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urticaria and angioedema

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https://www.readbyqxmd.com/read/28049210/hypersensitivity-reactions-to-nonsteroidal-anti-inflammatory-drugs-among-adults-clinical-features-and-risk-factors-for-diagnosis-confirmation
#1
Eva Rebelo Gomes, Luísa Geraldes, Ângela Gaspar, Daniela Malheiro, Susana Cadinha, Carmo Abreu, Marta Chambel, Eugénia Almeida, Emília Faria
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Laboratory investigations are mostly used for research purposes. Different phenotypes have been described. OBJECTIVE AND METHODS: Our aim was to describe the most common clinical manifestations of NSAID HS in a large population of adult patients, the drugs involved, the association with previously described risk factors, and the outcome of diagnostic procedures...
2016: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28007089/epidemiology-of-anaphylaxis-at-a-tertiary-care-center-a-report-of-730-cases
#2
Alexei Gonzalez-Estrada, Stacy K Silvers, Asaf Klein, Katrina Zell, Xiao-Feng Wang, David M Lang
BACKGROUND: Recent data reveal that the rate of anaphylaxis is increasing and suggest that idiopathic anaphylaxis may account for most of these cases. OBJECTIVE: To determine the pattern of anaphylaxis at a tertiary care referral center. METHODS: A retrospective electronic medical record review spanning 12 years (2002-2013) identified patients with anaphylaxis. RESULTS: Of the 4,777 records reviewed, 730 patients met our anaphylaxis definition...
January 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27979020/antiepilepsy-drugs-and-the-immune-system
#3
REVIEW
Neetu Godhwani, Sami L Bahna
OBJECTIVE: To alert physicians about the peculiar adverse effects of antiepilepsy drugs (AEDs) on the immune system. DATA SOURCES: PubMed literature during the past 25 years. STUDY SELECTIONS: Reports and review articles on the hypersensitivities of AEDs and their effect on immunity. RESULTS: AEDs have significant effects on the immune system in the form of hypersensitivity or immune suppression. IgE-mediated reactions can be urticaria, angioedema, bronchospasm, or anaphylaxis...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27942350/omalizumab-for-chronic-urticaria-in-latin-america
#4
Paul Wilches, Paola Wilches, Juan Carlos Calderon, Annia Cherrez, Ivan Cherrez Ojeda
BACKGROUND: Chronic urticaria (CU) is defined as the spontaneous appearance of wheals, with or without angioedema, persisting for ≥6 weeks. Chronic Spontaneous Urticaria (CSU) is a type of CU which affects 0.5-1 % of the global population, but it represents a high burden to patients. In recent years, omalizumab is available as treatment of disease. Our aim is to extend previous findings, analyzing effects of omalizumab on symptoms in Latin American patients with CSU. METHODS: Retrospective analysis of patients treated with omalizumab in Cuenca-Ecuador...
2016: World Allergy Organization Journal
https://www.readbyqxmd.com/read/27926978/potential-blood-biomarkers-in-chronic-spontaneous-urticaria
#5
REVIEW
P Kolkhir, F André, M K Church, M Maurer, M Metz
Chronic spontaneous urticaria (CSU) is a mast cell-driven disease that is defined as the recurrence of weals, angioedema or both for > 6 weeks due to known or unknown causes. As of yet, disease diagnosis is purely clinical. Objective tools are needed to monitor the activity of CSU and the efficacy of treatment. Recently, several reports have suggested that blood parameters may be considered as potential disease-related biomarkers. Here, we reviewed available literature on blood biomarkers for CSU diagnosis, activity monitoring, duration, patient subgroup allocation or response to treatment...
