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urticaria and angioedema

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27655415/new-advances-in-the-study-of-ige-drug-recognition
#16
Ángela Martín-Serrano, Nekane Barbero, José A Agundez, Yolanda Vida, Ezequiel Pérez-Inestrosa, María I Montañez
Allergic drug reactions are currently a major public health problem affecting patient health and increasing healthcare costs. They are caused by interactions between a drug and the human immune system and result in symptoms ranging from urticaria or angioedema to those more serious such as anaphylaxis or anaphylactic shock. The most commonly accepted mechanism for immunological activation is based on the hapten hypothesis. Drugs are low molecular weight substances that cannot cause an immune response on their own...
September 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27622434/inducible-urticaria-case-series-and-literature-review
#17
Daniel Amaya, Andrés Sánchez, Jorge Sánchez
Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment...
2016: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/27608064/proposed-icdrg-classification-of-the-clinical-presentation-of-contact-allergy
#18
Korbkarn Pongpairoj, Iris Ale, Klaus Ejner Andersen, Magnus Bruze, Thomas L Diepgen, Peter U Elsner, Chee Leok Goh, An Goossens, Hemangi Jerajani, Jean Marie Lachapelle, Jun Young Lee, Howard I Maibach, Kayoko Matsunaga, Rosemary Nixon, Pailin Puangpet, Denis Sasseville, Supitchaya Thaiwat, John P McFadden
The International Contact Dermatitis Research Group proposes a classification for the clinical presentation of contact allergy. The classification is based primarily on the mode of clinical presentation. The categories are direct exposure/contact dermatitis, mimicking or exacerbation of preexisting eczema, multifactorial dermatitis including allergic contact dermatitis, by proxy, mimicking angioedema, airborne contact dermatitis, photo-induced contact dermatitis, systemic contact dermatitis, noneczematous contact dermatitis, contact urticaria, protein contact dermatitis, respiratory/mucosal symptoms, oral contact dermatitis, erythroderma/exfoliative dermatitis, minor forms of presentation, and extracutaneous manifestations...
September 2016: Dermatitis
https://www.readbyqxmd.com/read/27585420/benzodiazepine-allergy-with-anesthesia-administration-a-review-of-current-literature
#19
Elliot Haybarger, Andrew S Young, Joseph A Giovannitti
The incidence of anaphylactic/anaphylactoid reactions has been reported to vary between 1 : 3500 and 1 : 20,000 cases with a mortality rate ranging from 3 to 9%. Clinical signs present as skin rash, urticaria, angioedema, bronchospasm, tachycardia, bradycardia, and hypotension. Rapid identification and treatment are crucial to overall patient prognosis, as delayed intervention is associated with increased mortality. Diagnosis may be confirmed with clinical presentation, serum tryptase levels, and skin test results...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27585061/diagnostic-utility-of-challenge-procedures-for-physical-urticaria-angioedema-syndromes-a-systematic-review
#20
Lyda Cuervo-Pardo, Alexei Gonzalez-Estrada, David M Lang
PURPOSE OF REVIEW: Physical urticaria/angioedema syndromes (PUAs) are commonly encountered. They are identified by a history of physical factors provoking cutaneous symptoms, and confirmed by provocation testing. Recent guidelines have recommended use of challenge procedures for diagnosis; however, their positive/negative likelihood ratios have not been established. RECENT FINDINGS: We conducted a systematic review to determine the diagnostic utility of recommended office procedures for three common PUAs: dermatographia (DERMATO), cholinergic urticaria (CHOL), and delayed pressure urticaria/angioedema (DPUA)...
October 2016: Current Opinion in Allergy and Clinical Immunology
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