scholarly journals The Rare Case of a Probably True IgE-Mediated Allergy to Local Anaesthetics

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Christina Fellinger ◽  
Felix Wantke ◽  
Wolfgang Hemmer ◽  
Gabriele Sesztak-Greinecker ◽  
Stefan Wöhrl
Keyword(s):  
Adverse Reactions ◽  
Skin Prick Testing ◽  
Local Anaesthetics ◽  
Specific Ige ◽  
Exceptional Case ◽  
Serum Tryptase ◽  
Normal Range ◽  
Intradermal Testing ◽  
Ige Mediated ◽  
Rule Out

The majority of immediate type adverse reactions to local anaesthetics seem to be non-IgE-mediated. We report a case of a 31-year-old woman, who developed conjunctivitis and conjunctival erythema immediately after intrauterine application of a local anaesthetic. Skin prick testing and intradermal testing were done with lidocaine, mepivacaine, and procaine. Intradermal testing showed positive reactions to mepivacaine (1 : 10), undiluted lidocaine, and procaine (1 : 10 and undiluted). Specific IgE could be detected against mepivacaine, but not against latex. Serum tryptase was in the normal range. In order to rule out the exceptional case of a true IgE-mediated reaction, allergy testing with local anaesthetics is still required in the workup of patients.

scholarly journals Additives and preservatives: Role in food allergy

2020 ◽  
Vol 2 (1) ◽  
pp. 119-123
Author(s):  
Amber N. Pepper ◽  
Panida Sriaroon ◽  
Mark C. Glaum
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Food Additives ◽  
Specific Ige ◽  
Food Additive ◽  
Blood Testing ◽  
Commercial Products ◽  
Natural Substances ◽  
Ige Mediated

Food additives are natural or synthetic substances added to foods at any stage of production to enhance flavor, texture, appearance, preservation, safety, or other qualities. Common categories include preservatives and antimicrobials, colorings and dyes, flavorings, antioxidants, stabilizers, and emulsifiers. Natural substances rather than synthetics are more likely to cause hypersensitivity. Although rare, food additive hypersensitivity should be suspected in patients with immunoglobulin E (IgE)-mediated reactions to multiple, unrelated foods, especially if the foods are prepared outside of the home or when using commercial products. A complete and thorough history is vital. Skin prick testing and/or specific IgE blood testing to food additives, if available, additive avoidance diets, and blind oral challenges can help establish the diagnosis. Once an allergy to a food additive is confirmed, management involves avoidance and, if necessary, carrying self-injectable epinephrine.

scholarly journals Immediate reactions with glatiramer acetate

2019 ◽  
Vol 10 (2) ◽  
pp. 170-177
Author(s):  
Guadalupe Marco-Martín ◽  
Pilar Tornero ◽  
Alicia Prieto ◽  
Alejandro La Rotta ◽  
Teresa Herrero ◽  
...  
Keyword(s):  
Glatiramer Acetate ◽  
Adverse Reactions ◽  
Clinical Evidence ◽  
Specific Ige ◽  
Accurate Diagnosis ◽  
Allergy Diagnosis ◽  
Close Collaboration ◽  
Intradermal Tests ◽  
Rule Out

Purpose of reviewDiverse adverse events have been associated with administration of glatiramer acetate (GA), mainly local reactions at the injection site. Other, less frequent generalized reactions include isolated postinjection reactions and anaphylaxis, which may lead to discontinuation of GA.Recent findingsClose collaboration between the allergy and neurology departments is needed to study adverse reactions to GA. The allergy study should include a detailed history and skin prick and intradermal tests with GA and, if possible, determination of specific IgE levels. Furthermore, the implication of other drugs should be ruled out.SummaryAn accurate diagnosis of reactions to GA is essential if we are to confirm or rule out allergy to GA. When an allergy diagnosis is confirmed or firmly suspected based on clinical evidence, desensitization protocols are increasingly seen as safe methods for reintroduction of GA.

scholarly journals Food Allergy: Unproven diagnostics and therapeutics

2020 ◽  
Vol 2 (1) ◽  
pp. 91-94
Author(s):  
Megan F. Patterson ◽  
Stacy L. Dorris
Keyword(s):  
Food Allergy ◽  
Adverse Reactions ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Scientific Evidence ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Therapeutic Modalities ◽  
Diagnostic Modalities