January 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27911016/positive-impact-of-omalizumab-on-angioedema-and-quality-of-life-in-patients-with-refractory-chronic-idiopathic-spontaneous-urticaria-analyses-according-to-the-presence-or-absence-of-angioedema
#6
M Maurer, H Sofen, B Ortiz, F Kianifard, S Gabriel, J A Bernstein
BACKGROUND: Approximately 50% of patients with chronic idiopathic/spontaneous urticaria (CIU/CSU) report hives and angioedema; some experience hives/ angioedema only. OBJECTIVE: Assess omalizumab's effect on angioedema and quality of life (QoL) in subgroups with refractory CIU/CSU: those with and without angioedema. METHODS: Patients received omalizumab (75, 150 or 300 mg) or placebo every 4 weeks for 12/24 weeks. Angioedema and QoL was assessed (Urticaria Patient Daily Diary and Dermatology Quality of Life Index [DLQI])...
December 2, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27886913/biologics-in-chronic-urticaria
#7
REVIEW
Adeeb Bulkhi, Andrew J Cooke, Thomas B Casale
Chronic urticaria (CU) is defined as wheals, angioedema, or both, that last more than 6 weeks. Second-generation antihistamines are considered the first-line therapy for CU. Unfortunately, many patients will fail antihistamines and require alternative therapy, including immune response modifiers or biologics. Multiple biological agents have been evaluated for use in antihistamine-refractory CU, including omalizumab, rituximab, and intravenous immunoglobulin; omalizumab is the most efficacious. Because of the success of omalizumab, multiple new biologics that are directed at the IgE pathway are under investigation...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27886908/cutaneous-manifestation-of-food-allergy
#8
REVIEW
Jonathan S Tam
Hypersensitivity reactions to foods can have diverse and highly variable manifestations. Cutaneous reactions, such as acute urticaria and angioedema, are among the most common manifestations of food allergy. However, cutaneous manifestations of food allergy encompass more than just IgE-mediated processes and include atopic dermatitis, contact dermatitis, and even dermatitis herpetiformis. These cutaneous manifestations provide an opportunity to better understand the diversity of adverse immunologic responses to food and the interconnected pathways that produce them...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27886907/differential-diagnosis-of-chronic-urticaria-and-angioedema-based-on-molecular-biology-pharmacology-and-proteomics
#9
REVIEW
David H Dreyfus
Differential diagnosis of urticaria and angioedema has been based on the phenotype as either acute or chronic depending on the duration of more than 6 to 8 weeks, respectively. Additional subdivisions include poorly defined terms such as idiopathic, spontaneous, or autoimmune. In this article, the author suggests that an increased understanding of the acquired and innate immune system and data from novel proteomic technology have blurred the lines between these categories of diagnosis. Specific molecular pathways and response to specific medications should be incorporated in classification and diagnosis schemes...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27882879/treatment-of-chronic-spontaneous-urticaria-with-an-inadequate-response-to-h1-antihistamines-an-expert-opinion
#10
Christian Vestergaard, Elias Toubi, Marcus Maurer, Massimo Triggiani, Barbara Ballmer-Weber, Alexander Marsland, Marta Ferrer, André Knulst, Ana Giménez-Arnau
Chronic spontaneous urticaria (CSU) is characterized by the sudden, continuous or intermittent appearance of pruritic wheals (hives), angioedema, or both for six weeks or more, with no known specific trigger. The international EAACI/GA(2)LEN/EDF/WAO urticaria guideline advises standard-dose, second-generation H1-antihistamines as first-line therapy. However, H1-antihistamine treatment leads to absence of symptoms in fewer than 50% of patients. Updosing of second-generation H1-antihistamines (up to fourfold) as recommended by the EAACI/GA(2)LEN/EDF/WAO urticaria guideline as second-line therapy, can improve response, but many patients remain symptomatic...
November 23, 2016: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/27865769/discrepancies-in-the-diagnosis-and-classification-of-nonsteroidal-anti-inflammatory-drug-hypersensitivity-reactions-in-children
#11
Tuğba Arikoglu, Gulen Aslan, Didem Derici Yildirim, Sehra Birgul Batmaz, Semanur Kuyucu
BACKGROUND: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently encountered in daily clinical practice. The aim of this study was to determine the confirmation rates, risk factors of NSAID hypersensitivity in children and to try to classify them with a standardized diagnostic protocol. METHODS: All patients with a suspicion of NSAID-induced hypersensitivity were evaluated with European Network for drug Allergy (ENDA) recommendations...
