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https://www.readbyqxmd.com/read/28734860/the-expanding-field-of-biologics-in-the-management-of-chronic-urticaria
#1
Shyam Joshi, David A Khan
Chronic urticaria (CU) is the occurrence of urticaria with or without angioedema for at least 6 weeks. Management has traditionally involved antihistamines as first-line therapy with various alternative therapies for refractory cases. Largely based on the success of biologics for various diseases, this class of drugs has come to the forefront of medical research. The first and only Food and Drug Administration-approved biologic for the management of CU is omalizumab (humanized anti-IgE mAb). In the past decade, a substantial amount of research has been centered on the mechanism of action, efficacy, dosing, and safety of omalizumab...
July 19, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28725969/mastocytosis-from-a-molecular-point-of-view
#2
REVIEW
Daniel Elieh Ali Komi, Todd Rambasek, Stefan Wöhrl
Mast cells (MCs) are physiologically activated by binding of stem cell factor (SCF) to the extracellular domains of the Kit receptor. This binding increases the proliferation and prolongs the survival of normal mature MCs, as well as intensifies the release of mediators. In mastocytosis, somatic mutations of the coding Kit gene cause autocrine dysregulation and lead to constitutive KIT activation even in the absence of its ligand SCF. Clinical symptoms are caused by MC-mediator release and/or infiltration of MCs into tissues...
July 19, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28720373/incidence-of-adverse-contrast-reaction-following-nonintravenous-urinary-tract-imaging
#3
Robert H Blackwell, Eric J Kirshenbaum, Matthew A C Zapf, Anai N Kothari, Paul C Kuo, Robert C Flanigan, Gopal N Gupta
Adverse reactions (ARs) to intravenous (IV) radiographic contrast range from mild urticaria to life-threatening anaphylaxis. Intraluminal contrast dye is routinely used in the urinary tract with a minimal perceived risk of AR. We used the Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida from 2007 to 2011 to identify patients who received urinary tract contrast dye for retrograde pyelography, percutaneous pyelography, retrograde/other cystogram, and ileal conduitogram...
February 2017: European Urology Focus
https://www.readbyqxmd.com/read/28687112/burden-of-illness-and-quality-of-life-measures-in-angioedema-conditions
#4
REVIEW
Teresa Caballero, Nieves Prior
Burden of illness studies and evaluation of health-related quality of life using validated questionnaires have become an important task in the comprehensive management of angioedema conditions, mainly angioedema associated with chronic spontaneous urticaria and hereditary angioedema caused by C1-inhibitor deficiency. A review of the principal tools and studies is presented. Both diseases present a higher proportion of psychiatric disorders, impair work and studies productivity, and produce high direct and indirect costs...
August 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28687103/histaminergic-angioedema
#5
REVIEW
Paula J Busse, Tukisa Smith
Angioedema is frequently categorized into histamine- or bradykinin-mediated disease. It is critical to determine the underlying mediator of symptoms as it directs treatment. Histaminergic angioedema is the most frequent cause of angioedema. It is classified as either acute (lasting <6 weeks) or chronic (symptoms >6 weeks). It is further classified into angioedema presenting with or without urticaria. Some patients with acute angioedema may have disease that becomes chronic. Mast cells and basophils are central to the underlying pathophysiology of histamine-mediated angioedema...
August 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28687102/the-clinical-evaluation-of-angioedema
#6
REVIEW
Parwinder Gill, Stephen D Betschel
The clinical evaluation of angioedema is reliant on obtaining a thorough patient and family history with an assessment of risk factors and presenting symptoms unique to each subtype. It is important to distinguish between angioedema with and without urticaria as a primary step in the evaluation; thereafter, laboratory parameters and investigations allow for subsequent stratification. There is a significant disease burden associated with angioedema and thus it is essential for health care practitioners to establish a prompt and accurate diagnosis, and a comprehensive care plan that addresses the patient's physical and mental well-being alike...
August 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28643673/-allergy-to-drugs-experience-in-771-procedures
#7
María Cecilia Juri, Diego S Fernández Romero, Blas Larrauri, Eloísa Malbrán, Gabriela Torre, Alejandro Malbrán
Drug hypersensitivity reactions (RHD) are those that present clinically as allergic. They can or cannot involve an immunologic mechanism of lesion. They are frequent and, occasionally, life threatening. Patients with RHD repeat the reaction when they are re-exposed to the drug, limiting the therapeutic options and exposing them to more expensive and toxic drugs. It is difficult to identify the responsible drug when the reaction was not recent or when it occurred in the context of therapy with multiple drugs or confusing concurrent diseases...
