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urticaria and angioedema

Abdullateef Abdulkareem, Ryan S D'Souza, Joshua Mundorff, Pragya Shrestha, Oluwaseun Shogbesan, Anthony Donato
Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions...
2018: Case Reports in Hematology
G Authried, S C Prasad, E Rye Rasmussen, A Bygum
A subset of patients with angioedema (AE) and urticaria has histamine releasing autoanti-boies. The histamine release test (HR-test) has been used as a tool in chronic urticaria to de-fine the autoimmune subgroup and may possibly guide the clinician to a more personalized therapy, like omalizumab and cyclosporine. The prevalence and value of positive histamine releasing autoantibodies in monosymptomatic AE is sparsely described in the literature. The purpose of this study was to report the prevalence of positive histamine releasing autoanti-bodies in a cohort of patients with recurrent AE and evaluate the usefulness of this test in AE patients...
February 19, 2018: European Annals of Allergy and Clinical Immunology
(no author information available yet)
BACKGROUND: Chronic idiopathic urticaria (CIU)/spontaneous urticaria (CSU) is defined by the presence of wheals,angioedema, or both for 6 weeks, with or without an identifiable trigger. Real-world health care data among children withCIU/CSU remain scarce. OBJECTIVES: To describe treatment patterns, health care resource utilization (HRU), and costs in pediatric patients with CIU/CSU (12 years old) and to compare these with pediatric patients without CIU/CSU. METHODS: A commercial administrative claims data base (September 2013 to June 2016) was used...
March 7, 2018: Allergy and Asthma Proceedings:
Eustachio Nettis, Luca Cegolon, Elisabetta Di Leo, Walter Giorgio Canonica, Aikaterini Detoraki
BACKGROUND: Omalizumab therapy is effective and safe in patients with chronic spontaneous urticaria (CSU) resistant to nonsedating histamine1 (H1 ) antihistamines (nsAHs). OBJECTIVE: To evaluate the efficacy and safety of omalizumab in elderly (aged ≥65 years) patients with nonsedating H1 -antihistamine-refractory CSU in a real-life setting. METHODS: Patients with nonsedating H1 -antihistamine-refractory CSU (n = 322) treated with omalizumab administered every 4 weeks in doses of 300 mg for 24 weeks were divided into 2 groups according to age at omalizumab treatment onset: 15 to 64 years and 65 years or older...
March 2018: Annals of Allergy, Asthma & Immunology
Paola L Minciullo, Antonio Cascio, Sebastiano Gangemi
BACKGROUND: The association between parasites and urticaria was first suggested in the last century. A wide range, 0-75.4%, of the prevalence of parasitic infection has been reported with chronic urticaria (CU). Moreover, urticaria may be detected in patients with parasitosis. Nematodes are a type of helminth that infect hundreds of millions of people throughout the world. OBJECTIVE: The aim of this work was to collect and review the published studies and cases of urticaria associated with nematode infections...
March 1, 2018: Allergy and Asthma Proceedings:
T A Kanters, H B Thio, L Hakkaart
BACKGROUND: Chronic spontaneous urticaria (CSU) is a skin disease, with itchy hives and / or angioedema that last for at least 6 weeks without an obvious external trigger. OBJECTIVES: The objective of this study was to determine the cost-effectiveness of omalizumab relative to standard of care (SoC; up to 4 times the daily dose of H1-antihistaminics) for the Netherlands from a societal perspective. METHODS: The Markov model used consisted of five health states based on Urticaria Activity Score over seven days (UAS7)...
February 24, 2018: British Journal of Dermatology
Gordon Sussman, Mohamed Abuzakouk, Frédéric Bérard, Walter Canonica, Hanneke Oude Elberink, Ana Giménez-Arnau, Clive Grattan, Kelly Hollis, Shannon Hunter, André Knulst, Jean-Philippe Lacour, Charles Lynde, Alexander Marsland, Doreen McBride, Marcus Maurer, Alla Nakonechna, Javier Ortiz de Frutos, Maria Reynolds, Carolyn Sweeney, Haijun Tian, Karsten Weller, Daniel Wolin, Maria-Magdalena Balp
BACKGROUND: ASSURE-CSU revealed differences in physician and patient reporting of angioedema. This post-hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema. METHODS: This international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient-reported data...
February 20, 2018: Allergy
Corinna Dressler, Ricardo Niklas Werner, Lisa Eisert, Torsten Zuberbier, Alexander Nast, Marcus Maurer
BACKGROUND: Chronic inducible urticaria (CindU) is a condition characterized by the appearance of recurrent wheals, angioedema or both, as a response to specific and reproducible triggers. OBJECTIVE: To systematically assess the evidence on the efficacy and safety of treatment options for CindU. Results were used to inform the 2017 update of "The EAACI/GA 2 LEN/EDF/WAO Guideline for the definition, classification, diagnosis and management of Urticaria." METHODS: Randomised controlled trials (RCTs) and controlled studies (CCTs) were systematically searched in various databases...