November 16, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/27826875/idiopathic-non-histaminergic-angioedema-successful-treatment-with-omalizumab-in-five-patients
#12
Charles Faisant, Aurélie Du Thanh, Catherine Mansard, Alban Deroux, Isabelle Boccon-Gibod, Laurence Bouillet
Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease characterized by AE resistant to antihistamines and a chronic course. We report five new cases of InH-AAE (two women and three men) with a rapid and dramatic response to the anti-immunoglobulin-E antibody omalizumab. In our literature review, we found 13 other relevant cases with a good response to this treatment. Overall, in 6 out of 18 patients, the doses of omalizumab required to prevent recurrences of attacks were higher than the licensed dose for chronic urticaria...
November 8, 2016: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/27779082/hypersensitivity-reactions-to-non-steroidal-anti-inflammatory-drugs
#13
Inmaculada Doña, María Salas, James R Perkins, Esther Barrionuevo, Francesco Gaeta, Jose A Cornejo-García, Paloma Campo, Maria José Torres
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs, and they are classified in two groups: those induced by non-specific immunological mechanisms (non-allergic or cross-intolerance (CI) reactions), or by specific immunological mechanisms (allergic or selective reactions (SR)). The pathogenesis of CI is associated with their pharmacological activity (COX-1 inhibition), with symptoms due to an imbalance in the arachidonic acid pathway, independently of their chemical structure...
September 28, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27777182/autoimmune-chronic-spontaneous-urticaria-what-we-know-and-what-we-do-not-know
#14
Pavel Kolkhir, Martin K Church, Karsten Weller, Martin Metz, Oliver Schmetzer, Marcus Maurer
Chronic spontaneous urticaria (CSU) is a mast cell-driven skin disease characterized by the recurrence of transient wheals, angioedema, or both for more than 6 weeks. Autoimmunity is thought to be one of the most frequent causes of CSU. Type I and II autoimmunity (ie, IgE to autoallergens and IgG autoantibodies to IgE or its receptor, respectively) have been implicated in the etiology and pathogenesis of CSU. We analyzed the relevant literature and assessed the existing evidence in support of a role for type I and II autoimmunity in CSU with the help of Hill's criteria of causality...
October 21, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27746265/the-comparative-safety-of-multiple-alternative-agents-in-refractory-chronic-urticaria-patients
#15
Sharon Seth, David A Khan
BACKGROUND: Patients who have failed traditional treatment of chronic urticaria may require trials of alternative medications. Safety profiles, continuous laboratory monitoring, and physician comfort are often barriers to treatment. OBJECTIVES: To evaluate the safety of alternative agents used in chronic urticaria. METHODS: A retrospective chart review of electronic medical records from a single-center allergy and immunology clinic in a major academic hospital was conducted...
October 13, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27732743/clinical-approach-on-challenge-and-desensitization-procedures-with-aspirin-in-patients-with-ischemic-heart-disease-and-nsaid-hypersensitivity
#16
G Cortellini, A Romano, A Santucci, A Barbaud, S Bavbek, D Bignardi, M Blanca, P Bonadonna, M T Costantino, J J Laguna, C Lombardo, L Losappio, J Makowska, A Nakonechna, O Quercia, E A Pastorello, V Patella, I Terreehorst, S Testi, J R Cernadas, J Dionicio Elera, D Lippolis, S Voltolini, D Grosseto
BACKGROUND: Hypersensitivity to acetylsalicylic acid (ASA) constitutes a serious problem for subjects with coronary artery disease. In such subjects, physicians have to choose the more appropriate procedure between challenge and desensitization. As the literature on this issue is sparse, the present study aims to establish in these subjects clinical criteria for eligibility for an ASA challenge and/or desensitization. METHODS: Collection and analysis of data on ASA challenges and desensitizations from 10 allergy centers, as well as consensus among the related physicians and an expert panel...
