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Allergy drug hypersensitivity

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https://www.readbyqxmd.com/read/27910104/long-term-reproducibility-of-positive-patch-test-reactions-in-patients-with-non-immediate-cutaneous-adverse-drug-reactions-to-antibiotics
#1
André Pinho, Ana Marta, Inês Coutinho, Margarida Gonçalo
BACKGROUND: As in contact allergy, T cell-mediated hypersensitivity in non-immediate (NI) cutaneous adverse drug reactions (CADRs) to antibiotics is considered to be lifelong, but, in this setting, patch tests have rarely been repeated after long time intervals. OBJECTIVE: To evaluate the long-term reproducibility of positive patch test reactions to antibiotics in patients with NI CADRs. METHODS: Fifty-six patients with NI CADRs to antibiotics who had relevant positive reactions during patch testing were invited to repeat patch tests with a similar antibiotic series 2-15 years thereafter...
December 2, 2016: Contact Dermatitis
https://www.readbyqxmd.com/read/27899028/nano-liposome-based-target-toxicity-machine-an-alternative-complementary-approach-in-atopic-diseases
#2
Behzad Mansoori, Ali Mohammadi, Neda Shajari, Sadaf Davudian, Shima Salehi, Behzad Baradaran
Despite using lots of progression in hypersensitivity, it is not yet a cure. Current treatment for allergy focuses on two approaches, including treats only the symptoms of allergy by utilizing drugs and the other is desensitization therapy (immunotherapy), which involves administration of specific allergens. The main obstacle to hypersensitivity permanent treatment is the IgE producing subclass of B-lymphocytes which is the source of IgE- producing in hypersensitive patients. Removal of these lymphocytes causes noticeable reduction in the levels of IgE and allergic responses significantly...
November 29, 2016: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/27889746/distinct-in-vitro-complement-activation-by-various-intravenous-iron-preparations
#3
Julia Cordelia Hempel, Felix Poppelaars, Mariana Gaya da Costa, Casper F M Franssen, Thomas P G de Vlaam, Mohamed R Daha, Stefan P Berger, Marc A J Seelen, Carlo A J M Gaillard
BACKGROUND: Intravenous (IV) iron preparations are widely used in the treatment of anemia in patients undergoing hemodialysis (HD). All IV iron preparations carry a risk of causing hypersensitivity reactions. However, the pathophysiological mechanism is poorly understood. We hypothesize that a relevant number of these reactions are mediated by complement activation, resulting in a pseudo-anaphylactic clinical picture known as complement activation-related pseudo allergy (CARPA). METHODS: First, the in-vitro complement-activating capacity was determined for 5 commonly used IV iron preparations using functional complement assays for the 3 pathways...
November 26, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27888028/identifying-allergic-drug-reactions-through-placebo-controlled-graded-challenges
#4
Melissa Iammatteo, Denisa Ferastraoaru, Rebecca Koransky, Santiago Alvarez-Arango, Niharika Thota, Ayobami Akenroye, Elina Jerschow
BACKGROUND: Graded challenges are performed to exclude hypersensitivity reactions in patients with a low likelihood of drug allergy. Literature regarding optimal protocols with a defined number of steps and use of placebo is lacking. OBJECTIVE: To identify allergic drug reactions (ADRs) through a 3-step protocol composed of placebo followed by a 2-step graded drug challenge. METHODS: We performed a 5-year retrospective chart review of all patients with historical ADRs who underwent single-blind, placebo-controlled graded drug challenges between October 2010 and November 2015 at an outpatient drug allergy clinic...
November 22, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27886905/cutaneous-manifestation-of-drug-allergy-and-hypersensitivity
#5
REVIEW
Anna Zalewska-Janowska, Radoslaw Spiewak, Marek L Kowalski
Drug hypersensitivity reactions may manifest with either organ-specific or systemic symptoms, but cutaneous eruptions are the most common manifestations. Different medications may cause identical skin symptoms, whereas hypersensitivity to a single drug may manifest with various patterns of symptoms depending on the pathomechanism of hypersensitivity. Drug reactions should be also taken into account in the differential diagnosis of numerous skin rashes. Analysis of morphology of drug-induced lesions, about potential immunologic or nonimmunological mechanisms, is important for the final diagnosis...
February 2017: Immunology and Allergy Clinics of North America
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/27865673/a-rare-cause-of-acute-coronary-syndrome-kounis-syndrome
#7
João Almeida, Sara Ferreira, Joana Malheiro, Paulo Fonseca, Daniel Caeiro, Adelaide Dias, José Ribeiro, Vasco Gama
Kounis syndrome is an acute coronary syndrome in the context of a hypersensitivity reaction. The main pathophysiological mechanism appears to be coronary vasospasm. We report the case of a patient with a history of allergy to quinolones, who was given ciprofloxacin before an elective surgical procedure and during drug administration developed symptoms and electrocardiographic changes suggestive of ST-segment elevation acute coronary syndrome. The drug was suspended and coronary angiography excluded epicardial coronary disease...
