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1
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Zhang Y, Zhang R, Li C, Peng G. Exploring the causal association between fatty acid-binding proteins and anaphylactic shock due to adverse reactions to medications: A two-sample Mendelian randomization study. Medicine (Baltimore) 2025; 104:e42171. [PMID: 40324257 PMCID: PMC12055110 DOI: 10.1097/md.0000000000042171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 03/27/2025] [Accepted: 04/01/2025] [Indexed: 05/07/2025] Open
Abstract
Previous studies have identified a relationship between fatty acid-binding proteins (FABPs) and immune diseases. This study aimed to investigate whether a causal relationship exists between FABPs and anaphylactic shock resulting from adverse drug reactions. Single nucleotide polymorphisms associated with FABPs were utilized as instrumental variables, sourced from the National Human Genome Research Institute-European Bioinformatics Institute Catalog of human genome-wide association studies. Data on anaphylactic shock due to adverse effects of correctly administered drugs were obtained from the FinnGen database, which includes genomic and health data from 500,000 Finnish biobank donors. A two-sample Mendelian randomization analysis was conducted to explore the causality between FABPs and anaphylactic shock due to adverse drug reactions. The analysis revealed a negative causal relationship between FABP5 (odds ratio [OR] = 0.40; 95% confidence interval [CI] = 0.17-0.92; P = .032) and FABP12 (OR = 0.77; 95% CI = 0.63-0.94; P = .009) and anaphylactic shock due to adverse drug reactions. These findings were corroborated by Mendelian randomization-Egger, weighted median, and weighted mode methods. This study provides robust evidence supporting a protective relationship between FABP5 and FABP12 and anaphylactic shock due to adverse drug reactions. Further experimental studies are warranted to elucidate the causal mechanisms and associations between FABP5, FABP12, and anaphylactic shock in the context of adverse drug reactions.
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Affiliation(s)
- Yu Zhang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
- National Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture, Nanjing, China
| | - Rusheng Zhang
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Cunyu Li
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
- National Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture, Nanjing, China
| | - Guoping Peng
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
- National Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture, Nanjing, China
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2
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Manzanares N, Pesqué D, Pujol RM, Giménez-Arnau AM. Metformin-Induced Acute Urticaria Mimicking Chronic Spontaneous Urticaria. Dermatitis 2024; 35:412-414. [PMID: 37878790 DOI: 10.1089/derm.2023.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Nerea Manzanares
- Department of Dermatology Hospital del Mar-Institut Mar d'Investigacions Mèdiques Universitat Autònoma de Barcelona (UAB) Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - David Pesqué
- Department of Dermatology Hospital del Mar-Institut Mar d'Investigacions Mèdiques Universitat Autònoma de Barcelona (UAB) Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - Ramon M Pujol
- Department of Dermatology Hospital del Mar-Institut Mar d'Investigacions Mèdiques Universitat Autònoma de Barcelona (UAB) Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - Ana M Giménez-Arnau
- Department of Dermatology Hospital del Mar-Institut Mar d'Investigacions Mèdiques Universitat Autònoma de Barcelona (UAB) Universitat Pompeu Fabra (UPF) Barcelona Spain
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3
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Zhang A, Zuo M, Sun Y, Chen J, Zhu L, Liu W. Latamoxef dosing regimen adjustments and pharmaceutical care in pediatrics. Front Pediatr 2024; 12:1302087. [PMID: 38362000 PMCID: PMC10867160 DOI: 10.3389/fped.2024.1302087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Latamoxef is a semi-synthetic, broad-spectrum oxacephem antibiotic used primarily to treat infectious diseases, but the adverse drug reactions, such as the risk of fatal bleeding, once caused physicians to use it less frequently. However, with the rise of antibiotic-resistant bacterial strains, latamoxef is being used again to treat infectious diseases, especially in pediatrics. The pharmacokinetic parameters of latamoxef are highly variable, given the changes in body composition, organ maturation, and development that occurs in pediatrics. Therefore, an appropriate dosing regimen is essential. Latamoxef dosing optimization in pediatrics should adequately account for current body weight, postnatal age, postmenstrual age, and different minimum inhibitory concentration (MIC) values. In addition, attention should also be paid to some of the adverse reactions associated with latamoxef, such as coagulation disorders and bleeding risks, disulfiram-like reactions, as well as hypersensitivity and anaphylactic shock. This review summarizes the dosing regimens and some key points of pharmaceutical care for latamoxef in pediatrics in order to provide a better reference for its application in clinical practice.