October 12, 2016: Allergy
https://www.readbyqxmd.com/read/27713240/hypersensitivity-reactions-to-nonsteroidal-anti-inflammatory-drugs-an-update
#17
Mario Sánchez-Borges, Fernan Caballero-Fonseca, Arnaldo Capriles-Hulett, Luis González-Aveledo
After beta lactam antibiotics, hypersensitivity reactions to nonsteroidal antiinflammatory drugs are the second cause of hypersensitivity to drugs. Acute manifestations affect the respiratory tract (aspirin exacerbated respiratory disease), the skin (urticaria and angioedema), or are generalized (anaphylaxis). Correct diagnosis and treatment in order to prevent unnecessary morbidity and the potential risk of death from these severe reactions, and to provide proper medical advice on future drug use frequently requires the participation of allergology specialists familiar with these clinical conditions...
January 5, 2010: Pharmaceuticals
https://www.readbyqxmd.com/read/27712763/pathogenesis-of-aspirin-induced-reactions-in-aspirin-exacerbated-respiratory-disease
#18
Katherine N Cahill, Tanya M Laidlaw
The acute clinical symptoms that develop following the oral ingestion of aspirin, or any other inhibitor of cyclooxygenase-1, are well established in aspirin-exacerbated respiratory disease: nasal congestion, rhinorrhea, and bronchospasm. Less commonly, gastrointestinal distress, rash, angioedema, or urticaria also develops. However, the pathobiology that drives these clinical reactions is poorly understood. Use of an intranasal aspirin challenge protocol or administration of premedications inhibiting the leukotriene pathway decreases the severity of clinical reaction, which suggests the involvement of both local effector cells and cysteinyl leukotrienes in the pathogenesis of aspirin-induced reactions...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712573/diagnosing-%C3%AE-lactam-hypersensitivity
#19
Francesco Gaeta, Maria J Torres, Rocco Luigi Valluzzi, Cristiano Caruso, Cristobalina Mayorga, Antonino Romano
Hypersensitivity reactions to β-lactam antibiotics are commonly reported. They can be classified as immediate or non-immediate according to the time interval between the last drug administration and their onset. Immediate reactions occur within one hour after the last drug administration and are manifested clinically by urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock; they may be mediated by specific IgE-antibodies. Non-immediate reactions occur more than one hour after the last drug administration...
October 4, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27690471/clinical-practice-guideline-for-diagnosis-and-management-of-urticaria
#20
Kanokvalai Kulthanan, Papapit Tuchinda, Leena Chularojanamontri, Pattriya Chanyachailert, Wiwat Korkij, Amornsri Chunharas, Siriwan Wananukul, Wanida Limpongsanurak, Suwat Benjaponpitak, Wanee Wisuthsarewong, Kobkul Aunhachoke, Vesarat Wessagowit, Pantipa Chatchatee, Penpun Wattanakrai, Orathai Jirapongsananuruk, Jettanong Klaewsongkram, Nopadon Noppakun, Pakit Vichyanond, Puan Suthipinittharm, Kiat Ruxrungtham, Srisupalak Singalavanija, Jarungchit Ngamphaiboon
Urticaria is a common skin condition that can compromise quality of life and may affect individual performance at work or school. Remission is common in majority of patients with acute spontaneous urticaria (ASU); however, in chronic cases, less than 50% had remission. Angioedema either alone or with urticaria is associated with a much lower remission rate. Proper investigation and treatment is thus required. This guideline, a joint development of the Dermatological Society of Thailand, the Allergy, Asthma, and Immunology Association of Thailand and the Pediatric Dermatological Society of Thailand, is graded and recommended based on published evidence and expert opinion...
September 2016: Asian Pacific Journal of Allergy and Immunology
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