scholarly journals Anaphylaxis after jellyfish ingestion with no history of stings: a pediatric case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mitsuru Tsuge ◽  
Masanori Ikeda ◽  
Osamu Mitani ◽  
Masato Yasui ◽  
Hirokazu Tsukahara
Keyword(s):  
Immunoglobulin E ◽  
Case Reports ◽  
Challenge Test ◽  
Previous History ◽  
Food Challenge ◽  
Basophil Activation Test ◽  
Skin Reactions ◽  
Prick Test ◽  
Ige Reactivity ◽  
History Of

Abstract Background Jellyfish stings are known to induce allergic skin reactions; however, case reports of anaphylaxis after jellyfish ingestion have been increasing, especially in Asian countries. Some cases of anaphylaxis after jellyfish ingestion have been reported in patients with a previous history of frequent jellyfish stings. Herein, we report a pediatric patient with anaphylaxis after jellyfish ingestion with no history of jellyfish stings. Case presentation A 14-year-old girl developed two episodes of anaphylaxis, and her diet diaries revealed that edible jellyfish was common to the meals in both the anaphylaxis events. A skin prick test using five types of edible jellyfish products revealed a positive reaction to some jellyfish, and anaphylaxis was observed after the ingestion of jellyfish in an oral food challenge test. She had no history of jellyfish stings or frequent swimming in the ocean. The basophil activation test showed positive results on stimulation with extracts from various types of edible jellyfish. We observed serum immunoglobulin E (IgE) reactivity to purified jellyfish collagen and jellyfish acid-soluble extracts. Moreover, immunoblotting analysis showed IgE reactivity to two bands at approximately 40 and 70 kDa using purified jellyfish collagen, which may be a causative antigen. Conclusions Edible salted jellyfish can be one of the causative foods of anaphylaxis. Clinicians should be aware of the possibility of anaphylactic reactions due to jellyfish ingestion even without a history of jellyfish stings.

scholarly journals Birch Pollen Related Pear Allergy: A Single-Blind Oral Challenge TRIAL with 2 Pear Cultivars

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1355
Author(s):  
Nicolette W. de Jong ◽  
Severina Terlouw ◽  
Frank E. van Boven ◽  
M.S. van Maaren ◽  
Marco W.J. Schreurs ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Birch Pollen ◽  
Food Challenge ◽  
Pyrus Communis ◽  
Primary Objective ◽  
Food Sources ◽  
Prick Test ◽  
Allergic Symptoms ◽  
History Of ◽  
Single Blind

Approximately 70% of birch pollen allergic patients in Europe experience hypersensitivity reactions to Immunoglobulin E (IgE) cross-reactive food sources. This so-called pollen-food syndrome (PFS) is defined by allergic symptoms elicited promptly by the ingestion of fruits, nuts, or vegetables in these patients. So far, in the literature, less attention has been given to Bet v 1 cross-reactive symptoms caused by pear (Pyrus communis). In the Netherlands, pears are widely consumed. The primary objective of this study was to measure the type and severity of allergic symptoms during pear challenges in birch pollen allergic patients, with a positive history of pear allergy, using two different pear varieties. Fifteen patients were included, skin prick test (SPT), prick-to-prick test (PTP), specific Immunoglobulin E (sIgE), and single-blind oral challenges were performed with two pear (Pyrus communis) varieties: the ‘Cepuna’ (brand name Migo®) and the ‘Conference’ pears. All patients were sensitized to one or both pear varieties. A total of 12 out of 15 participants developed symptoms during the ‘Cepuna’ food challenge and 14/15 reacted during the ‘Conference’ challenge. Challenges with the ‘Cepuna’ pears resulted in less objective symptoms (n = 2) in comparison with challenges with ‘Conference’ pears (n = 7). Although we did not find significance between both varieties in our study, we found a high likelihood of fewer and less severe symptoms during the ‘Cepuna’ challenges. Consequently selected pear sensitized patients can try to consume small doses of the ‘Cepuna’ pear outside the birch pollen season.

scholarly journals Natural History of Allergy to Hen’s Egg: A Prospective Study in Children Aged 6 to 12 Years

2021 ◽  
pp. 1-11
Author(s):  
Hiroaki Taniguchi ◽  
Kiyotake Ogura ◽  
Sakura Sato ◽  
Motohiro Ebisawa ◽  
Noriyuki Yanagida
Keyword(s):  
Natural History ◽  
Immunoglobulin E ◽  
Previous History ◽  
Food Challenge ◽  
Oral Immunotherapy ◽  
Natural Course ◽  
Factors Affecting ◽  
Hen’S Egg ◽  
History Of ◽  
A Prospective Study

