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Idiopathic anaphylaxis

So Yeon Lee, Kangmo Ahn, Jihyun Kim, Gwang Cheon Jang, Taek Ki Min, Hyeon Jong Yang, Bok Yang Pyun, Ji Won Kwon, Myung Hyun Sohn, Kyung Won Kim, Kyu Earn Kim, Jinho Yu, Soo Jong Hong, Jung Hyun Kwon, Sung Won Kim, Tae Won Song, Woo Kyung Kim, Hyung Young Kim, You Hoon Jeon, Yong Ju Lee, Hae Ran Lee, Hye Young Kim, Youngmin Ahn, Hye Yung Yum, Dong In Suh, Hyun Hee Kim, Jin Tack Kim, Jeong Hee Kim, Yong Mean Park, Sooyoung Lee
PURPOSE: Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. METHODS: We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. RESULTS: A total of 991 cases (mean age=5...
November 2016: Allergy, Asthma & Immunology Research
Pablo Florenzano, Verónica Mezzano, Marcela Le-Bert, Gilberto González
Systemic mastocytosis (SM) is characterized by pathologic expansion and activation of mast cells. The main clinical manifestations of SM include skin involvement, gastrointestinal symptoms and anaphylaxis due to the release of its mediators. Thirty percent of pat ients with SM have a low bone mass and 20% fractures. At the same time, SM affects 10% of male patients with idiopathic osteoporosis. Measuring serum tryptase is essential for the screening of MS. We report two cases of SM with bone involvement. A 25-year- old woman with prior diagnosis of SM, based on skin involvement, flushing, high serum tryptase and compatible bone marrow (BM) biopsy and genetic study...
March 2016: Revista Médica de Chile
Rafael Bonamichi-Santos, Mariana Castells
Due to the increase in utilization of chemotherapies and antibodies, drug hypersensitivity reactions have increased dramatically worldwide, preventing the use of first-line therapies and impacting patients' survival and quality of life. Some of the more frequently used medications in cancer include taxanes for ovarian, lung, breast, and prostate cancers. Monoclonal antibodies are used in the treatment of neoplastic, autoimmune, and inflammatory diseases, and their clinical applications are becoming broader...
June 8, 2016: Clinical Reviews in Allergy & Immunology
Nannan Jiang, Jia Yin, Liping Wen, Hong Li
PURPOSE: Comprehensive evaluation of anaphylaxis in China is currently lacking. In this study, we characterized the clinical profiles, anaphylactic triggers, and emergency treatment in pediatric and adult patients. METHODS: Outpatients diagnosed with "anaphylaxis" or "severe allergic reactions" in the Department of Allergy, Peking Union Medical College Hospital from January 1, 2000 to June 30, 2014 were analyzed retrospectively. RESULTS: A total of 1,952 episodes of anaphylaxis in 907 patients were analyzed (78% were adults and 22% were children)...
July 2016: Allergy, Asthma & Immunology Research
Sean S Liour, Andrew Tom, Yueh-Hsuan Chan, Tse Wen Chang
Targeting the IgE pathway is a clinically validated strategy for treating IgE-mediated diseases. Omalizumab, an anti-IgE antibody, which binds to free IgE and prevents the binding of IgE to FcεRI on mast cells and basophils has been approved for severe persistent allergic asthma and chronic spontaneous (idiopathic) urticaria. The therapeutic efficacy of anti-IgE has also been reported in allergic rhinitis, allergic bronchopulmonary aspergillosis, latex allergy, atopic dermatitis, allergic urticaria, anaphylaxis, and others...
August 2016: Pediatric Allergy and Immunology
T A Le, M Al Kindi, J-A Tan, A Smith, R J Heddle, F E Kette, P Hissaria, W B Smith
BACKGROUND: IgE-mediated allergy to the wheat protein omega-5-gliadin (O5G) is associated with wheat-dependent exercise-induced anaphylaxis (WDEIA), where exercise acts as a cofactor, triggering anaphylaxis after wheat ingestion. The wider application of O5G-specific IgE (sIgE) testing has revealed that the manifestations of O5G allergy extend beyond WDEIA. AIMS: This study documents clinical manifestations in a large series of patients with sIgE to O5G. METHODS: A retrospective clinical audit was performed on adult patients with a positive O5G sIgE (>0...