December 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27864093/skin-testing-and-drug-challenge-outcomes-in-antibiotic-allergic-patients-with-immediate-type-hypersensitivity
#8
Stephanie L Mawhirt, Luz S Fonacier, Rose Calixte, Mark Davis-Lorton, Marcella R Aquino
BACKGROUND: The evaluation of antibiotic immediate-type hypersensitivity is intricate because of nonstandardized skin testing and challenge method variability. OBJECTIVE: To determine the safety outcomes and risk factors for antibiotic challenge reactions in patients reporting a history of antibiotic immediate-type hypersensitivity. METHODS: A 5-year retrospective review of patients evaluated for immediate-type antibiotic allergy was conducted...
November 15, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27857897/interleukin-4-and-interferon-%C3%AE-are-possible-allergic-markers-in-pediatric-patients-with-%C3%AE-lactam-hypersensitivity
#9
Khaled H Mahmoud, Abdullateef A Alzolibani, Zafar Rasheed, Yasser Farouk, Ghada Bin Saif, Ahmad A Al Robaee
BACKGROUND: β-lactam agents are known to elicit T-cell-mediated immune responses that play a central role in the onset of allergic reactions, but the involvement of specific type of cytokines in drug allergy remains largely unexplored in humans. OBJECTIVES: This study was undertaken to investigate the role of cytokines involvement in pediatric patients with β-lactam hypersensitivity and to determine whether involvement of cytokines in drug-mediated reactions are important for the perspective of allergic patient's management...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27856924/prevention-of-carboplatin-induced-hypersensitivity-reactions-in-women-with-ovarian-cancer
#10
Katarzyna J Jerzak, Shaidah Deghan Manshadi, Pamela Ng, Manjula Maganti, Jeanna M McCuaig, Marcus Bulter, Amit Oza, Helen J Mackay
BACKGROUND: Carboplatin-based chemotherapy offers high response rates and improved overall survival for women with epithelial ovarian cancer, but its use is limited by the occurrence of hypersensitivity reactions. To evaluate the efficacy of prophylactic diphenhydramine for hypersensitivity reaction prevention, we reviewed the incidence of hypersensitivity reactions and identified patients at high risk of hypersensitivity reactions. METHODS: Women receiving ≥6 cycles of carboplatin-based chemotherapy for epithelial ovarian cancer were identified from our institutional database at the Princess Margaret Cancer Centre...
November 17, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27852424/hypersensitivity-to-beta-lactam-antibiotics-a-three-year-study
#11
I Mota, Â Gaspar, M Chambel, S Piedade, M Morais-Almeida
BACKGROUND: Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. METHODS: Over a three-year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated according to the European Network for Drug Allergy guidelines. RESULTS: HS to BL was confirmed in 43 pts (18%), without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27834127/hypersensitivity-reactions-from-excipients-in-systemic-glucocorticoid-formulations
#12
Gianfranco Calogiuri, Lene H Garvey, Paolo Romita, Luigi Macchia, Caterina Foti
Glucocorticoids are the most widely used drugs for the treatment of hypersensitivity, however these drugs themselves and the excipients contained in commercial corticosteroid formulations are able to induce severe immediate-type hypersensitivity reactions. Reactions involving excipients have been confirmed to be IgE mediated by the demonstration of specific-IgE to excipients such as carboxymethylcellulose and lactose. In case of hypersensitivity reactions to corticosteroid preparations, a complete allergy work-up with skin tests and/or challenge tests should include testing excipients as well as the active ingredients...
November 9, 2016: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/27832658/anaphylaxis-to-over-the-counter-flurbiprofen-in-a-child
#13
Mattia Giovannini, Lucrezia Sarti, Simona Barni, Neri Pucci, Elio Novembre, Francesca Mori
Non-steroidal anti-inflammatory drugs are suspected to cause drug hypersensitivity very frequently in paediatric patients. In this article, we describe the first case of anaphylaxis to flurbiprofen in a child and provide insight into the possibility of severe reactions and even anaphylaxis to over-the-counter flurbiprofen. Finally, the importance of a rigorous allergy work-up in reaching a confident diagnosis and providing the patient with a safe alternative is shown.
November 11, 2016: Pharmacology
https://www.readbyqxmd.com/read/27824862/delayed-type-hypersensitivity-to-metals-of-environmental-burden-in-patients-with-takotsubo-syndrome-is-there-a-clinical-relevance
#14
Jan Manousek, Vera Stejskal, Petr Kubena, Jiri Jarkovsky, Petr Nemec, Petr Lokaj, Ludmila Dostalova, Andrea Zadakova, Marie Pavlusova, Klara Benesova, Petr Kala, Roman Miklik, Jindrich Spinar, Jiri Parenica
OBJECTIVE: Takotsubo syndrome (TS) is a heart condition characterised by a sudden transient left ventricular dysfunction; its pathophysiology is probably associated with elevated levels of catecholamines but the exact mechanism is not known as yet. Literature and clinical experience suggest that TS affects persons with various comorbidities. This pilot work aims to evaluate the frequency of comorbidities with potential pathological immune reactivity, and to evaluate the potential association between TS and hypersensitivity to metals assessed by LTT-MELISA®...