February 10, 2018: Journal of Allergy and Clinical Immunology
Jonathan A Bernstein, Abhishek Kavati, Michael D Tharp, Benjamin Ortiz, Karen MacDonald, Kris Denhaerynck, Ivo Abraham
Chronic idiopathic/spontaneous urticaria (CIU/CSU) is a dermatological condition characterized by itchy wheals and/or angioedema of continuous or intermittent duration of ≥6 weeks with a high burden of disease and impact on quality of life. Omalizumab is a recombinant humanized monoclonal antibody that inhibits the binding of IgE to high affinity receptors, and is approved for the CIU/CSU indication. The objective of this systematic review was to evaluate and synthesize the evidence on the real-world effectiveness of omalizumab in CIU/CSU in daily clinical practice...
February 12, 2018: Expert Opinion on Biological Therapy
Paul V Williams, Abhishek Kavati, Dominic Pilon, Yongling Xiao, Maryia Zhdanava, Maria-Magdalena Balp, Patrick Lefebvre, Benjamin Ortiz, Vivian Hernandez-Trujillo
INTRODUCTION: Few studies have described chronic idiopathic/spontaneous urticaria (CIU/CSU) healthcare burden in adults, while this information remains largely unknown in children. We aimed to describe treatment patterns, healthcare resource utilization (HRU), and costs in CIU/CSU pediatric patients, as well as to compare HRU and costs in CIU/CSU and CIU/CSU-free pediatric patients. METHODS: Medicaid claims from four states (09/01/2013-03/31/2016) were used to identify patients less than 12 years old...
February 10, 2018: Dermatology and Therapy
Mark Yarema, Puja Chopra, Marco L A Sivilotti, David Johnson, Alberto Nettel-Aguirre, Benoit Bailey, Charlemaigne Victorino, Sophie Gosselin, Roy Purssell, Margaret Thompson, Daniel Spyker, Barry Rumack
BACKGROUND: Anaphylactoid reactions to intravenous (IV) N-acetylcysteine (NAC) are well-recognized adverse events during treatment for acetaminophen (APAP) poisoning. Uncertainty exists regarding their incidence, severity, risk factors, and management. We sought to determine the incidence, risk factors, and treatment of anaphylactoid reactions to IV NAC in a large, national cohort of patients admitted to hospital for acetaminophen overdose. METHODS: This retrospective medical record review included all patients initiated on the 21-h IV NAC protocol for acetaminophen poisoning in 34 Canadian hospitals between February 1980 and November 2005...
February 8, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Michael M McNeil, Frank DeStefano
Vaccine-associated hypersensitivity reactions are not infrequent; however, serious acute-onset, presumably IgE-mediated or IgG and complement-mediated anaphylactic or serious delayed-onset T cell-mediated systemic reactions are considered extremely rare. Hypersensitivity can occur because of either the active vaccine component (antigen) or one of the other components. Postvaccination acute-onset hypersensitivity reactions include self-limited localized adverse events and, rarely, systemic reactions ranging from urticaria/angioedema to full-blown anaphylaxis with multisystem involvement...
February 2018: Journal of Allergy and Clinical Immunology
Hye Jung Park, Kyung Soo Suk, Jung Won Park
Intraoperative bovine-derived topical thrombin is still widely used for hemostasis during surgery. A 38-year-old woman with chronic spontaneous urticaria was referred to the orthopedic surgery department for herniated disk and myelopathy. During the first stage of operation, bovine-derived thrombin powder soaked in Gelfoam was used as a hemostatic aid. After 30 minutes, the patient developed anaphylactic shock with systemic skin rash and angioedema. Repeated intravenous bolus and infusion of vasopressor were carried out, and her blood pressure normalized...
March 2018: Allergy, Asthma & Immunology Research
Mona Al-Ahmad, Tito Rodriguez-Bouza, Midhat Nurkic
BACKGROUND: A history of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with cross-intolerance to several drugs is common in some patients with coronary artery disease. We present a series of patients with acute coronary syndrome undergoing ASA desensitization prior to a possible stent to evaluate the short- and long-term efficacy and safety. The aim was to evaluate the outcomes of an ASA desensitization protocol developed by our center based on the guidelines proposed by the EAACI drug allergy expert recommendations...