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Affiliation(s)
- Ailin Zhang
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Meiling Zuo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxuan Sun
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Jingtao Chen
- School of Statistics and Data Science, Nankai University, Tianjin, China
| | - Liqin Zhu
- First Central Clinical College, Tianjin Medical University, Tianjin, China
- Department of Pharmacy, Tianjin First Central Hospital, Tianjin, China
| | - Wei Liu
- Tianjin Children's Hospital, Children's Hospital of Tianjin University, Tianjin, China
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4
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Lee AY. Immunological Mechanisms in Cutaneous Adverse Drug Reactions. Biomol Ther (Seoul) 2024; 32:1-12. [PMID: 38148549 PMCID: PMC10762274 DOI: 10.4062/biomolther.2023.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 12/28/2023] Open
Abstract
Adverse drug reactions (ADRs) are an inherent aspect of drug use. While approximately 80% of ADRs are predictable, immune system-mediated ADRs, often unpredictable, are a noteworthy subset. Skin-related ADRs, in particular, are frequently unpredictable. However, the wide spectrum of skin manifestations poses a formidable diagnostic challenge. Comprehending the pathomechanisms underlying ADRs is essential for accurate diagnosis and effective management. The skin, being an active immune organ, plays a pivotal role in ADRs, although the precise cutaneous immunological mechanisms remain elusive. Fortunately, clinical manifestations of skin-related ADRs, irrespective of their severity, are frequently rooted in immunological processes. A comprehensive grasp of ADR morphology can aid in diagnosis. With the continuous development of new pharmaceuticals, it is noteworthy that certain drugs including immune checkpoint inhibitors have gained notoriety for their association with ADRs. This paper offers an overview of immunological mechanisms involved in cutaneous ADRs with a focus on clinical features and frequently implicated drugs.
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Affiliation(s)
- Ai-Young Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea
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5
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Abstract
Drug hypersensitivity reactions are a diverse group of reactions mediated by the immune system after exposure to a drug. The Gell and Coombs classification divides immunologic DHRs into 4 major pathophysiologic categories based on immunologic mechanism. Anaphylaxis is a Type I hypersensitivity reaction that requires immediate recognition and treatment. Severe cutaneous adverse reactions (SCARs) are a group of dermatologic diseases that result from a Type IV hypersensitivity process and include drug reaction with eosinophilia and systemic symptom (DRESS) syndrome, Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP). Other types of reactions are slow to develop and do not always require rapid treatment. Emergency physicians should have a good understanding of these various types of drug hypersensitivity reactions and how to approach the patient regarding evaluation and treatment.
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Affiliation(s)
- R Gentry Wilkerson
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
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6
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Tolu-Akinnawo O, Ogwu OI, Nnamani I, Talabi T. Ipsilateral Orolingual Angioedema Following Alteplase Administration for the Treatment of Suspected Acute Ischemic Stroke. Cureus 2023; 15:e38714. [PMID: 37168409 PMCID: PMC10166123 DOI: 10.7759/cureus.38714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/13/2023] Open
Abstract
Intravenous tissue plasminogen activator (tPA) remains the standard of treatment for patients presenting with acute ischemic stroke within the treatment window. In most patients, this often leads to an effective and life-prolonging intervention in the acute setting. This is, however, not without complications, which sometimes could be potentially fatal. Hemorrhagic complications, such as hemorrhagic conversion and bleeding, are the most discussed; however, facial angioedema has also been reported. We present a case of a 72-year-old African American male who developed right-sided ipsilateral orolingual angioedema 20 minutes after starting a tPA infusion. He was subsequently managed with antihistamine medications and steroids with interval resolution of symptoms. This case highlights the need for close monitoring while on tPA infusion, early detection, and management of potential facial angioedema complications. It also serves as a template for further studies focusing on preventative strategies for tPA-induced angioedema.
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Affiliation(s)
| | - Oghanim I Ogwu
- Internal Medicine, Meharry Medical College, Nashville, USA
| | - Ikenna Nnamani
- Internal Medicine, Meharry Medical College, Nashville, USA
| | - Taiwo Talabi
- Internal Medicine, Meharry Medical College, Nashville, USA
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7
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Liu K, Bao JF, Wang T, Yang H, Xu BP. Camrelizumab-induced anaphylactic shock in an esophageal squamous cell carcinoma patient: A case report and review of literature. World J Clin Cases 2022; 10:6198-6204. [PMID: 35949858 PMCID: PMC9254201 DOI: 10.12998/wjcc.v10.i18.6198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/13/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Camrelizumab (SHR-1210), an immune checkpoint inhibitor, is clinically used as a therapeutic option for various types of tumors. However, reports of adverse reactions associated with camrelizumab are gradually increasing. Anaphylactic shock due to camrelizumab has not been reported previously, until now. We report here, for the first time, a case of anaphylactic shock associated with camrelizumab in a patient with esophageal squamous cell carcinoma.
CASE SUMMARY An 84-year-old male esophageal cancer patient received radiotherapy and chemotherapy 11 years ago. He was diagnosed with advanced esophageal squamous cell carcinoma with liver metastasis (TxN1M1) and received the first immunotherapy (camrelizumab 200 mg/each time, once every 3 wk) dose in December 2020, with no adverse reactions. Three weeks later, a generalized rash was noted on the chest and upper limbs; palpitations and breathing difficulties with a sense of dying occurred 10 min after the patient had been administered with the second camrelizumab therapy. Electrocardiograph monitoring revealed a 70 beats/min pulse rate, 69/24 mmHg (1 mmHg = 0.133 kPa) blood pressure, 28 breaths/min respiratory rate, and 86% pulse oximetry in room air. The patient was diagnosed with anaphylactic shock and was managed with intravenous fluid, adrenaline, dexamethasone sodium phosphate, calcium glucosate, and noradrenaline. Approximately 2 h after treatment, the patient’s anaphylactic shock symptoms had been completely relieved.