2017: Medicina
https://www.readbyqxmd.com/read/28634542/angioedema-perioperative-management
#8
Andrew A Maynard, Christina F Burger, Joseph J Schlesinger
OBJECTIVE: To describe the perioperative management of a patient with acquired angioedema (AAE). METHODS: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28633739/autoimmune-progesterone-dermatitis-presenting-as-fixed-drug-eruption-a-case-report
#9
Raya Mokhtari, Mozhdeh Sepaskhah, Fatemeh Sari Aslani, Ladan Dastgheib
Autoimmune progesterone dermatitis (APD) is a rare disorder characterized by periodic skin lesions that erupt during the luteal phase of the menstrual cycle. Clinical manifestations of APD is caused by an unusual allergy to progesterone and has a wide range of clinical manifestations from eczema and urticaria to angioedema and erythema multiforme. A 46-year-old woman described recurrent, round erythematous plaques on the lower lip, both forearms and buttocks. These skin eruptions waxed and waned for 10 months, reoccurring 3-4 days before menstruation...
June 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28616043/angioedema-suppressed-by-a-combination-of-anti-histamine-and-leukotriene-modifier
#10
Brendan N Wong, Peter Vadas
RATIONALE: Angioedema without co-existent urticaria is due to a limited number of causes, including hereditary and acquired C1 esterase inhibitor deficiency, drug-induced angioedema or idiopathic histaminergic or non-histaminergic angioedema. We describe a cohort of patients with recurrent angioedema whose clinical features and response to medications are distinct from the causes above. METHODS: Patients were accrued retrospectively from an academic allergy practice between 2007 and 2014...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28584758/atypical-lichen-myxedematosus-a-case-with-remarkable-response-to-low-dose-melphalan
#11
Mini Gomathy, Beena Sunny, Krishna Anitha, Sukumarakurup Sreekanth, Kunnaruvath Rajeevan, Soni C Das
A 41-year-old man was referred to our outpatient department with a diagnosis of urticaria with angioedema of 3 months duration. On examination, he had generalized coalescent waxy papules and diffuse periorbital swelling. Systemic examination was unremarkable except for limited finger flexion. Serum electrophoresis and thyroid function tests were normal. Histopathological examination showed normal epidermis and intradermal mucin deposition, which was diagnostic of lichen myxedematosus (LM). The patient showed prompt response to melphalan...
May 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28583263/increased-serum-soluble-vascular-endothelial-cadherin-levels-in-patients-with-chronic-spontaneous-urticaria
#12
Tao Chen, Zai-Pei Guo, Wen-Ju Wang, Li-Xin Fu, Qiao-Mei Sun, Pei-Mei Zhou
BACKGROUND: Chronic spontaneous urticaria (CSU) is a common skin disease characterized by recurrent itchy wheals with or without angioedema that lasts longer than 6 weeks. Vascular endothelial (VE)-cadherin is an endothelial cell-specific adhesion molecule that plays critical roles in angiogenesis and endothelial permeability. OBJECTIVE: To investigate serum levels of soluble VE (sVE)-cadherin in patients with CSU. METHODS: Serum levels of sVE-cadherin in patients with CSU, patients with atopic dermatitis, and healthy controls were determined by enzyme-linked immunosorbent assay...
June 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28576691/recurrent-elevated-liver-transaminases-and-acute-liver-failure-in-two-siblings-with-novel-bi-allelic-mutations-of-nbas
#13
Frederico S Regateiro, Serkan Belkaya, Nélson Neves, Sandra Ferreira, Paula Silvestre, Sónia Lemos, Margarida Venâncio, Jean-Laurent Casanova, Isabel Gonçalves, Emmanuelle Jouanguy, Luísa Diogo
BACKGROUND: Acute liver failure (ALF) in children can be life-threatening. Although many causes are known, ALF remains unexplained in about half of the cases. Recently, bi-allelic mutations in NBAS were reported to underlie recurrent episodes of elevated liver transaminases (ELT) and ALF in the context of diverse extrahepatic phenotypes. METHODS AND RESULTS: We here describe two sisters, born to non-consanguineous Portuguese parents, who had short stature and presented with recurrent episodes of severe ELT triggered by febrile respiratory viral infections since early childhood...
August 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28552101/allergic-adverse-events-following-2015-seasonal-influenza-vaccine-victoria-australia
#14
Hazel J Clothier, Nigel Crawford, Melissa A Russell, Jim P Buttery
Australia was alerted to a possible increase in allergy-related adverse events following immunisation (AEFI) with 2015 seasonal trivalent influenza vaccines (TIV) by the Victorian state vaccine safety service, SAEFVIC. We describe SAEFVIC's initial investigation and upon conclusion of the 2015 influenza vaccination programme, to define the signal event and implications for vaccine programmes. Allergy-related AEFI were defined as anaphylaxis, angioedema, urticaria or generalised allergic reaction. Investigations compared 2015 TIV AEFI reports to previous years as proportions and reporting risk (RR) per 100,000, stratified by influenza vaccine brand...