Food allergy or intolerance is often attributed by patients as the cause of many symptoms unknown to be directly related to food ingestion. For immunoglobulin E (IgE) mediated food allergy, diagnostic modalities are currently limited to the combination of clinical history, evidence of sensitization with food-specific IgE testing and skin-prick testing, and oral food challenge. Many patients find an appeal in the promise of identification of the etiology of their symptoms through alternative food allergy or intolerance diagnostic modalities. These patients may seek guidance from allergists or their general providers as to the legitimacy of these tests or interpretation of results. These tests include food-specific serum IgG or IgG4 testing, flow cytometry to measure the change in leukocyte volume after exposure to food, intradermal or sublingual provocation-neutralization, electrodermal testing, applied kinesiology, hair analysis, and iridology. In addition, there are some unconventional therapeutic modalities for adverse reactions to foods, including rotary diets. None of these have been supported by scientific evidence, and some even carry the risk of severe adverse reactions. It is important that we offer our patients evidence-based, accurate counseling of these unproven modalities by understanding their methods, their paucity of credible scientific support, and their associated risks.

scholarly journals Allergic Reaction to Mint Leads to Asthma

2011 ◽  
Vol 2 (1) ◽  
pp. ar.2011.2.0008 ◽  
Author(s):  
Anthony M. Szema ◽  
Tisha Barnett
Keyword(s):  
Contact Dermatitis ◽  
Adverse Reactions ◽  
Skin Testing ◽  
Specific Ige ◽  
Delayed Type Hypersensitivity ◽  
Contact Allergens ◽  
Multiple Alternative ◽  
Alternative Measures ◽  
Ige Mediated ◽  
Cutaneous Adverse Reactions

Respiratory and cutaneous adverse reactions to mint can result from several different mechanisms including IgE-mediated hypersensitivity, delayed-type hypersensitivity (contact dermatitis), and nonimmunologic histamine release. Reactions to cross-reacting plants of the Labiatae family, such as oregano and thyme, as well as to the chemical turpentine, may clue the clinician in on the diagnosis of mint allergy. Contact dermatitis can result from menthol in peppermint. Contact allergens have been reported in toothpastes, which often are mint-flavored. Allergic asthma from mint is less well-recognized. A case of a 54-year-old woman with dyspnea on exposure to the scent of peppermint is presented in whom mint exposure, as seemingly innocuous as the breath of others who had consumed Tic Tac candies, exacerbated her underlying asthma. This case highlights the importance of testing with multiple alternative measures of specific IgE to mint, including skin testing with mint extract, and skin testing with fresh mint leaves. Additionally, this cases suggests that asthma can result from inhaling the scent of mint and gives consideration to obtaining confirmatory pre- and postexposure pulmonary function data by both impulse oscillometry and spirometry.

scholarly journals Galactose-alpha-1,3-galactose syndrome

2020 ◽  
Vol 2 (1) ◽  
pp. 108-110
Author(s):  
Mary Nguyen ◽  
Jordan Heath
Keyword(s):  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Skin Testing ◽  
Specific Ige ◽  
Carbohydrate Antigen ◽  
Total Serum ◽  
Intradermal Testing ◽  
Total Ige ◽  
Lone Star Tick ◽  
Mammalian Meat

The galactose-alpha-1,3-galactose (alpha-Gal) syndrome is a newly recognized and unique form of food allergy, characterized by delayed reactions to mammalian meats. This form of allergy occurs in individuals who become sensitized to alpha-Gal, a carbohydrate that is present on most mammalian tissues. Sensitization occurs after exposure to multiple arthropod bites, most commonly the lone star tick. Cases of the alpha-Gal syndrome are primarily found in the southeastern United States, which overlaps with the known geographic distribution of the lone star tick. Patients present with a history of delayed symptom onset, ∼2‐6 hours after ingestion of mammalian meat. As with other immunoglobulin E (IgE) mediated food allergic reactions, alpha-Gal reaction symptoms may include skin, respiratory, gastrointestinal, or cardiovascular systems, and severity may range from mild reactions to severe anaphylaxis. The diagnosis is based on the detection of alpha-Gal specific IgE (sIgE) as well as the total IgE value because some cases include patients with low total IgE levels but a high percentage of alpha-Gal sIgE to total serum IgE levels. Percutaneous testing with commercial meat skin-prick testing extracts is not a reliable tool for diagnosis. Prick-prick skin testing to fresh cooked meat may be considered, whereas intradermal testing to fresh meat is primarily reserved for research purposes. The mainstay of treatment involves avoidance of mammalian meat and medications that express the same carbohydrate antigen. With a small portion of patients, other meat-containing products should also be avoided if symptoms persist with mammalian meat avoidance alone. Prolonged avoidance of mammalian meat as well as avoidance of further tick bites can decrease alpha-Gal sIgE over time, and some patients are able to reintroduce mammalian meat into their diet.