CONCLUSION Due to the widespread use of camrelizumab, attention should be paid to anti-programmed cell death 1 antibody therapy-associated hypersensitivity or anaphylactic shock.
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Affiliation(s)
- Kai Liu
- Department of Radiotherapy, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
| | - Jian-Feng Bao
- Department of Immunology, Xixi Hospital of Hangzhou affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou 310023, Zhejiang Province, China
| | - Tao Wang
- Department of Urology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan 528401, Guangdong Province, China
| | - Hao Yang
- Department of Critical Care Medicine, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
| | - Bao-Ping Xu
- Department of Critical Care Medicine, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
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8
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Abstract
Drug hypersensitivity reactions are a diverse group of reactions mediated by the immune system after exposure to a drug. The Gell and Coombs classification divides immunologic DHRs into 4 major pathophysiologic categories based on immunologic mechanism. Anaphylaxis is a Type I hypersensitivity reaction that requires immediate recognition and treatment. Severe cutaneous adverse reactions (SCARs) are a group of dermatologic diseases that result from a Type IV hypersensitivity process and include drug reaction with eosinophilia and systemic symptom (DRESS) syndrome, Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP). Other types of reactions are slow to develop and do not always require rapid treatment. Emergency physicians should have a good understanding of these various types of drug hypersensitivity reactions and how to approach the patient regarding evaluation and treatment.
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Affiliation(s)
- R Gentry Wilkerson
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
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9
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Ouanounou A, Ng K, Chaban P. Adverse drug reactions in dentistry. Int Dent J 2020; 70:79-84. [PMID: 31944297 DOI: 10.1111/idj.12540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 11/26/2022] Open
Abstract
An adverse drug reaction (ADR) is an undesirable effect of a drug. ADRs are possible with any medication that is prescribed or administered in the dental office. While most pharmacological agents in use today have favourable drug profiles and are relatively safe, the prudent clinician must be aware of the potential ADRs that can occur and be prepared to manage any complications. Here we review the most commonly used agents in dentistry, namely local anaesthetics, sedatives, analgesics and antibiotics, and their ADRs and management.
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Affiliation(s)
- Aviv Ouanounou
- Department of Clinical Sciences, Pharmacology & Preventive Dentistry, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Kester Ng
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Peter Chaban
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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10
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Doña I, Salas M, Pérez-Sánchez NI, Moreno-Aguilar C, Torres MJ. Phenotypes and Natural Evolution of Drug Hypersensitivity. CURRENT TREATMENT OPTIONS IN ALLERGY 2019. [DOI: 10.1007/s40521-019-0200-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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11
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Zhang P, Li Y, Nie K, Wang L, Zhang Y. Hypotension and bradycardia, a serious adverse effect of piribedil, a case report and literature review. BMC Neurol 2018; 18:221. [PMID: 30591018 PMCID: PMC6307137 DOI: 10.1186/s12883-018-1230-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 12/19/2018] [Indexed: 12/01/2022] Open
Abstract
Background Dopamine agonists (DAs) are efficacious for the treatment of motor and nonmotor symptoms in patients with Parkinson’s disease (PD). The treatment of PD with DAs is often complicated by adverse drug reactions (ADRs) of dopaminergic and non-dopaminergic origins. The DA piribedil is widely used in Asian, European, and Latin American countries; therefore, its ADRs are pertinent to clinicians. Here we present a rare case of hypotension and bradycardia that is significantly related to the dosage of piribedil. Case presentation A middle-aged male, diagnosed with PD, received dopamine replacement with piribedil. When taking 50 mg piribedil daily dose, the patient didn’t feel any discomfort. Two hours after taking 100 mg piribedil he presented with serious concomitant hypotension and bradycardia with a blood pressure (BP) reading of 85/48 mmHg and a heart rate (HR) of 45 beats/min when sitting. After taking 75 mg piribedil, the patient showed the same symptoms with BP reading at 70/45 mmHg and HR of 47 beats/min in the same position. Upon replacing treatment with pramipexole 0.125 mg, 0.25 mg, and 0.375 mg three times a day, no further cardiovascular effects persisted. Conclusions No studies have previously reported the simultaneous observation of position-unrelated hypotension and bradycardia after taking small doses of piribedil. More studies are needed to explore the effects of DAs on BP and HR, especially piribedil. Piribedil is efficacious for the treatment of PD, but it is important to weigh the potential risk of hypotension and bradycardia against the clinical benefits of this drug.