<b><i>Introduction:</i></b> There are limited reports on the natural history of hen’s egg (HE) allergy (HEA) in children &#x3c;6 years. We aimed to investigate the natural history of HEA in children aged 6–12 years and the factors affecting its tolerance acquisition. <b><i>Methods:</i></b> Using the database in our hospital, a total of 137 patients diagnosed with a definitive immediate-type reaction to HE when they turned 6 years were enrolled, and the natural course of HEA was prospectively examined until patients turned 12 years. Tolerance was defined as being able to pass an oral food challenge to consume a half or whole heated HE or consume heated HE freely without symptoms. Thirty patients (21.9%) who were enrolled for oral immunotherapy and 21 (15.3%) who discontinued follow-up were considered dropouts. Kaplan-Meier estimation was used to evaluate the rate of tolerance. <b><i>Results:</i></b> Fifty-five of the 137 patients (40.1%) had a previous HE anaphylaxis history; 61 (44.5%) patients had acquired tolerance to HE by age 12 years; and 25 (18.2%) continued total or partial HE elimination. The estimated acquired tolerance rates by ages 7, 9, and 12 years were 14.6%, 40.8%, and 60.5%, respectively. A previous history of HE anaphylaxis before 6 years of age, reacting to small amounts of heated HE by 6 years of age, and higher ovomucoid-specific immunoglobulin E values at the same age were associated with persistent HEA. <b><i>Conclusion:</i></b> This study provides important insights into the natural course of HEA beyond early childhood, with the acquisition of HE tolerance continuing throughout the duration of the study.

scholarly journals Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Areen Abdulelah Murshid ◽  
Hatim Q. Al-Maghraby
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Desmoid Tumor ◽  
Case Reports ◽  
Previous History ◽  
Subsequent Development ◽  
Stromal Tumor ◽  
Desmoid Tumors ◽  
Mesenchymal Tumors ◽  
First Case ◽  
History Of

Desmoid tumors (deep fibromatosis) of the mesentery are rare mesenchymal tumors. They are often misdiagnosed, especially with a previous history of resection for gastrointestinal stromal tumor (GIST). Immunohistochemistry can help differentiate between these two tumors. In this article, we present a case we had encountered: a Desmoid tumor developing in a patient with a history of GIST 3 years ago. It is the first case of GIST with subsequent development of Desmoid tumor to be reported in Saudi Arabia. We discuss the two entities of Desmoid tumor and GIST by comparing their definitions, clinical presentations, histological features, immunohistochemistry stains, molecular pathogenesis, prognosis, and treatment. We also discuss the relationship between GIST and the subsequent development of Desmoid tumors and compare our case with case reports in literature.

Adult-onset otitis media with effusion: results following ventilation tube insertion

2001 ◽  
Vol 115 (11) ◽  
pp. 874-878 ◽  
Author(s):  
M. W. Yung ◽  
R. Arasaratnam
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Previous History ◽  
Endoscopic Examination ◽  
Lateral Nasal Wall ◽  
Adult Onset ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Prick Test ◽  
History Of

The outcome of otitis media with effusion (OME) in children is generally good. However, it is less clear in adults. All adult patients who had a ventilation tube inserted for OME at the Ipswich Hospital between 1996 and 1997 were studied. Of 53 patients studied, 28 had had a previous history of ventilation tube insertion. Furthermore, at 15–27 months following ventilation tube insertion, the ventilation tube had already extruded in 31 patients and the OME had already recurred in 19 of these. Endoscopic examination revealed that many patients still had evidence of inflammation at the lateral nasal wall (26.4 per cent) and at the eustachian tube orifice (51 per cent). There is also a strong history of atopy in the studied group and the skin prick test was positive in 57 per cent of the patients. This study shows that many patients with adult-onset OME have underlying pathology that could lead to recurrence of OME following ventilation tube extrusion.