June 2016: Internal Medicine Journal
Cita Zupanc, Mitja Košnik
INTRODUCTION: Angioedema (AE) is a localized swelling of the subcutaneous tissue and mucosa. We aimed to identify how often AE is associated with angiotensin-converting enzyme inhibitor (ACEI-AE) therapy and whether the severity of AE episodes in these patients differs from the severity in idiopathic AE (IAE). METHODS: We included patients with AE that were referred to a tertiary allergy clinic from 2005 to 2014. We obtained data on AE location, severity, number, and treatment of episodes from patient medical files...
2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
Cosby A Stone, Jane J Choi
No abstract text is available yet for this article.
February 2016: Annals of Allergy, Asthma & Immunology
Scott P Commins, Maya R Jerath, Kelly Cox, Loren D Erickson, Thomas Platts-Mills
IgE-mediated hypersensitivity refers to immune reactions that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. To that end, identification of the associated allergen is important for facilitating both education and allergen avoidance that are essential to long-term risk reduction. As the number of known exposures associated with anaphylaxis is limited, discovery of novel causative agents is crucial to evaluation and management of patients with idiopathic anaphylaxis. Within the last 10 years several apparently separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins...
January 2016: Allergology International: Official Journal of the Japanese Society of Allergology
Dana L Baker, Gerald R Nakamura, Henry B Lowman, Saloumeh Kadkhodayan Fischer
Omalizumab (Xolair®) is a recombinant humanized monoclonal antibody that selectively binds to human immunoglobulin E (IgE). Omalizumab is used to treat IgE-mediated diseases such as chronic idiopathic urticaria (CIU) and moderate to severe allergic asthma. In pre-marketing clinical trials in patients with asthma, anaphylaxis was reported in 3 of 3,507 (0.1%) patients. In post-marketing spontaneous reports, the frequency of anaphylaxis attributed to omalizumab use was estimated to be at least 0.2% of patients based on an estimated exposure of about 57,300 patients from June 2003 through December 2006...
January 2016: AAPS Journal
F Alvarez Caro, V García González, J González García, R García Mozo, B García Norniella, A Gómez Farpó
No abstract text is available yet for this article.
2015: Journal of Investigational Allergology & Clinical Immunology
Emmanuel N Menga, Cole Hirschfeld, Amit Jain, Dong-Phuong Tran, Heather D Caine, Dolores B Njoku, Lori A Karol, Paul D Sponseller
STUDY DESIGN: Retrospective review. OBJECTIVE: To report the incidence of and risk factors for intraoperative cardiopulmonary arrest (ICA) in children undergoing spinal deformity surgery. SUMMARY OF BACKGROUND DATA: Spinal deformities in children are associated with comorbidities that can pose substantial risks during surgery. METHODS: We reviewed records of patients who underwent surgery at two pediatric tertiary-care hospitals from 2004 through 2014...
November 2015: Spine
Hwa Sik Jung, Chan-Ho Park, Young Tae Park, Mi Ae Bae, Youn Im Lee, Byung Ju Kang, Yangjin Jegal, Jong Joon Ahn, Taehoon Lee
H1-antihistamine is generally a well-tolerated and safe drug. However, in resemblance with all other drugs, H1-antihistamines can also prompt adverse drug reactions (ADRs). We recently encountered the very unusual ADR of H1-antihistamine-induced gynecomastia. A 21-year-old man with idiopathic anaphylaxis was treated with ebastine (Ebastel), a second-generation H1-antihistamine, for the prevention of anaphylaxis. Three months later, the patient remained well without anaphylaxis, but had newly developed gynecomastia...
July 2015: Asia Pacific Allergy
A Matito, M Carter
Childhood mastocytosis is usually a clonal mast cell disease related to activating mutations in KIT. The symptoms in childhood mastocytosis are typically cutaneous in nature although systemic symptoms including anaphylaxis due to the release of mast cells (MC) mediators can also manifest. The prevalence of anaphylaxis reported in childhood mastocytosis is higher than the rates reported in the pediatric general population, but lower than the prevalence of anaphylaxis described in adult mastocytosis. An extensive cutaneous involvement was reported as a risk factor for anaphylaxis, and patients with diffuse cutaneous mastocytosis have been documented to have more severe anaphylaxis symptoms...