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Affiliation(s)
- Piao Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong province, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong province, China
| | - Yan Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong province, China
| | - Kun Nie
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong province, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong province, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong province, China.
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12
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Sumaila AN, Tabong PTN. Rational prescribing of antibiotics in children under 5 years with upper respiratory tract infections in Kintampo Municipal Hospital in Brong Ahafo Region of Ghana. BMC Res Notes 2018; 11:443. [PMID: 29973249 PMCID: PMC6031134 DOI: 10.1186/s13104-018-3542-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of the study was to assess the rational use of antibiotics in children with URTIs in the Kintampo Municipal Hospital in Ghana. RESULTS A total of 839 medicines were prescribed, 237 were antibiotics. The mean number of medicines prescribed per patient encounter was 3.1. The percentage of patient encounters with antibiotics was 28.2 and 0.4% for injections. The percentage of medicines prescribed by generic was 93.8% and from the essential medicines list was 94.9%. Ninety-two of patients received amoxicillin. Polypharmacy was common as prescriptions with five to six medicines per patient encounter was found. Some prescribers are not following the WHO/INRUD requirement of prescribing medicines in their generic and from the essential medicine list of the country.
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Affiliation(s)
- Abdul-Nasiru Sumaila
- Pharmacy Department, Jema District Hospital, Ghana Health Services, Accra, Brong Ahafo Region Ghana
| | - Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana
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13
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Doña I, Caubet JC, Brockow K, Doyle M, Moreno E, Terreehorst I, Torres MJ. An EAACI task force report: recognising the potential of the primary care physician in the diagnosis and management of drug hypersensitivity. Clin Transl Allergy 2018; 8:16. [PMID: 29760877 PMCID: PMC5944153 DOI: 10.1186/s13601-018-0202-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 04/04/2018] [Indexed: 01/20/2023] Open
Abstract
Adverse drug reactions include drug hypersensitivity reactions (DHRs), which can be immunologically mediated (allergy) or non-immunologically mediated. The high number of DHRs that are unconfirmed and often self-reported is a frequent problem in daily clinical practice, with considerable impact on future prescription choices and patient health. It is important to distinguish between hypersensitivity and non-hypersensitivity reactions by adopting a structured diagnostic approach to confirm or discard the suspected drug, not only to avoid life-threatening reactions, but also to reduce the frequent over-diagnosis of DHRs. Primary care physicians are often the first point of contact for the sufferer of a reaction, as such they have a key role in deciding whether to discard the diagnosis or send the patient for further investigation. In this review, we highlight the importance of diagnosing DHRs, analysing in detail the role of primary care physicians. We describe the common patterns of DHRs and signs of its progression, as well as the indications and contraindications for referring the patient to an allergist. The diagnostic process is described and the possible tests are discussed, which often depend on the drug involved and the type of DHR suspected. We also describe recommendations regarding the avoidance of medication suspected to have caused the reaction and the use of alternatives.
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Affiliation(s)
- I. Doña
- Allergy Unit (Pavilion C), Regional University Hospital of Malaga, UMA, IBIMA, National Network ARADyAL, Plaza del Hospital Civil, 29009 Malaga, Spain
| | - J. C. Caubet
- Department of Child and Adolescent, Medical School of the University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
| | - K. Brockow
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
| | - M. Doyle
- Indigo Medical, Saint Helier, Jersey
| | - E. Moreno
- Allergy Service, University Hospital of Salamanca, National Network ARADyAL, Salamanca, Spain
- Biosanitary Institute of Salamanca, Salamanca, Spain
- Department of Biomedical and Diagnostics Sciences, Salamanca Medical School, Salamanca, Spain
| | - I. Terreehorst
- Department of ENT, Academisch Medisch Centrum, Amsterdam, The Netherlands
| | - M. J. Torres
- Allergy Unit (Pavilion C), Regional University Hospital of Malaga, UMA, IBIMA, National Network ARADyAL, Plaza del Hospital Civil, 29009 Malaga, Spain
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14
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Sim DW, Koh YI. Unusual Clinical Manifestation of Laryngeal Edema in a Case of DRESS Syndrome. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:2108-2109. [PMID: 29574127 DOI: 10.1016/j.jaip.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Da Woon Sim
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Korea.
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Korea
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15
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How to Manage Antibiotic Allergy in Cystic Fibrosis? Epidemiologic, Diagnostic, and Therapeutic Aspects. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0152-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Minić I, Pejčić A, Obradović R, Mirković D, Bradić M. Allergic manifestations in oral cavity. ACTA STOMATOLOGICA NAISSI 2018. [DOI: 10.5937/asn1877793m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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17
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Zalewska-Janowska A, Spiewak R, Kowalski ML. Cutaneous Manifestation of Drug Allergy and Hypersensitivity. Immunol Allergy Clin North Am 2017; 37:165-181. [PMID: 27886905 DOI: 10.1016/j.iac.2016.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
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. Thus, here the authors present a morphologic approach to the diagnosis of cutaneous drug-induced eruptions.
