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Allergy & Rhinology

A Banerji, M Bas, J A Bernstein, I Boccon-Gibod, M Bova, J Dempster, A S Grumach, M Magerl, K Poarch, M B Ferreira
BACKGROUND: Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. OBJECTIVE: An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE...
September 22, 2016: Allergy & Rhinology
D L Erickson, C A Coop
CASE REPORT: A 59-year old man currently on >5 years of angiotensin-converting enzyme inhibitor (ACEI) therapy presented to the emergency department with angioedema of the tongue and difficulty swallowing. After receiving conventional therapy of antihistamine, steroids, and epinephrine, the patient's condition continued to deteriorate, with imminent intubation. The patient was treated with a C1-esterase inhibitor (C1-INH) and experienced rapid resolution of symptoms, which avoided airway complications...
August 5, 2016: Allergy & Rhinology
B Chauhan, M Gupta, K Chauhan
BACKGROUND: Antioxidants have a preventive or therapeutic role in oxygen free radical-mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. METHODS: Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks...
July 26, 2016: Allergy & Rhinology
William Rae, Rainer Doffinger, Fenella Shelton, Eleanor Sproson, Hasnaa Ismail-Koch, Valerie J Lund, Philip G Harries, Efrem Eren, Rami J Salib
BACKGROUND: Chronic granulomatous invasive fungal rhinosinusitis (CGIFRS) is a rare disease. The underlying immune responses that drive the development of CGIFRS, as opposed to successful pathogen clearance and controlled inflammation, are not currently known. OBJECTIVE: To characterize the immune responses associated with CGIFRS. METHODS: In addition to a battery of basic investigations, more in-depth immunologic testing involves ex vivo whole-blood stimulation with the polyclonal T-cell mitogen phytohemagglutinin and fungal antigens with interleukin (IL) 12, was undertaken to investigate cell-mediated immune responses associated with CGIFRS...
January 2016: Allergy & Rhinology
Nathan D Vandjelovic, Ian M Humphreys
OBJECTIVE: Immunoglobulin G4 (IgG4) related sclerosing disease (RSD) of the paranasal sinuses is a rare lesion of dense lymphoplasmacytic tissue, with a high proportion of IgG4+ plasma cells. We presented a rare case of IgG4-RSD with isolated involvement of the paranasal sinuses in the absence of multiorgan involvement. METHODS: A case report and comprehensive literature review. RESULTS: To our knowledge, only 11 cases of IgG4-RSD with paranasal sinus involvement have been reported...
January 2016: Allergy & Rhinology
Roshan K Verma, P Lokesh, Naresh K Panda
BACKGROUND: Bilateral congenital choanal atresia that presents in adulthood is rare. There are only eight reported cases in the literature. METHOD: We present a ninth case of adult bilateral choanal atresia diagnosed at the age of 20 years. Can a bilateral choanal atresia present so late in life when such a condition is considered incompatible with life? RESULTS AND CONCLUSION: Clinical details, diagnosis, and surgical steps with a clear depiction of photographs and comparison with all other previously reported cases, which can help novel otolaryngologists in their clinical practice are discussed...
January 2016: Allergy & Rhinology
Bhushan Chauhan, Manish Gupta, Komal Chauhan
BACKGROUND: Antioxidants have a preventive or therapeutic role in oxygen free radical-mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. METHODS: Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks...
January 2016: Allergy & Rhinology
Hirokuni Otsuka, Hiroyuki Tsukagoshi, Hirokazu Kimura, Ikuo Takanashi, Kimihiro Okubo
BACKGROUND: Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. OBJECTIVE: We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. METHODS: In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined...
January 2016: Allergy & Rhinology
Moira E Breslin, Joanna H Lin, Robert Roberts, Kellie J Lim, E Richard Stiehm
BACKGROUND: We reported on six infants between 5 and 11 months old, with transient hypogammaglobulinemia of infancy and severe refractory atopic dermatitis, who were treated with open-label immunoglobulin (Ig) after conventional therapy failed. All six infants had an IgG level of <225 mg/dL, elevated eosinophil and IgE levels, and no urine or stool protein losses, but they did exhibit hypoalbuminemia. OBJECTIVE: To evaluate the utility of open-label immunoglobulin in infants with severe atopic dermatitis for whom conventional therapy failed...
January 2016: Allergy & Rhinology
Edward C Kuan, Bobby A Tajudeen, Sunita M Bhuta, Miguel Fernando Palma Diaz, Paul A Kedeshian, Jeffrey D Suh
INTRODUCTION: Septoplasty, or surgical correction of the deviated septum, is an elective, routinely performed rhinologic procedure to address nasal airway obstruction. In many cases, resected septal cartilage and bone fragments are sent for pathologic review, although there is no consensus on this practice. We reported two cases of incidentally diagnosed lymphoma after elective septoplasty and discussed clinical presentation, diagnosis, and management. METHODS: Retrospective chart review of two patients who underwent septoplasty at a tertiary academic medical center and found to have incidental lymphoma based on histopathology...
January 2016: Allergy & Rhinology
Warner Carr, Jack Schaeffer, Eric Donnenfeld
BACKGROUND: Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action. METHODS: In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations...
