub food on your baby’s skin, as this will not help to identify possible food allergies. ASCIA INFORMATION FOR PATIENTS, CONSUMERS AND CARERS 2 Q3: What should you do if your baby has an allergic reaction? • If you notice any swelling of the lips, eyes or face, hives or welts, vomiting, or any change

2019 Australasian Society of Clinical Immunology and Allergy

114. ASCIA Event record for allergic reactions

of reaction ? Home ? School ? Childcare ? Work ? Dining out ? Other__________________________________________________________________ Activity immediately before reaction: ? Eating ? Gardening ? Exercise ? Other: _________________________________ Other medical conditions ? Asthma ? Other: _______________________________________________________ Previous allergic reactions ? Mild-moderate ? Severe (anaphylaxis) Allergen/s________________________________________________________________ Adrenaline (...) ASCIA Event record for allergic reactions This document should be completed by the patient (to provide to their doctor or nurse practitioner) or completed by the doctor or nurse practitioner. Patient name: _____________________________________________________________ Date and time of reaction: ___________________________________________________ GP: ______________________________Specialist: ______________________________ Suspected trigger/s (if known) ? Food /s

2015 Australasian Society of Clinical Immunology and Allergy

115. Hypersensitivity pneumonitis

. Immunological reaction to inhaled antigen is corroborative. No pathognomonic tests. Treatment involves avoidance of causative agent and use of corticosteroids. Definition Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is the result of non-IgE mediated immunological inflammation. HP is caused by repeated inhalation of non-human protein, which can be of natural plant or animal origin or can be the result of a chemical conjugated to a human airway protein, such as albumin (...) . The inflammation of HP manifests itself in the alveoli and distal bronchioles. The clinical manifestations of HP depend on the concentration and frequency of exposure. The clinical syndromes - acute, sub-acute, and chronic HP - present differently. Slavin RG. What the allergist should know about hypersensitivity pneumonitis. Allergy Asthma Proc. 2007 Jan-Feb;28(1):25-7. http://www.ncbi.nlm.nih.gov/pubmed/17390753?tool=bestpractice.com Ismail T, McSharry C, Boyd G. Extrinsic allergic alveolitis. Respirology

2017 BMJ Best Practice

116. Egg allergy prevention

reaction, egg can be introduced in gradually increasing amounts. Tips and challenges The key message is that consumption not avoidance reduces the risk of developing egg allergy. This is part of a broader message of early introduction of a range of foodstuffs consistent with a change in guidelines (see Consumer resources). Supporting this message is the finding that hydrolysed preparations do not reduce the risk of allergic or autoimmune disease. The timing of egg introduction is not associated (...) with a personal history of atopy (particularly moderate-severe eczema) or with a family history of atopy are at high risk of developing allergic disease, including food allergies. These infants may benefit from evaluation by an allergist or a general practitioner trained in management of allergic diseases in this age group to diagnose food allergy and assist in early egg introduction if appropriate. Adverse effects There were no deaths in the studies (which included children at higher risk) and no significant

2017 Handbook of Non-Drug interventions (HANDI)

117. 3-year follow-up after peanut food challenges: accidental reactions in allergic children and introduction failure in tolerant children. Full Text available with Trip Pro

3-year follow-up after peanut food challenges: accidental reactions in allergic children and introduction failure in tolerant children. Forty-one percent of peanut allergic children have allergic reactions and 32% of tolerant children fail to introduce peanut during 3-years after food challenges. Quality of life improved only after successful peanut introduction.Copyright © 2019. Published by Elsevier Inc.

2019 Journal of Allergy and Clinical Immunology

118. Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. Full Text available with Trip Pro

Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. Current guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus.We aimed to assess anaphylaxis treatment practices over 10 years, covering several European regions, all allergen sources, and all age groups.The European Anaphylaxis Register tracks elicitors (...) professional background, and patient characteristics did not explain which reactions were treated.Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

2019 The journal of allergy and clinical immunology. In practice Controlled trial quality: uncertain

119. Diagnostic Value of Tryptase in Food Allergic Reactions: A Prospective Study of 160 Adult Peanut Challenges. (Abstract)

Diagnostic Value of Tryptase in Food Allergic Reactions: A Prospective Study of 160 Adult Peanut Challenges. Serum tryptase is useful in diagnosing drug and venom anaphylaxis. Its utility in food anaphylaxis is unknown.The objective of this study was to determine whether tryptase rises in food allergic reactions, optimal sampling time points, and a diagnostic cutoff for confirming a clinical reaction.Characterized peanut allergic patients were recruited and underwent up to 4 peanut challenges (...) curve analysis demonstrated the optimal cutoff to identify a reaction as a 30% rise (sensitivity 0.53; specificity 0.85), area under the curve 0.72 (95% CI, 0.67-0.78).Serum tryptase measurement is valuable in food allergic reactions, and correlates with symptom severity. Comparing peak reaction levels at 2 hours with baseline is essential. A rise in tryptase of 30% is associated with food allergic reactions.Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

2019 The journal of allergy and clinical immunology. In practice Controlled trial quality: uncertain

120. Antibodies Predict Pegaspargase Allergic Reactions and Failure of Rechallenge. Full Text available with Trip Pro

Antibodies Predict Pegaspargase Allergic Reactions and Failure of Rechallenge. Pegaspargase (PEG-ASP) has largely replaced native Escherichiacoli asparaginase (L-ASP) in the treatment of acute lymphoblastic leukemia because of its longer half-life and lower immunogenicity. Risk factors for allergic reactions to PEG-ASP remain unclear. Here, we identify risk factors for reactions in a front-line acute lymphoblastic leukemia trial and assess the usefulness of serum antibodies for diagnosing (...) allergy and predicting rechallenge outcome.PEG-ASP was administered to 598 patients in St Jude's Total XVI study. Results were compared with Total XV study ( ClinicalTrials.gov identifiers: NCT00549848 and NCT00137111 ), which used native L-ASP. Serum samples (n = 5,369) were analyzed for anti-PEG-ASP immunoglobulin G by enzyme-linked immunosorbent assay. Positive samples were tested for anti-polyethylene glycol (PEG) and anti-L-ASP. We analyzed potential risk factors for reactions and associations

2019 Journal of Clinical Oncology

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