J Invest Allerg Clin
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J Invest Allerg Clin · Jan 2003
Case ReportsAnaphylaxis due to patent blue dye during lymphography, with negative skin prick test.
We report here a case of anaphylaxis due to patent blue dye, which was administered to an adult female during a lymphographic intraoperative procedure. The patient was not atopic, and other possible causes of anaphylaxis (anesthetics, latex) had been carefully excluded through routine tests. ⋯ There was no available commercial, specific IgE assay for PB dye, but the negativity of prick tests would exclude the involvement of an IgE-mediated mechanism. We want to highlight the possible danger derived from a dye that is considered inert, and that is now increasingly being used in surgical procedures.
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Because of widespread latex manufacturing in the last decades, exposure to latex has become ever greater, as has the incidence of latex allergy among the general population as well as the high-risk groups. Clinical manifestations range from local reactions (edema, itching, erythema, and papulae), rhino-conjunctivitis, asthma, pharyngeal edema, to severe systemic reactions such as anaphylactic shock (from parenteral exposure especially during medical examinations or surgical procedures). Diagnosis is formulated on the basis of the personal history and an accurate allergological evaluation. ⋯ The criteria of effectiveness are the capability to use latex items, to undergo medical examinations (even invasive), and to remain in an environment where latex particles can be inhaled (such as surgical departments), without symptoms. The first attempts were performed by subcutaneous administration of latex, but this protocol seems to be delicate to perform because of the side effects. Two different alternative methods (percutaneous and sublingual) were successfully performed and proved to be safer and more effective, even though further studies on a larger group of patients are needed.
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J Invest Allerg Clin · Jan 2002
Comparative StudyAirway obstruction induced by inhaled acetaldehyde in asthma: repeatability relationship to adenosine 5'-monophosphate responsiveness.
Inhaled acetaldehyde and adenosine 5'-monophosphate (AMP) cause bronchoconstriction in asthmatics by a mechanism believed to involve histamine release from airway mast cells. This study investigates the repeatability of the acetaldehyde challenge and the relationship between airway responsiveness to acetaldehyde and AMP. To this end, we examined the effect of inhaled acetaldehyde on airway tone in comparison with either methacholine or AMP in 16 asthmatics. ⋯ The challenge procedure with acetaldehyde was moderately repeatable (coefficient of repeatability = +/- 1.4 doubling concentrations, intraclass correlation coefficient = 0.64). We conclude that inhaled acetaldehyde is less potent than AMP in causing bronchoconstriction in asthma, and that the response to inhaled acetaldehyde is repeatable. Furthermore, the present data lends indirect support to the suggestion that acetaldehyde responsiveness and AMP responsiveness are not identifying the same alterations in the airways.
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J Invest Allerg Clin · Jan 2002
Case ReportsVocal cord dysfunction: more morbid than asthma if misdiagnosed.
Vocal cord dysfunction may lead to respiratory distress, which in turn may cause the misdiagnosis of asthma. We present two adolescents who were misdiagnosed as asthmatic and aggressively treated for asthma with resulting iatrogenic complications. Vocal cord dysfunction simulating or coexisting with asthma should be considered especially in patients with frequent emergency visits for episodic dyspnea despite aggressive treatment.
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A 19-year-old man exhibited symptoms of immediate urticaria and angioedema related to contact with raw potato. A prick-by-prick test with potato pulp and rub test were positive. Specific IgE to potato was positive (class 2).