International archives of allergy and immunology
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Int. Arch. Allergy Immunol. · Jan 2010
Penicillin allergy: value of including amoxicillin as a determinant in penicillin skin testing.
Allergy to penicillins remains an important issue. Penicillin skin testing (PST) with major and minor determinants has been shown to be a highly valuable tool for identifying IgE-mediated penicillin allergy. The value of additional testing with side-chain-specific moieties from semisynthetic penicillins such as amoxicillin is not well-established in spite of the widespread use of these medications. ⋯ These data indicate that the inclusion of the amoxicillin determinant appears to identify a small but important group of allergic individuals who may otherwise test negative on a PST panel.
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Macrophage activation syndrome (MAS) is a phenomenon characterized by cytopenia, organ dysfunction, and coagulopathy associated with an inappropriate activation of macrophages. Current diagnostic criteria are imprecise, but the syndrome is now recognized as a form of hemophagocytic lymphohistiocytosis that is characteristically associated with autoimmune diatheses. ⋯ Proposed treatment regimens include aggressive approaches that require validation in future controlled studies. This review discusses the major aspects of the pathophysiology, diagnosis, and management of MAS with a focus on the association with autoimmune disease.
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Int. Arch. Allergy Immunol. · Jan 2010
Association of indoor air pollution with rhinitis symptoms, atopy and nitric oxide levels in exhaled air.
Exposure to particulate matter (PM) outdoors can induce airway inflammation and exacerbation of asthma in adults. However, there is limited knowledge about the effects of exposure to indoor PM. The aim of this study was to investigate the association of exposure to indoor sources of PM with rhinitis symptoms, atopy and nitric oxide in exhaled air (FeNO) as a measure of airway inflammation. ⋯ Self-reported exposure to the use of woodstoves, candles or gas cookers was not significantly associated with an increased risk of rhinitis symptoms or atopy, nor increased FeNO. Self-reported exposure to ETS was associated with a slightly higher prevalence of self-reported rhinitis symptoms without any clear dose-response relationship.
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Int. Arch. Allergy Immunol. · Jan 2010
Comparative StudyInvolvement of galectin-9 in lung eosinophilia in patients with eosinophilic pneumonia.
Although we first found galectin-9 (Gal-9) as an eosinophil chemoattractant, its role in eosinophilic inflammation is still obscure. The purpose of the present study is to clarify the role of Gal-9 in human eosinophilic pulmonary inflammation in comparison with eotaxin (CCL11). ⋯ The present results provide two possibilities: that Gal-9 is involved in pulmonary eosinophilia in patients with AEP and CEP, and that Gal-9 exhibits regulatory functions for activated eosinophils at the site of inflammation.
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Int. Arch. Allergy Immunol. · Jan 2010
Increased adverse drug reactions to cephalosporins in penicillin allergy patients with positive penicillin skin test.
Cephalosporin administration in patients with a history of penicillin allergy is controversial. Studies looking at the safety of cephalosporin in patients with a history of penicillin allergy lacked a control group, had a small number of patients, and/or lacked confirmation of penicillin allergy by penicillin skin testing. The purpose of this study was to determine whether patients with penicillin allergy were at increased risk of adverse drug reactions when administered cephalosporin. ⋯ A greater risk of an adverse drug reaction to cephalosporin exists in patients with penicillin allergy. We recommend penicillin skin testing if cephalosporin, especially a first-generation cephalosporin, is to be administered to patients with a history of penicillin allergy.