May 18, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28543019/the-burden-of-chronic-spontaneous-urticaria-is-substantial-real-world-evidence-from-assure-csu
#15
M Maurer, M Abuzakouk, F Bérard, W Canonica, H Oude Elberink, A Giménez-Arnau, C Grattan, K Hollis, A Knulst, J-P Lacour, C Lynde, A Marsland, D McBride, A Nakonechna, J Ortiz de Frutos, C Proctor, G Sussman, C Sweeney, H Tian, K Weller, D Wolin, M-M Balp
BACKGROUND: Chronic spontaneous urticaria (CSU) can be debilitating, difficult to treat, and frustrating for patients and physicians. Real-world evidence for the burden of CSU is limited. The objective of this study was to document disease duration, treatment history, and disease activity, as well as impact on health-related quality of life (HRQoL) and work among patients with inadequately controlled CSU, and to describe its humanistic, societal, and economic burden. METHODS: This international observational study assessed a cohort of 673 adult patients with CSU whose symptoms persisted for ≥12 months despite treatment...
May 19, 2017: Allergy
https://www.readbyqxmd.com/read/28511831/obstructive-sleep-apnea-and-dermatologic-disorders
#16
Madhulika A Gupta, Fiona C Simpson, Branka Vujcic, Aditya K Gupta
Obstructive sleep apnea (OSA) is present in at least 2% of women and 4% of men, and its prevalence is increasing, because a major predisposing factor for OSA is a high body mass index. Psoriasis has the most strongly substantiated link with OSA, where the relationship may be bidirectional. Dermatologic disorders may be comorbid with OSA due to several factors: (i) the heightened proinflammatory state in OSA, which can occur independent of body mass index, and may exacerbate inflammatory dermatoses; (ii) intermittent hypoxemia may promote neovascularization and tumor growth in certain cancers, such as melanoma; (iii) obesity, present in majority of OSA patients, can be associated with a heightened proinflammatory state; (iv) upper airway obstruction due to local tumors or soft tissue swelling due to physical urticaria or angioedema; (v) acute nasal congestion in the atopic patient with allergic rhinitis; (vi) dermatologic disorders associated with other OSA risk factors (eg, acanthosis nigricans and metabolic syndrome); and (vii) a high sympathetic tone (eg, in atopic dermatitis) and resultant sleep fragmentation contributing to upper airway instability during sleep...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28476259/levocetirizine-and-prednisone-are-not-superior-to-levocetirizine-alone-for-the-treatment-of-acute-urticaria-a-randomized-double-blind-clinical%C3%A2-trial
#17
Caroline Barniol, Emilie Dehours, Jean Mallet, Charles-Henri Houze-Cerfon, Dominique Lauque, Sandrine Charpentier
STUDY OBJECTIVE: We evaluate the efficacy of a 4-day course of prednisone added to antihistamine for the management of acute urticaria in an emergency department (ED). METHODS: In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older and with acute urticaria of no more than 24 hours' duration. Patients with anaphylaxis or who had received antihistamines or glucocorticoids during the previous 5 days were not included...
May 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28474101/-chronic-urticaria-in-childhood-rational-diagnostics-and-treatment
#18
H Ott
Chronic urticaria (CU) is defined by episodes of urticaria with or without angioedema, which recur daily or nearly daily over more than 6 weeks. Sudden manifestations of CU with or without known causes are termed chronic spontaneous urticaria, which is differentiated from chronic inducible urticaria. The differential diagnoses of CU in childhood range from self-limiting dermatoses to severe systemic diseases. Further targeted steps are taken to detect potential trigger factors or underlying illnesses only if suspicion arises on anamnestic grounds and CU is best treated in accordance with international guidelines...
May 4, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28405547/autologous-serum-and-plasma-skin-tests-in-chronic-spontaneous-urticaria-a-reappraisal
#19
Muthu Sendhil Kumaran, Sonia Mangal, Tarun Narang, Davinder Parsad
AIM: The objective of this study was to assess autologous serum skin test (ASST) vs autologous plasma skin test (APST) response in chronic spontaneous urticaria (CSU) patients and study the significance of intensity of positive responses in relation to clinicoepidemiological parameters. MATERIALS AND METHODS: One hundred CSU patients and 100 age and sex-matched controls were recruited. The demographic and clinical features were recorded in all patients and routine investigations were performed...
March 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28390587/clinical-features-of-adolescents-with-chronic-idiopathic-or-spontaneous-urticaria-review-of-omalizumab-clinical-trials
#20
Stanley Goldstein, Susan Gabriel, Farid Kianifard, Benjamin Ortiz, David P Skoner
BACKGROUND: Adults and adolescents were included in 3 phase 3 omalizumab trials in chronic idiopathic urticaria (CIU): ASTERIA I, ASTERIA II, and GLACIAL. OBJECTIVE: To describe the baseline clinical profile of adolescent patients with CIU enrolled in the omalizumab trials to add to the limited literature available on CIU in this population. METHODS: Data for patient demographics, baseline clinical disease characteristics, medical history, and previous CIU medication information (not efficacy assessments) from phase 3 omalizumab trials were pooled and descriptive statistical analyses performed for adolescent (12 to <18 years old) and adult (≥18 years old) subgroups...
April 2017: Annals of Allergy, Asthma & Immunology
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