Suspected Lamotrigine-Induced Toxic Epidermal Necrolysis

1997 ◽  
Vol 31 (6) ◽  
pp. 720-723 ◽  
Author(s):  
Julie J Chaffin ◽  
Steven M Davis
Keyword(s):  
Valproic Acid ◽  
Toxic Epidermal Necrolysis ◽  
Case Reports ◽  
Stevens Johnson Syndrome ◽  
Complex Partial Seizures ◽  
Skin Reactions ◽  
Johnson Syndrome ◽  
Patient Reported ◽  
History Of ◽  
Relationship Of

OBJECTIVE: To describe a patient who developed toxic epidermal necrolysis (TEN) possibly secondary to lamotrigine use. CASE SUMMARY: A 74-year-old white man with a history of probable complex partial seizures was admitted to the neurology service for a prolonged postictal state. His antiepileptic regimen was changed while he was in the hospital to include lamotrigine. After 19 days of hospitalization and 14 days of lamotrigine therapy, the patient became febrile. The next day he developed a rash which progressed within 4 days to TEN, diagnosed by skin biopsy. All suspected drugs were discontinued, including lamotrigine. The patient was treated with hydrotherapy in the burn unit. His symptoms improved and he was discharged from the hospital 26 days after the rash developed. DISCUSSION: During lamotrigine's premarketing clinical trials, the manufacturer reported several cases of Stevens-Johnson syndrome and TEN. There are several published case reports of lamotrigine-induced severe skin reactions. All of these reports included patients being treated with both valproic acid and lamotrigine. Our patient was exposed to phenytoin, carbamazepine, clindamycin, and lamotrigine, but not valproic acid. The patient reported prior use of phenytoin with no skin rash. Carbamazepine was the antiepileptic drug the patient was maintained on prior to his hospital admission, and the symptoms of TEN resolved while he was still receiving carbamazepine. The patient received only two doses of clindamycin, which makes this agent an unlikely cause of TEN. CONCLUSIONS: Because of the temporal relationship of the onset of the patient's rash and several drugs that are known to cause severe rashes, it is not certain which drug was the definite culprit. However, based on the evidence from the literature, lamotrigine appears to be the causative agent.

Impact of infertility treatment in patients with previous history of borderline ovarian tumors: Results of a multicenter study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5055-5055
Author(s):  
A. Fortin ◽  
P. Morice ◽  
A. Thoury ◽  
C. Yazbeck ◽  
S. Camatte ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Early Stage ◽  
Case Reports ◽  
Previous History ◽  
Infertility Treatment ◽  
Ovarian Tumors ◽  
Borderline Ovarian Tumors ◽  
History Of

5055 Background: The use of infertility drugs (ID) in infertile patients treated conservatively for ovarian malignancies remains theoretically contraindicated. Few recent case reports seem to suggest that ID could be used in patients treated for a borderline ovarian tumors (BOT). The aim of this multicenter retrospective study was to report the outcomes of the largest series of patients with a previous history of a BOT who underwent the use of ID. Methods: A multicenter retrospective study was conducted among centers which participate in the French National Register on In Vitro Fertilization registry to evaluate the outcomes of patients with a previous history of a BOT treated with ID. Four criteria were defined to select cases: 1. Histologic confirmation of BOT, 2. The use of a conservative surgery, 3. The use of ID and 4. A follow-up ≥ 12 months after the end of infertility treatment. Results: Thirty cases fulfilled inclusion criteria. Infertility therapy began in November 1989. Disease stages were: I (n = 20), II /III with noninvasive implants (n = 8) and unknown in 2 cases. The mean number of cycles of ovarian induction per patient was 2.6 (range,1–10). After a median follow-up of 42 months after infertility treatment, 4 recurrences were observed (all of them were borderline tumors on a remaining ovary treated by surgery alone). All patients are currently disease-free. Thirteen patients have since become pregnant. The median interval between treatment of the BOT and the use of ID is shorter in patients who relapsed compared to patients who did not (5 versus 29 months; p=.07). Conclusions: These results suggest that infertility drugs could be safely used in patients who experience infertility after conservative management of an early-stage BOT. A minimal interval should be respected between treatment of the ovarian tumor and the use of infertility drugs in order to decrease the risk of recurrence. No significant financial relationships to disclose.

scholarly journals Atypical Kawasaki Disease after COVID-19 Vaccination: A New Form of Adverse Event Following Immunization

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 126
Author(s):  
Ana Lilia Peralta-Amaro ◽  
Melina Ivone Tejada-Ruiz ◽  
Karen Lilian Rivera-Alvarado ◽  
Orestes de Jesús Cobos-Quevedo ◽  
Patricia Romero-Hernández ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Viral Vector ◽  
Case Reports ◽  
Previous History ◽  
Immunoglobulin Therapy ◽  
Adult Patients ◽  
Intravenous Immunoglobulin Therapy ◽  
American College Of Rheumatology ◽  
Liver And Kidney ◽  
History Of

