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urticaria and angioedema

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https://www.readbyqxmd.com/read/28226401/natural-evolution-in-patients-with-non-steroidal-anti-inflammatory-drugs-induced-urticaria-angioedema
#1
Inmaculada Doña, Esther Barrionuevo, María Salas, José Antonio Cornejo-García, James R Perkins, Gádor Bogas, Ana Prieto, María José Torres
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequent triggers of drug hypersensitivity with NSAIDs-induced urticaria/angioedema (NIUA) the most common phenotype. Loss of hypersensitivity has been reported for IgE-mediated reactions; however it has not been assessed in non-immunological reactions such as NIUA. We evaluated NSAID-hypersensitivity over time in NIUA patients. METHODS: Patients confirmed as NIUA by positive drug provocation test (DPT) with acetylsalicylic acid (ASA) during 2005-2012 (V1) were included (n=38)...
February 22, 2017: Allergy
https://www.readbyqxmd.com/read/28219634/management-of-chronic-spontaneous-urticaria-in-routine-clinical-practice-following-the-eaaci-ga-2-len-edf-wao-guidelines
#2
I Marín-Cabañas, L Berbegal-de Gracia, F de León-Marrero, P Hispán, J F Silvestre
INTRODUCTION: Chronic spontaneous urticaria is a prevalent and difficult-to-treat condition that has a very negative impact on patient quality of life. OBJECTIVE: To describe the epidemiological and clinical characteristics of patients presenting with chronic spontaneous urticaria and the response to treatment administered according to the EAACI/GA(2)LEN/EDF/WAO consensus guideline. MATERIAL AND METHOD: Descriptive cross-sectional study of all the patients with chronic spontaneous urticaria who consulted a skin allergy unit in the dermatology department of a tertiary hospital in Spain between July 2011 and July 2015...
February 17, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28219067/d-dimer-plasma-levels-parallel-the-clinical-response-to-omalizumab-in-patients-with-severe-chronic-spontaneous-urticaria
#3
Riccardo Asero, Angelo V Marzano, Silvia Ferrucci, Massimo Cugno
Omalizumab is very effective in the majority of patients with severe chronic spontaneous urticaria (CSU), but its mechanism of action is still unclear. In CSU the coagulation cascade is activated with an intensity that parallels the disease severity, and elevated plasma D-dimer levels are associated with a poor response to both antihistamines and cyclosporin. We measured D-dimer plasma levels before and after the first administration of omalizumab in 32 patients with severe CSU. A number of clinical and laboratory parameters were recorded, including the urticaria activity score, presence of angioedema, disease duration, C-reactive protein, anti-nuclear, and anti-thyroid antibodies...
February 21, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28211343/immediate-reactions-to-more-than-1-nsaid-must-not-be-considered-cross-hypersensitivity-unless-tolerance-to-asa-is-verified
#4
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND AND OBJECTIVES: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28193678/aspirin-desensitization-in-patients-with-coronary-artery-disease-results-of-the-multicenter-adapted-registry-aspirin-desensitization-in-patients-with-coronary-artery-disease
#5
Roberta Rossini, Annamaria Iorio, Roberto Pozzi, Matteo Bianco, Giuseppe Musumeci, Sergio Leonardi, Corrado Lettieri, Irene Bossi, Paola Colombo, Stefano Rigattieri, Cinzia Dossena, Angelo Anzuini, Davide Capodanno, Michele Senni, Dominick J Angiolillo
BACKGROUND: There are limited data on aspirin (ASA) desensitization for patients with coronary artery disease. The aim of the present study was to assess the safety and efficacy of a standard rapid desensitization protocol in patients with ASA sensitivity undergoing coronary angiography. METHODS AND RESULTS: This is a prospective, multicenter, observational study including 7 Italian centers including patients with a history of ASA sensitivity undergoing coronary angiography with intent to undergo percutaneous coronary intervention...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28160338/h1-antihistamine-refractory-chronic-spontaneous-urticaria-it-s-worse-than-we-thought-first-results-of-the-multicenter-real-life-aware-study
#6
Marcus Maurer, Petra Staubach, Ulrike Raap, Grit Richter-Huhn, Andrea Bauer, Franziska Ruëff, Thilo Jakob, Amir S Yazdi, Vera Mahler, Nicola Wagner, Undine Lippert, Uwe Hillen, Andreas Schwinn, Mario Pawlak, Norbert Behnke, Kamel Chaouche, Nadine Chapman-Rothe
BACKGROUND: Most data on chronic spontaneous urticaria (CSU) originate from highly selected patient populations treated at specialized centers. Little is known about CSU patient characteristics and the burden of CSU in routine clinical practice. AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is an ongoing global study designed to assess chronic urticaria in the real-life setting. OBJECTIVE: To describe the baseline characteristics of the first 1,539 German AWARE patients with H1-antihistamine-refractory CSU...
February 4, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28125304/omalizumab-for-treating-chronic-spontaneous-urticaria-an-expert-review-on-efficacy-and-safety
#7
Ana M Giménez-Arnau
Chronic spontaneous urticaria (CSU) is characterized by the recurrence of itchy hives and/or angioedema for greater than six weeks, with no known external trigger. Omalizumab, a humanized, recombinant, monoclonal anti-IgE antibody, is the only approved add-on therapy for H1-antihistamine refractory CSU patients. Areas covered: The objective of this article is to discuss the mechanism of action, pharmacokinetics and pharmacodynamics of omalizumab for the treatment of CSU. The review also summarizes efficacy and safety data from proof-of-concept, Phase II (X-QUISITE, MYSTIQUE), and pivotal Phase III omalizumab studies (ASTERIA I, ASTERIA II, and GLACIAL)...
January 26, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28121807/sulfasalazine-related-hypersensitivity-reactions-in-patients-with-rheumatic-diseases
#8
Songul Cildag, Taskin Senturk
BACKGROUND: Sulfasalazine (SSZ), which has an arylamine sulfonamide structure, is an anti-inflammatory drug used in the treatment of many rheumatic diseases. Various adverse effects have been reported related to SSZ. In the present study, we aimed to define the frequency of SSZ-related hypersensitivity reaction in patients with rheumatoid arthritis and ankylosing spondylitis. METHODS: A total of 136 patients were included in this study. During follow-ups, reaction type, reaction duration, and drug doses were recorded in patients who developed hypersensitivity reactions...
January 24, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28049210/hypersensitivity-reactions-to-nonsteroidal-anti-inflammatory-drugs-among-adults-clinical-features-and-risk-factors-for-diagnosis-confirmation
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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 were 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
#15
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
#16
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
#17
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
#18
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...
February 1, 2017: 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
#19
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
#20
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...
January 2017: Journal of Clinical Immunology
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