May 2015: Current Allergy and Asthma Reports
Nana Fenny, Leslie C Grammer
Idiopathic anaphylaxis is a diagnosis of exclusion after other causes have been thoroughly evaluated and excluded. The pathogenesis of idiopathic anaphylaxis remains uncertain, although increased numbers of activated lymphocytes and circulating histamine-releasing factors have been implicated. Signs and symptoms of patients diagnosed with idiopathic anaphylaxis are indistinguishable from the manifestations of other forms of anaphylaxis. Treatment regimens are implemented based on the frequency and severity of patient symptoms and generally include the use of epinephrine autoinjectors, antihistamines, and steroids...
May 2015: Immunology and Allergy Clinics of North America
Cem Akin
Anaphylaxis results from severe systemic mast cell activation. In addition to IgE-mediated and physical triggers, it may occur with a clonal mast cell disease and in an idiopathic fashion without clear provoking factors. Disorders of mast cell activation are classified into primary (clonal), secondary, and idiopathic. Mast cell activation syndrome (MCAS) is a multisystem disorder characterized by objective documentation of elevated mast cell mediators during attacks and a favorable response to antimediator therapy...
May 2015: Immunology and Allergy Clinics of North America
James L Kuhlen, Yamini V Virkud
Idiopathic anaphylaxis (IA) is a life-threatening allergic disease and the most common diagnosis given to patients following an anaphylactic event. The inability of the healthcare provider and the patient to identify the trigger for anaphylaxis makes standard allergen avoidance measures ineffectual. IA is diagnosed after other causes of anaphylaxis have been excluded. Mast cell activation syndromes (MCAS), mastocytosis, IgE to galactose-alpha-1,3-galactose (α-gal), and certain medications have recently been recognized as causes of anaphylaxis that were previously labeled idiopathic...
February 2015: Discovery Medicine
Cassyanne L Aguiar, Nancy Pan, Alexa Adams, Laura Barinstein, Thomas J Lehman
We present the case of a 2-year-old boy with a history of necrotizing enterocolitis (NEC) with ileostomy diagnosed with systemic juvenile idiopathic arthritis (sJIA) at 10 months of age controlled on anti-interleukin-1 (anti-IL-1) therapy (anakinra). At 17 months of age, ileostomy reversal and bowel re-anastomosis was scheduled with anakinra discontinued 3 days prior to the surgery and steroids initiated in its place. Ten days postoperatively, anakinra was re-started for signs of sJIA flare. Three months later, he developed persistent peripheral eosinophilia and subsequent anaphylactic reaction 6 months postoperatively...
October 2015: Clinical Rheumatology
Ya Sophia Xu, Monika Kastner, Laurie Harada, Anna Xu, Jane Salter, Susan Waserman
BACKGROUND: Examining deaths caused by anaphylaxis may help identify factors that may decrease the risk of these unfortunate events. However, information on fatal anaphylaxis is limited. The objectives of our study were to examine all cases of fatal anaphylaxis in Ontario to determine cause of death, associated features, co factors and trends in mortality. The identification of these factors is important for developing effective strategies to overcome gaps in monitoring and treatment of patients with food allergies and risk for anaphylaxis...
2014: Allergy, Asthma, and Clinical Immunology
Linda Tognetti, Francesco Murdaca, Michele Fimiani
We report the case of a young woman presenting with recurrent urticaria. The episodes occurred both in and out of the workplace. On three occasions it presented as urticaria-angioedema, requiring emergency care on one occassion. A thorough clinical history along with serological and allergological tests allowed a diagnosis of caffeine-induced urticaria-angioedema. We advised the patient to follow a caffeine-free diet and to avoid all caffeine or methylxanthine-containing drugs. After two years of caffeine abstinence, she had not experienced any further episodes of urticaria-angioedema...
December 2014: Indian Dermatology Online Journal
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