January 26, 2018: International Archives of Allergy and Immunology
R A Fernandes, F Regateiro, C Pereira, E Faria, J Pita, A Todo-Bom, I Carrapatoso
Background. Anaphylaxis is an acute, potentially fatal, multi-organ allergic reac-tion. Our aim was to characterize the population with food induced anaphylaxis followed over a one-year period. Methods. Retrospective analysis of clinical files of patients with food anaphylaxis observed in our food allergy consultation during 2016. Results. Sixty-two patients were included. In the pediatric group, the implicated allergens were cow's milk, egg and fish and in the adults' group, the commonest allergens were nuts and wheat...
March 2018: European Annals of Allergy and Clinical Immunology
R Asero
Up to 30% of cases of chronic spontaneous urticaria (CSU) are exacerbated by COX-1 inhibit-ing nonsteroidal anti-inflammatory drugs (NSAID); this clinical picture is termed NECD (NSAID-exacerbated cutaneous disease). On the other hand, multiple NSAID hypersensitivity may occur in the absence of an underlying CSU also, a situation that is termed NIUA (NSAID-induced urticaria / angioedema). The present study reports a case of multiple NSAID hypersensitivity that occurred in a man much before he developed severe CSU...
November 30, 2017: European Annals of Allergy and Clinical Immunology
Rung-Chi Li, Kathleen M Buchheit, Jonathan A Bernstein
PURPOSE OF REVIEW: Progestogen hypersensitivity (PH) is a rare disorder which usually occurs in women of childbearing age with symptoms ranging from urticaria with or without angioedema, multiple organ involvement consistent with allergic anaphylaxis, to a spectrum of other non-evanescent skin eruptions. In this review, we present a clinical vignette of PH and discuss the clinical presentation and proposed pathomechanisms, diagnosis, and treatment of PH. RECENT FINDINGS: The hypersensitivity symptoms are associated with exogenous progestin exposure (e...
January 19, 2018: Current Allergy and Asthma Reports
Sakshi Kohli, Vikram K Mahajan, Baldev S Rana, Karaninder S Mehta, Rashmi Kaul Raina, Pushpinder S Chauhan, Vikas Sharma, Ritu Rawat
BACKGROUND: The Helicobacter pylori infection is linked to chronic urticaria in nearly 60% of patients. We studied clinicoepidemiologic features in patients with chronic urticaria with and without H. pylori infection. METHODS: Endoscopic antral biopsy for the rapid urease test (RUT) and histopathology, and serum IgG ELISA for H. pylori infection were performed in 150 patients (male:female ratio 1:2.4) of chronic urticaria aged 18-68 years. Clinicoepidemiologic features including age, gender, age of onset and duration, frequency and distribution of wheals, urticaria severity score, and systemic symptoms were analyzed in patients with and without H...
January 19, 2018: International Archives of Allergy and Immunology
T Zuberbier, W Aberer, R Asero, A H Abdul Latiff, D Baker, B Ballmer-Weber, J A Bernstein, C Bindslev-Jensen, Z Brzoza, R Buense Bedrikow, G W Canonica, M K Church, T Craig, I V Danilycheva, C Dressler, L F Ensina, A Giménez-Arnau, K Godse, M Gonçalo, C Grattan, J Hebert, M Hide, A Kaplan, A Kapp, C H Katelaris, E Kocatürk, K Kulthanan, D Larenas-Linnemann, T A Leslie, M Magerl, P Mathelier-Fusade, R Y Meshkova, M Metz, A Nast, E Nettis, H Oude-Elberink, S Rosumeck, S S Saini, M Sánchez-Borges, P Schmid-Grendelmeier, P Staubach, G Sussman, E Toubi, G A Vena, C Vestergaard, B Wedi, R N Werner, Z Zhao, M Maurer
This evidence and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. The conference was held on December 1st, 2016. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-founded network of excellence, the Global Allergy and Asthma European Network (GA²LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of 48 delegates of 42 national and international societies...
January 15, 2018: Allergy
S Altrichter, T Hawro, M Liedtke, G Holtappels, C Bachert, P S Skov, M Maurer
BACKGROUND: Chronic spontaneous urticaria (CSU) is a frequent disorder with recurrent itchy wheals and/or angioedema. Despite the known effectiveness of omalizumab therapy, the relevant IgE antigens are largely unknown. Recently, increased rates of elevated levels of IgE towards Staphylococcus aureus enterotoxins (SEs) were described in CSU. AIM: To assess the prevalence and functional relevance of IgE to SEs in CSU. METHOD: We investigated serum levels of IgE against SEs in 49 CSU patients and in 15 CSU patients additional specific IgE to SE components and basophil histamine release (BHR)...
January 9, 2018: Allergy
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