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Affiliation(s)
- Anna Zalewska-Janowska
- Department of Psychodermatology, Medical University of Lodz, 251 Pomorska Street, Lodz 92-213, Poland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, Krakow 30-688, Poland
| | - Marek L Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, 251 Pomorska Street, Lodz 92-213, Poland.
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18
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Young CJ. What underlies the unconscious negative attitude of healthcare professionals towards patient-reported drug allergies? DRUGS & THERAPY PERSPECTIVES 2017; 33:345-347. [DOI: 10.1007/s40267-017-0418-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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19
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20
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Wang Y, Zhu R, Huang N, Li W, Yang L, Zhang S, Liu G. Knowledge, attitudes, and practices survey of drug allergy among healthcare practitioners in central China: a multicenter study. Asia Pac Allergy 2016; 6:105-11. [PMID: 27141484 PMCID: PMC4850333 DOI: 10.5415/apallergy.2016.6.2.105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 04/18/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Drug allergy (DA) is one of the most important contributors to iatrogenic morbidity and mortality. Currently DA remains a major challenge for healthcare practitioners (HCPs). OBJECTIVE To assess the knowledge, attitudes and practices of DA among HCPs in Central China. METHODS A 25-item self-administered DA questionnaire were developed and applied in our study. The questionnaire covered 3 domains: knowledge, attitudes, and practice patterns. From July 2015 to October 2015, HCPs in 7 cities of Central China anonymously participated in the cross-sectional study. RESULTS A total of 350 HCPs participated the study, 91 questionnaires uncompleted and 259 were analyzed. Among the respondents, 166 (64.1%) were doctors, 55 (21.2%) were nurses and 38 (14.7%) were medical students. The mean knowledge precision was 59.8%. HCPs agreed that drug induced immediate allergic reactions were IgE mediated (83.4%) and happened within 6 hours after drug administration (89.6%), and epinephrine was the first choice for drug induced anaphylaxis (79.5%). They also agreed that penicillin skin test was valuable to predict allergic reaction (88.4%). However, high proportion of HCPs (66.0%) believed glucocorticoids had an impact on drug skin test rather than antihistamines (4.2%), 47.1% never performed positive and negative control during skin test. More than 90% of the respondents would take patients' allergic history before drug administration, 98.8% agreed that they should receive advanced training of DA knowledge and practice. CONCLUSION The HCPs demonstrated a low level of knowledge regarding DA. Advanced education is urgently needed for better understanding and filling the gaps exist in knowledge and clinical practice of DA.
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Affiliation(s)
- Yin Wang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Nan Huang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Wenjing Li
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Lin Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Shucheng Zhang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Guanghui Liu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
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Simón Díaz M, Tirado Sánchez A, Ponce Olivera R. Dermatologic emergencies. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2016. [DOI: 10.1016/j.hgmx.2015.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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22
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Pereira LC, Nogueira TA, Barbosa LADO, Calil-Elias S, Castilho SRD. Adverse reactions to docetaxel: an active survey. BRAZ J PHARM SCI 2015. [DOI: 10.1590/s1984-82502015000300007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The rates of breast cancer mortality remain high in Brazil. Docetaxel is a semi-synthetic taxane used to treat various tumors, particularly tumors of the breast, lung and prostate. In this study ADR that occurred in 45 docetaxel users with breast cancer were surveyed. They were identified by type, causality (Naranjo algorithm and World Health Organization categories) and, if considered probable or defined, rated for severity according to SOBRAFO proposal (2007). A total of 325 ADR were observed: 165 in the first, 137 in the second and 23 in the third cycle. Fifty seven ADR were immediate and the others, late. Fatigue and exhaustion for more than five days, classified as Grade 3 by SOBRAFO (2007), were reported as the primary late RAM. There was no significant difference in the occurrence of immediate and late ADR between cycles (p=1 and p=0.3577, respectively). The presence of a pharmacist gave the patients a better understanding of the occurrence of RAM, especially those that occur outside the hospital, between chemotherapy cycles and are often not reported to the healthcare team, creating institutional demands and reaching the goal to track, observe and correlate the RAM for each user.