January 2016: Allergy & Rhinology
Tiago Costa, Eduardo Ferreira, Luís Antunes, Paulo Borges Dinis
INTRODUCTION: The frequently used irrigant in dental surgery, sodium hypochlorite, is occasionally the cause of minor, usually circumscribed, adverse effects. Severe, extensive complications, with lasting sequelae, however, also can occur, as in the case we report herein. CASE REPORT: A 55-year-old woman underwent an endodontic procedure on a maxillary molar, whose roots, unknown to the surgeon, were protruding into the maxillary sinus. After sodium hypochlorite root canal irrigation, the patient immediately developed intense facial pain, facial edema, and periorbital cellulitis...
January 2016: Allergy & Rhinology
Isamara Simas de Oliveira, Paulo Fernando Tormin Borges Crosara, Geovanni Dantas Cassali, Diego Carlos Dos Reis, Danilo Santana Rodrigues, Flavio Barbosa Nunes, Roberto Eustáquio Santos Guimarães
INTRODUCTION: Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases. Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments. OBJECTIVES: To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables. METHODS: The present investigation was a self-paired case study of 33 patients with ENP...
January 2016: Allergy & Rhinology
Sandeep Suresh, Dayanand Arumugam, George Zacharias, Sengottaiah Palaninathan, Ravisankar Vishwanathan, Vaidyanathan Venkatraman
BACKGROUND: There are only a few landmark studies from the Indian subcontinent on fungal rhinosinusitis. The lack of awareness among clinicians regarding the varying clinical presentations of fungal rhinosinusitis prompted us to undertake this study. OBJECTIVE: To determine the prevalence, etiologic basis, clinical features, radiologic features, and microscopic features of fungal rhinosinusitis, and to evaluate the various treatment modalities available. METHODS: This was a prospective study in which evaluation of 100 patients with chronic rhinosinusitis was done...
January 2016: Allergy & Rhinology
Karen Ganacias, Sarah Spriet, Taylor A Banks
BACKGROUND: Vesicular rashes are associated with a variety of infectious and noninfectious causes. OBJECTIVE: To discuss the differential diagnoses of vesicular rashes. METHODS: We present the clinical case of an adult woman who was immunocompetent and who developed several clear fluid-filled vesicles on her upper extremity within days of receiving the varicella zoster vaccine. Over the next several days, the skin eruption generalized, and she developed new lesions in various stages of healing...
January 2016: Allergy & Rhinology
Patrick Kennedy, Ahmed Bassiouni, Alkis Psaltis, Jastin Antisdel, Joseph Brunworth
OBJECTIVE: In this report, we present a rare case of avascular necrosis (AVN) in an otherwise healthy 42-year-old male patient treated with low dose oral corticosteroids for his bronchitis. A systematic review of the literature related to AVN and corticosteroids was performed. CASE REPORT: Forty-two-year-old male with no underlying conditions predisposing him to AVN who had been treated four years before for chronic bronchitis with two courses of oral prednisone therapy presented with bilateral AVN of the hips...
January 2016: Allergy & Rhinology
Mukadder Korkmaz, Selen Uslu, Hakan Korkmaz, Yeliz Çetinkol
BACKGROUND: Sarcoidosis is a multisystem granulomatous inflammatory disease that is induced by infectious or noninfectious environmental antigens in a genetically susceptible host. Tuberculosis and sarcoidosis are two diseases with similar clinical and pathologic findings. The link between these two diseases has been extensively studied. OBJECTIVE: Herein we describe a case of sarcoidosis associated with tuberculosis, treated for tuberculosis, and, 1 year, later presented with a nasal dorsal lump and skin lesions on the extremities...
January 2016: Allergy & Rhinology
Chelsea Michaud, Brian Peppers, John Frith, Haig Tcheurekdjian, Robert Hostoffer
BACKGROUND: Hyperimmunoglobulin E syndrome (HIES) is a rare primary immunodeficiency characterized by recurrent skin infections with abscesses, recurrent pneumonias with pneumatoceles, and immunoglobulin E levels of >10 times the upper limit of normal. CASE: The patient described herein had a classic case of signal transducer and activator of transcription 3 (STAT3) deficiency associated with HIES diagnosed several years before this particular presentation. He demonstrated extraimmune manifestations of the disease as well, including characteristic facies and a history of skeletal fractures...
January 2016: Allergy & Rhinology
Thiago L I Serrano, Leopoldo Pfeilsticker, Vanessa Silva, Igor Hazboun, Jorge Paschoal, Rebecca Maunsell, Eulalia Sakano
INTRODUCTION: Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases...
January 2016: Allergy & Rhinology
Rami Abo-Shasha, Camilla Stepniak, David H Yeh, Brian Rotenberg
INTRODUCTION: We report on a case of isolated metastatic breast cancer to the medial rectus muscle. This entity is exceedingly rare. CASE: A 44-year-old female with a history of breast cancer presented with unilateral maxillary symptoms and was treated for sinusitis. Over time, she developed ocular pain, diplopia, blurred vision and eventually complete adduction deficit. RESULTS: T1-weighted magnetic resonance imaging revealed a medial rectus lesion...
January 2016: Allergy & Rhinology
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