Kawasaki disease (KD) is a medium-vessel vasculitis that is typically presented during childhood; fewer than 100 cases of KD have been reported worldwide in adult patients who met the criteria according to the American College of Rheumatology. This study presents the case of an 18-year-old patient with no previous history of any disease, who presented atypical KD with liver and kidney dysfunction, with a good response to intravenous immunoglobulin therapy. The symptoms began 22 days after the application of the COVID-19 vaccine (nonreplicating viral vector Vaxzevria), and other conditions were ruled out. The term Adverse Events Following Immunization (AEFI)encompasses all the reactions that follow the application of any vaccine with no necessary causal relationship and can be due to the vaccine product, quality of the vaccine, immunization errors, or anxiety or just happen to be coincident events. These reactions should be reported so that clinicians can identify compatible cases and consider that the presentation of this disease, despite being atypical, can be manifested in adult patients. Likewise, case reports are an important basis for the pharmacovigilance of vaccines.

scholarly journals A Case of α-Gal-Unrelated Red Meat-Induced Urticaria Treated by Omalizumab

2021 ◽  
pp. 437-440
Author(s):  
Makoto Kondo ◽  
Yoshiaki Matsushima ◽  
Shohei Iida ◽  
Ai Umaoka ◽  
Takehisa Nakanishi ◽  
...  
Keyword(s):  
Chronic Urticaria ◽  
Challenge Test ◽  
Healthy Woman ◽  
Food Challenge ◽  
Red Meat ◽  
Meat Allergy ◽  
Red Meat Allergy ◽  
History Of ◽  
Food Challenge Test ◽  
Repeatability Test

A 70-year-old healthy woman was referred to our hospital for chronic urticaria. She did not have a history of allergy, asthma, and rhinitis. She was initially diagnosed with α-gal-related urticaria based on an episode of delayed-type urticaria after eating red meat. The results of the intracutaneous allergen test for beef and pork were negative. Fluorenzyme immunoassays specific for IgE against α-gal, beef, and pork were also negative. She was diagnosed with an α-gal-unrelated red meat allergy following the reproduction of urticaria by a food challenge test. The patient was unresponsive to several drugs, including antihistamines or immunosuppressants. However, omalizumab administration suppressed her symptoms. <b><i>Key Clinical Message:</i></b> The diagnosis of red meat allergy may require a repeatability test by consuming red meat even though serum α-gal IgE antibody might be negative. The α-gal-unrelated red meat urticaria may be responsive to omalizumab.

scholarly journals Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

2021 ◽  
Vol 49 (2) ◽  
pp. 53-59
Author(s):  
Mehmet Kilic ◽  
Lütfiye Çilkol ◽  
Erdal Taşkın
Keyword(s):  
Immunoglobulin E ◽  
Food Challenge ◽  
Cow’S Milk ◽  
Milk Products ◽  
Prick Test ◽  
Cow's Milk ◽  
Predictive Parameters ◽  
Decision Points ◽  
Ige Mediated ◽  
Baked Milk

Background: Inclusion of baked-milk products to the diet appears to markedly accelerate tolerance to unheated milk compared to a strict avoidance diet.Objective: The present study aims to investigate the predictors of baked-milk tolerance in children with Immunoglobulin E (IgE)-mediated cow’s milk (CM) allergy.Methods: The study included 80 patients diagnosed with IgE-mediated CM allergy upon oral food challenge (OFC) testing at our clinic. Patients who developed and did not develop reactions during OFC with baked milk were compared considering clinical and laboratory parameters.Results: Eighty patients with CM allergy comprised 48 male and 32 female infants with an average age of 7.25 ± 2.45 (3–13) months. We found that 62.5% of them showed tolerance to baked milk in the OFC test performed with cakes containing 2.6-g milk protein. When the patients who tolerated and could not tolerate baked-milk products were compared for test results, we detected a statistically significant intergroup difference regarding diameter of wheal in skin prick test (SPT) performed with muffin slurry, levels of specific Immunoglobulin E (sIgE) in CM, sheep’s milk (SM), goat’s milk (GM), casein, and the amount of unheated milk consumed until a reaction developed in the OFC test performed with unheated milk (P < 0.05).Conclusion: We defined novel decision points based on CM, SM, GM, casein sIgE levels, wheal diameter in SPT with muffin slurry, and the amount of milk ingested during OFC performed with unheated milk that may be useful in predicting outcomes of baked-milk ingestion.

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