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23
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Perioperative anaphylactic reactions: Review and procedure protocol in paediatrics. Allergol Immunopathol (Madr) 2015; 43:203-14. [PMID: 24231150 DOI: 10.1016/j.aller.2013.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/20/2013] [Indexed: 11/21/2022]
Abstract
Perioperative anaphylactic reactions are immediate, hypersensitive reactions that are potentially life-threatening resulting from a sudden release of mediators from mast cells and basophiles, due to either immune (IgE or non-IgE mediated) or non-immune mechanisms. The most frequent causing agents are neuromuscular blocking agents (NMBAs), latex and antibiotics, with latex being the first cause in paediatrics. With regard to perioperative anaphylactic reactions, the usual early signs and symptoms of an anaphylactic reaction could be overlooked or erroneously interpreted and non-severe anaphylaxis could go undetected, with a risk of more severe reactions in the future. Using the data registered on the anaesthesia sheet, it is essential to establish a chronological relationship between drugs and/or substances administered and the reaction observed. An elevated level of tryptase confirms an anaphylactic reaction, but this does not usually increase in the absence of compromised circulation. An allergy study should be carried out preferably between 4 and 6 weeks after the reaction, using a combination of specific IgE, skin and controlled exposure tests (if indicated). Test sensitivity is good for NMBAs, latex, antibiotics, chlorhexidine, gelatine and povidone, and poor for barbiturates, opiates (these can give false positives since they are histamine releasers) and benzodiazepines. Special preventive measures should be taken, especially in the case of latex. We present the maximum concentrations recommended for skin tests, the recommended dosage to treat anaphylactic reactions in paediatrics and a procedure algorithm for the allergological study of these reactions.
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24
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Madden B, Chebl RB. Hemi orolingual angioedema after tPA administration for acute ischemic stroke. West J Emerg Med 2015; 16:175-7. [PMID: 25671036 PMCID: PMC4307711 DOI: 10.5811/westjem.2014.12.24210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 12/15/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Bryan Madden
- Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan
| | - Ralphe B Chebl
- American University of Beirut, Department of Emergency Medicine, Beirut, Lebanon
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25
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26
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Maher NG, de Looze J, Hoffman GR. Anaphylaxis: an update for dental practitioners. Aust Dent J 2014; 59:142-8; quiz 273. [DOI: 10.1111/adj.12161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- NG Maher
- John Hunter Hospital; Newcastle New South Wales
| | - J de Looze
- John Hunter Hospital; Newcastle New South Wales
| | - GR Hoffman
- John Hunter Hospital; Newcastle New South Wales
- The University of Newcastle; Newcastle New South Wales
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27
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Yalcinkaya E, Celik M. Determining the etiology of hypotension: associated with reperfusion injury? Am J Emerg Med 2014; 32:469-70. [DOI: 10.1016/j.ajem.2014.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 01/08/2014] [Indexed: 11/25/2022] Open
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28
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Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, Khan DA, Lang DM, Park HS, Pichler W, Sanchez-Borges M, Shiohara T, Thong BYH. International Consensus on drug allergy. Allergy 2014; 69:420-37. [PMID: 24697291 DOI: 10.1111/all.12350] [Citation(s) in RCA: 665] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 01/11/2023]
Abstract
When drug reactions resembling allergy occur, they are called drug hypersensitivity reactions (DHRs) before showing the evidence of either drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term ‘allergy’) are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective drugs, in contrast to patients who had undergone a complete drug allergy workup. Several guidelines and/or consensus documents on general or specific drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on drug allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of DHRs.
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Affiliation(s)
- P. Demoly
- Département de Pneumologie et Addictologie; Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France and Sorbonne Universités; Paris France
| | - N. F. Adkinson
- Division of Allergy and Clinical Immunology; The Johns Hopkins Asthma and Allergy Center; The Hopkins Bayview Medical Campus; Baltimore MD USA
| | - K. Brockow
- Department of Dermatology and Allergology Biederstein; Technische Universität München; Munich Germany
| | - M. Castells
- Division of Rheumatology, Allergy and Immunology; Department of Medicine; Brigham and Women's Hospital; Boston MA
| | - A. M. Chiriac
- Département de Pneumologie et Addictologie; Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France and Sorbonne Universités; Paris France
| | - P. A. Greenberger
- Division of Allergy-Immunology; Northwestern University Feinberg School of Medicine; Chicago IL
| | - D. A. Khan
- Division of Allergy & Immunology; University of Texas Southwestern Medical Center; Dallas TX
| | - D. M. Lang
- Department of Allergy/Immunology; Respiratory Institute; Cleveland Clinic Foundation; Cleveland OH USA
| | - H.-S. Park
- Department of Allergy and Clinical Immunology; Ajou University School of Medicine; Suwon Korea
| | - W. Pichler
- Division of Allergology; Department of Rheumatology and Allergology/Clinical Immunology; Inselspital, University of Bern; Bern Switzerland
| | - M. Sanchez-Borges
- Allergy and Clinical Immunology Department; Centro Medico Docente La Trinidad; Caracas Venezuela
| | - T. Shiohara
- Department of Dermatology; Kyorin University School of Medicine; Tokyo Japan
| | - B. Y.-H. Thong
- Department of Rheumatology, Allergy and Immunology; Tan Tock Seng Hospital; Singapore
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Santhosh MCB, Pai RB, Rao RP. Acute pulmonary edema following inflation of arterial tourniquet. ACTA ACUST UNITED AC 2013; 61:451-3. [PMID: 24199916 DOI: 10.1016/j.redar.2013.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/15/2013] [Accepted: 09/02/2013] [Indexed: 11/19/2022]
Abstract
Arterial tourniquets are used as one of the methods for reducing blood loss and for allowing blood free surgical field. A 20-year-old, 45 kg healthy female with a sphere shaped pendunculated hemangioma in the popliteal fossa of her left lower limb was applied with arterial tourniquet after exsanguination. The procedure was performed under general anesthesia. Soon after exsanguination and tourniquet inflation, the patient developed pulmonary edema which subsided after deflating the tourniquet. The clinical evolution, treatment and pathophysiology of this complication are described.