2016: PloS One
https://www.readbyqxmd.com/read/27820941/functions-of-exosomes-and-microbial-extracellular-vesicles-in-allergy-and-contact-and-delayed-type-hypersensitivity
#15
Katarzyna Nazimek, Krzysztof Bryniarski, Philip W Askenase
Extracellular vesicles, such as exosomes, are newly recognized intercellular conveyors of functional molecular mechanisms. Notably, they transfer RNAs and proteins between different cells that can then participate in the complex pathogenesis of allergic and related hypersensitivity responses and disease mechanisms, as described herein. This review highlights this important new appreciation of the in vivo participation of such extracellular vesicles in the interactions between allergy-mediating cells. We take into account paracrine epigenetic exchanges mediated by surrounding stromal cells and the endocrine receipt of exosomes from distant cells via the circulation...
2016: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/27795214/-modified-tests-basophil-degranulation-and-leukocyte-migration-inhibition-factor-in-drug-allergy-study-2009-2014
#16
María Lourdes Irigoyen-Coria, María Isabel Rojo-Gutiérrez, Rubén Humberto Meyer-Gómez, Isabel Leyva-Carmona, Víctor Manuel Zendejas-Buitrón, Angélica Dinorah García-Ruiz, Jaime Mellado-Ábrego, Ilayalid García-Ortega, Gloria Castillo-Narváez
BACKGROUND: Adverse reactions to drugs are increasing and there are few studies for the diagnosis. OBJECTIVE: To determine the utility of modified basophil degranulation (MBD) test and modified leukocyte migration inhibition factor (MLMIF) test to prove drug hypersensitivity. METHODS: 177 patients of both sexes were studied with the diagnosis of drug hypersensitivity, determining MBD, MLMIF, or both, between 2009 and 2014. They were matched with positive and negative controls and the non-allergic population...
October 2016: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/27779086/genetic-predictors-of-drug-hypersensitivity
#17
José A Cornejo-García, Abderrahim Oussalah, Miguel Blanca, Rosa-María Guéant-Rodríguez, Cristobalina Mayorga, Julie Waton, Annick Barbaud, Francesco Gaeta, Antonino Romano, Jean-Louis Guéant
Our knowledge of genetic predisposing factors of drug hypersensitivity reactions (DHRs) is still scarce. The analysis of the genetic basis of these reactions may contribute to dissect the underlying mechanisms. We will outline current knowledge of the genetic predictors of most common DHRs, including reactions to betalactam antibiotics (BLs), nonsteroidal anti-inflammatory drugs (NSAIDs) and biological agents. The predictors of DHRs to BLs are mostly linked to IgE-class switching, IgE pathway and atopy (IL4R, NOD2, LGALS3) in replicated candidate gene studies, and to antigen presentation (HLA-DRA) in the single replicated GWAS performed so far...
September 27, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27753687/old-dog-begging-for-new-tricks-current-practices-and-future-directions-in-the-diagnosis-of-delayed-antimicrobial-hypersensitivity
#18
Katherine C Konvinse, Elizabeth J Phillips, Katie D White, Jason A Trubiano
PURPOSE OF REVIEW: Antimicrobials are a leading cause of severe T cell-mediated adverse drug reactions (ADRs). The purpose of this review is to address the current understanding of antimicrobial cross-reactivity and the ready availability of and evidence for in-vitro, in-vivo, and ex-vivo diagnostics for T cell-mediated ADRs. RECENT FINDINGS: Recent literature has evaluated the efficacy of traditional antibiotic allergy management, including patch testing, skin prick testing, intradermal testing, and oral challenge...
December 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27748716/pathophysiology-of-immediate-reactions-to-injectable-gadolinium-based-contrast-agents
#19
Tara F Carr
OBJECTIVE: The aim of this paper was to review the classification of adverse drug reactions, highlight the known pathophysiology of immediate hypersensitivity reactions, and discuss the utility of diagnostic testing for immunologically mediated immediate reactions to gadolinium-based contrast agents (GBCAs). METHODS: Current literature on immediate reactions to GBCA was reviewed and summarized. RESULTS: Adverse drug reactions to GBCA are rare, and can be attributed to physiologic, immunologic, and nonimmunologic processes...
December 2016: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/27748714/incidence-and-risk-factors-for-gadolinium-based-contrast-agent-immediate-reactions
#20
James R Costello, Bobby Kalb, Diego R Martin
Since their clinical introduction in 1988, gadolinium-based contrast agents (GBCAs) have demonstrated an excellent safety profile with a reported acute adverse reaction rate ranging from 0.01% to 2%. By comparison, the acute adverse reaction rate of low osmolar nonionic computed tomography contrast agents (CTCs) ranges from 0.7% to 3.1%. Many of the risk factors associated with CTC reactions (drug allergies, asthma, atopy, prior contrast reaction) also point toward an increased incidence of acute adverse events to GBCAs...
December 2016: Topics in Magnetic Resonance Imaging: TMRI
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