scholarly journals Peanut Sensitization Profiles in Italian Children and Adolescents with Specific IgE to Peanuts

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Elisabetta Calamelli ◽  
Carlo Caffarelli ◽  
Giampaolo Ricci
Keyword(s):  
Children And Adolescents ◽  
Adverse Reactions ◽  
Pediatric Population ◽  
Pollen Allergy ◽  
Specific Ige ◽  
School Age Children ◽  
School Age ◽  
Increasing Trend ◽  
Ige Mediated ◽  
Italian Children

Peanuts are one of the most relevant foods implicated in IgE-mediated adverse reactions in pediatric population. This study aimed to evaluate the pattern of sensitization towards five peanut allergenic components (rAra h 1, 2, 3, 8 and 9) in a population of Italian children and adolescents with specific IgE (sIgE) to peanut. rAra h 9 was the main allergen implicated in peanut sensitization (58%), followed by rAra h 8 (35%), rAra h 2 (27%), rAra h 3 (23%) and rAra h 1 (12.5%). rAra h 1, 2, and 3 were the main allergenic components in young children: 8/13 (62%) between 2 and 5 years, 8/23 (35%) between 6 and 11 years, and 3/12 (25%) between 1 and 16 years. No differences were found among the levels of sIgE towards rAra h 1, 2, 3, and 9 in the three groups; in contrast, the levels of sIgE against rAra h 8 showed an increasing trend according to age. In conclusion rAra h 1, 2, and 3 were the prevalent sensitizing allergens during the first years of life in Italian patients with sIgE to peanuts (“genuine” allergy); in contrast rAra h 9 and 8 were mainly involved in school-age children and adolescents with pollen allergy (“secondary” sensitization).

Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

2020 ◽  
Vol 41 (5) ◽  
pp. 336-340
Author(s):  
Yasmin Hamzavi Abedi ◽  
Cristina P. Sison ◽  
Punita Ponda
Keyword(s):  
Retrospective Chart Review ◽  
Clinical History ◽  
Specific Ige ◽  
Exact Test ◽  
Ara H 1 ◽  
Sige Level ◽  
History Of ◽  
Laboratory Procedures ◽  
Ige Mediated ◽  
The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

Immunotheraphy in Allergic Diseases

2018 ◽  
Vol 24 (11) ◽  
pp. 1174-1194
Author(s):  
Albert Roger ◽  
Maria Basagana ◽  
Aina Teniente-Serra ◽  
Nathalie Depreux ◽  
Yanina Jurgens ◽  
...  
Keyword(s):  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Specific Ige ◽  
World Population ◽  
Allergen Specific Immunotherapy ◽  
Routes Of Administration ◽  
Disease Modifying Therapy ◽  
History Of ◽  
Ige Mediated ◽  
Special Case

The prevalence of allergic diseases is increasing worldwide. It is estimated that more than 30% of the world population is now affected by one or more allergic conditions and a high proportion of this increase is in young people. The diagnosis of allergy is dependent on a history of symptoms on exposure to an allergen together with the detection of allergen-specific IgE. Accurate diagnosis of allergies opens up therapeutic options. Allergen specific immunotherapy is the only successful disease-modifying therapy for IgE-mediated allergic diseases. New therapeutic strategies have been developed or are currently under clinical trials. Besides new routes of administration, new types of allergens are being developed. The use of adjuvants may amplify the immune response towards tolerance to the antigens. In this review, we analyze different antigen-specific immunotherapies according to administration route, type of antigens and adjuvants, and we address the special case of food allergy.

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