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Affiliation(s)
- M C B Santhosh
- Department of Anesthesiology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
| | - R B Pai
- Department of Anesthesiology, Goa Medical College, Goa, India
| | - R P Rao
- Department of Anesthesiology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
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Rasmussen ER, Bygum A. ACE-inhibitor induced angio-oedema treated with complement C1-inhibitor concentrate. BMJ Case Rep 2013; 2013:bcr2013200652. [PMID: 24096073 PMCID: PMC3822139 DOI: 10.1136/bcr-2013-200652] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ACE-inhibitor is an antihypertensive drug which is increasingly used to treat a wide range of medical conditions. A known adverse reaction is angio-oedema of the head and neck, which can become fatal when the upper airway is involved, causing asphyxia. We present a Caucasian man, who developed severe angio-oedema of the tongue and floor of the mouth. He was successfully treated with complement C1-concentrate causing the swelling to regress within 20 min. This treatment option can be an effective alternative to bradykinin antagonists, which might not be available in the emergency room, or more invasive measures like intubation or emergency airway puncture.
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Affiliation(s)
- Eva Rye Rasmussen
- Department of Otorhinolaryngology Head and Neck Surgery, Koege Hospital, Koege, Denmark
| | - Anette Bygum
- Dermatology and Allergy Center, University Hospital of Odense, Odense, Denmark
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31
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Ruppert SD. Recognizing and managing acute anaphylaxis. Nurse Pract 2013; 38:10-13. [PMID: 23958667 DOI: 10.1097/01.npr.0000433082.01313.c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Susan D Ruppert
- The University of Texas Health Science Center, Houston School of Nursing, Houston, Tex., USA
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32
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Cvetković Z, Suvajdžić-Vuković N, Todorović Z, Panić M, Nešković A. Simvastatin and amlodipine induced thrombocytopenia in the same patient: double trouble and a literature review. J Clin Pharm Ther 2013; 38:246-248. [PMID: 23442182 DOI: 10.1111/jcpt.12051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 01/31/2013] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Drug-induced thrombocytopenia (DITP) may be a fatal adverse reaction to many drugs. It is often misdiagnosed as primary immune thrombocytopenia (ITP), and thus diagnosis can be delayed and patients can be treated inappropriately. Amlodipine a calcium-channel blocker, and simvastatin, a statin, have very rarely been implicated in DITP. We report on an investigation of the causal relationship of amlodipine and simvastatin with thrombocytopenia occurring in the same patient, and review the literature. CASE SUMMARY We present the case of a 78-year-old female hypertensive diabetic patient with three successive DITPs. The first attack of acute severe thrombocytopenia occurred after a 2-week course of amlodipine, and was initially misdiagnosed as ITP. Her platelet count normalized after the amlodipine was discontinued. The second attack followed her restarting simvastatin 3 weeks later. She had stopped it 2 months earlier having previously taken it for over 5 years. Again, she recovered once the simvastatin was discontinued. The third DITP attack occurred when she accidently took a single dose of amlodipine 9 months later. WHAT IS NEW AND CONCLUSION We provide clear evidence of a causal association of amlodipine with thrombocytopenia, and probable evidence of a causal association of simvastatin with thrombocytopenia. This is the first reported case of DITPs occurring with two of the most widely prescribed drugs in the same patient. Many hypertensive patients need to take multiple drugs in order to achieve their treatment goals and this increases their risk of drug-induced adverse reactions and makes identification of the causal drug (or drugs) extremely difficult.
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Affiliation(s)
- Zorica Cvetković
- Department of Hematology, Clinical Hospital Center Zemun, Belgrade, Serbia.
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Leonardi A, Bogacka E, Fauquert JL, Kowalski ML, Groblewska A, Jedrzejczak-Czechowicz M, Doan S, Marmouz F, Demoly P, Delgado L. Ocular allergy: recognizing and diagnosing hypersensitivity disorders of the ocular surface. Allergy 2012; 67:1327-37. [PMID: 22947083 DOI: 10.1111/all.12009] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2012] [Indexed: 12/28/2022]
Abstract
Ocular allergy includes several clinically different conditions that can be considered as hypersensitivity disorders of the ocular surface. The classification of these conditions is complex, and their epidemiology has not been adequately studied because of the lack of unequivocal nomenclature. Ocular allergy symptoms are often, but not always, associated with other allergic manifestations, mostly rhinitis. However, specific ocular allergic diseases need to be recognized and managed by a team that includes both an ophthalmologist and an allergist. The diagnosis of ocular allergy is usually based on clinical history and signs and symptoms, with the support of in vivo and in vitro tests when the identification of the specific allergic sensitization is required for patient management. The aims of this Task Force Report are (i) to unify the nomenclature and classification of ocular allergy, by combining the ophthalmology and allergy Allergic Rhinitis and its Impact on Asthma criteria; (ii) to describe current methods of diagnosis; (iii) to summarize the therapeutic options for the management of ocular allergic inflammation.
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Affiliation(s)
- A. Leonardi
- Department of Neuroscience; Ophthalmology Unit; University of Padua; Padua; Italy
| | - E. Bogacka
- Department of Internal Medicine, Allergy and Geriatrics; Medical Academy of Wrocław; Wrocław; Poland
| | - J. L. Fauquert
- Unité d'Allergologie de l'enfant; CHU Estaing; Clermont-Ferrand; France
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Medical University of Lodz; Łódź; Poland
| | - A. Groblewska
- Department of Ophthalmology; Polish Mother's Memorial Hospital; Łódź; Poland
| | | | - S. Doan
- Hopital Bichat and Fondation A. de Rothschild; Paris; France
| | - F. Marmouz
- Pole sanitaire du Vexin; Pontoise; France
| | - P. Demoly
- Inserm U454 - IFR3; hôpital Arnaud-de-Villeneuve; Montpellier; France
| | - L. Delgado
- Faculty of Medicine; Department of Immunology; University of Porto; Porto; Portugal
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Toklu Y, Sarac O, Berk S, Simsek S. Angioedema after intravitreal bevacizumab injection. Cutan Ocul Toxicol 2012; 31:85-6. [DOI: 10.3109/15569527.2011.609207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Ong GSY, Somerville CP, Jones TW, Walsh JP. Anaphylaxis triggered by benzyl benzoate in a preparation of depot testosterone undecanoate. Case Rep Med 2012; 2012:384054. [PMID: 22272209 PMCID: PMC3261473 DOI: 10.1155/2012/384054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 11/25/2011] [Indexed: 11/23/2022] Open
Abstract
We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle). While considered to have a favourable safety profile, serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components. As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, individual components of pharmaceuticals should be tested when investigating drug allergies. Doctors should be alert to the potential for serious reactions to any of the components of Reandron 1000.
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Affiliation(s)
- Gregory S. Y. Ong
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 1st Floor, C-Block, Hospital Avenue, Nedlands, WA 6009, Australia
| | | | - Timothy W. Jones
- School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
| | - John P. Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 1st Floor, C-Block, Hospital Avenue, Nedlands, WA 6009, Australia
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Lee SY, Kim MY, Kang SY, Song WJ, Kang HR. A case of trimebutine-induced anaphylaxis. Allergol Int 2011; 60:555-6. [PMID: 22113162 DOI: 10.2332/allergolint.10-cr-0289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Accepted: 04/12/2011] [Indexed: 11/20/2022] Open
Abstract
Trimebutine maleate [2-dimethylamino-2-phenylbutyl 3,4,5-trimethoxybenzoic acid] has been demonstrated to be active for relieving abdominal pain and it is widely used for patients with irritable bowel syndrome. Adverse drug reactions are mostly mild and well-tolerated. To our knowledge, only two cases of trimebutine induced hypersensitivity have been reported, and both were delayed type reactions. Here, we report the first case of trimebutine maleate-induced anaphylaxis.
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Affiliation(s)
- Suh-Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Korea
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Haines EC, Wall GC. Possible Angiotensin-Converting Enzyme Inhibitor (ACEI)-Induced Small Bowel Angioedema. J Pharm Pract 2011; 24:564-7. [DOI: 10.1177/0897190011406126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To report a case of possible lisinopril-induced angioedema of the small bowel. Case Summary: A 67-year-old female was admitted to the hospital with abdominal pain, nausea, vomiting, and diarrhea. A computed tomography (CT) scan of the abdomen/pelvis was obtained which showed wall thickening around the area of the jejunum and scant ascites consistent with several diagnoses, including small bowel angioedema. She was treated with intravenous fluids and nasogastric decompression. Stool studies were negative. Her lisinopril was held due to the possibility of small bowel angioedema. A CT enterography obtained 5 days after the discontinuation of lisinopril showed complete resolution of the inflammatory changes and perihepatic fluid. It was felt that angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema of the small bowel was the most likely etiology of her symptoms. Discussion: Angiotensin-converting enzyme inhibitor small bowel angioedema is an uncommon cause of abdominal symptoms. In several cases, patients had been taking ACEIs for years before symptoms occur. Treatment includes cessation of the ACEI and supportive care. Conclusions: Angiotensin-converting enzyme inhibitor-related small bowel angioedema should be considered in the differential diagnosis of unexplained abdominal pain.
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Affiliation(s)
| | - Geoffrey C. Wall
- Iowa Methodist Medical Center, Des Moines, IA, USA
- College of Pharmacy and Health Sciences, Drake University, Des Moines, IA, USA
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